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Section 1848(p)(3) of the Act provides that costs shall be evaluated, to the extent practicable, based on a composite of appropriate measures of costs established by the Secretary as further specified therein

This can result in cancer of the oral cavity, pharynx, larynx, and esophagus

It gained popularity in America during the 1800s as "moist snuff," with strong Scandinavian influences reflected in brand names like Copenhagen and Skoal (from "skl," meaning "cheers")

However, we continued to caution against using reliability as the sole metric to evaluate a measure because of the tradeoffs between accuracy and reliability, and the role of service assignment in reducing noise

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