“Tobacco use” means a person has used a tobacco product an average or four or more times per week for the past six months. A state can increase the number of times per week or reduce the “look-back” period to less than six months. Check with your state Marketplace to learn more.

The federal rule applies to “all tobacco products” and no specific products are mentioned. It is not clear whether insurers can also apply a premium surcharge to users of e-cigarettes and vaping devices, which contain nicotine and not tobacco.