A majority of States, though not all of them, charge a premium for those that utilize tobacco products when they apply for health insurance, in which the Affordable Care Act (ACA), permits insurance companies to charge a premium of up to 50% more for those that admit to using tobacco. If this question was asked, amongst other relevant health questions, such as diet, weight, alcohol usage, illicit drug usage, prescription drug usage, and exercise, then it would represent a reasonable question, necessitating a reasonable answer; but in fact, the tobacco usage question, is often, the only health question asked, besides a qualification that you cannot exceed a certain weight limit.
The fact that tobacco usage is singled out as apparently the one valid reason why health insurance premiums should be adjusted appreciably higher, demonstrates conclusively the vilification of tobacco, as if tobacco, alone, out of everything that people do and ingest on a given day and in a given life, is the bogey man that kills all that takes part in tobacco usage of any amount and any potency.
In point of fact, as in virtually every circumstance, the amount that a product is used, how often it is used, and when it is used, amongst various other additional choices that a given individual makes in regards to their body, are a far more complete determinate of how debilitating or not, things such as tobacco usage really is for that particular individual. For whatever reason, tobacco usage is vilified as some sort of scourge that kills all that take part in its usage; but that isn't factually true, as cbsnews.com reported on June 19, 2018, that "Smoking in the U.S. has hit another all-time low. About 14 percent of U.S adults were smokers last year." Yet, as reported by cnn.com, on December 21, 2017, "Life expectancy in the United States has dropped again following last year's decline… On average, Americans can now expect to live 78.6 years." Then again, Japan, which has a smoking rate of just barely under 20%, also has a significantly higher life expectancy rate than America of 83.7 years, thereby indicating, that the health insurance providers in America, are either not asking the right questions, or not asking enough questions, or don't seem to understand exactly how debilitating tobacco usage is, and clearly demonstrates that tobacco usage itself does not affect every individual in exactly the same way; as demonstrated by healthhubs.com, stating that: "Overall age adjusted cancer rates in the USA are more than 50% higher than in Japan."
One would assume that health insurance companies believe that by asking if a given individual is a tobacco user, and this being their only salient question asked in regards to an individual's health, that this therefore clearly represents their belief that tobacco usage, more than anything else, is the difference between good health and bad health. That belief is misguided and misplaced, for there are far more salient questions that ought to be asked and that should be asked, that would be far better at determining whether the person applying for health insurance is more or less susceptible to adverse health issues.
Perhaps, America is proud that they nailed big tobacco to the cross, and this is why the tobacco question is asked; but the sad fact of the matter is, that life expectancy in America is as reported by the economist.com, "… are already two years shorter than the average in the OECD group of 35 rich and soon-to-be-rich countries." This so indicates, that the ill smoke of bad health, which purports to be conclusively the fire of tobacco usage, is foundationally wrong, and this misdiagnosis is a significant reason as to why in aggregate more Americans are needlessly dying before their due time.