The answer lies in understanding the ingredients and types of gum available
(ii) Determining the 99th percentile of national Medicare fee-for-service expenditures for assignable beneficiaries for purposes of the following: (A) Truncating assigned beneficiary expenditures used in calculating benchmark expenditures under 425.601(a)(4) and 425.652(a)(4), and performance year expenditures under 425.605(a)(3) and 425.610(a)(4)
This can be done by substituting tobacco with regular chewing gum
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Abrupt switches, especially from heavy use, tend to fail because they address only one side of the habit