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* * * * * (c)(1) CMS uses the following criteria to determine the removal of a quality measure: (i) If the Secretary determines that the quality measure is no longer meaningful, such as measures that are topped out

While pipe smokers may face different cancer site risks than cigarette smokers, research shows mortality rates from smoking-related diseases are nearly identical between the two groups

These factors can lead to tooth loss, which progresses to jawbone loss

Taken together, the findings implied that nicotine pouches and ECs might alter the oral microbiome and contribute to periodontal disease risk, though further quantitative studies are needed to confirm these preliminary results [69]

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