 [ Symptoms ] there is a small purplered spot on the bottom of my toe and feels like a needle is poking it what could it be [ Disease ] smokers can be charged more for their coverage under the law than non smokers by as much as 50 the law defines a tobacco user as someone who uses any tobacco product including cigarettes cigars chewing tobacco snuff and pipe tobacco four or more times a week within the past 6 months under small employer health plans you can not be charged the surcharge if you join a smoking cessation program but that is not available to people buying coverage on their own some states have decided that insurers cannot charge smokers more for coverage so see what is available in your state