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Employers must offer a reasonable alternative program to help employees quit smoking, such as counseling or nicotine replacement therapy, in order for the surcharge to be valid

However, it can provide strong clues about chronic, long-term alcohol use through a specific marker: the Mean Corpuscular Volume (MCV)

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However, the authors did not provide a comprehensive risk profile and prognostic estimates of smokers versus non-smokers among the CKD patients and the small sample size did not allow to observe a sufficient and heterogeneous number of CV events because the analysis was limited to myocardial infarction and stroke