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Section 425.655 is amended by revising paragraph (d)(2) to read as follows: Calculating the regional risk score growth cap adjustment factor

Like other smokeless tobacco products, it contains nicotine, is addictive, and is associated with serious health risks, including an increased risk of cancers of the mouth and throat

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This means that menopause in women who smoke is 1 to 4 years earlier than the non-smokers