CMS does all of the following to determine the adjustment, if any, applied to the historical benchmark: (A) Computes the regional adjustment in accordance with 425.656, the prior savings adjustment in accordance with 425.658, and the health equity benchmark adjustment (HEBA) in accordance with 425.662
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For instance, the sale of items that resemble tobacco products but do not contain tobacco, such as candy cigarettes, is prohibited
J Agric Food Chem 37:426430 Burton HR, Dye NK, Bush LP (1994) Relationship between tobacco-specific nitrosamines and nitrite from different air-cured tobacco varieties
If it comes and goes, then again, there is probably nothing to worry about