Life insurers began pricing for cigarette smoking in the late 1970s.
In the intervening years, four iterations evolved in the approach to tobacco use in underwriting:
1. Cigarette use only.
2. All tobacco smoking.
3. All tobacco use.
4. All tobacco and nicotine replacement therapy use.
Today, many define "users" as those who 1) admit tobacco consumption, 2) confess to use of nicotine therapy, or 3) deny both and then "get caught" by testing positive for the nicotine by-product cotinine.
Some timely observations are in order regarding prevalent industry practices (or lack thereof) in 2007 in the following areas.
Cotinine: All this test shows is that the applicant did one of three things prior to specimen collection: used tobacco, used a nicotine Rx product, or used "betel." All the urban legends about cotinine test results are irrelevant. Fact is, industry labs should report cotinine as either "positive" or "negative." The quantity present is meaningless.
Cigars: Enough already with fantasy cigar use rules! In the upscale market, the cigar-attributable risk pales by comparison with cigarettes.
Smokeless (snuff, chew): There is little to support the argument that smokeless use–in those who do not also smoke–has much risk significance. Some insurance companies already reflect this in their practices.
Betel nut: First off, it isn't "betel nut." It is "areca nut," from a different plant species.
This mild but addicting euphoriant is consumed in a variety of ways (including as a dessert food) in India, Pakistan, Taiwan and elsewhere in Asia. Immigrants bring this culturally-ingrained practice with them.
