Surcharges of $20 to $50 per month are becoming more common for smokers who are covered by employer-paid health insurance, the Associated Press reported Feb. 16.

"With health care costs increasing by double digits in the last few years, employers are desperate to rein in costs to themselves and their employees," said Linda Cushman, senior health care strategist with Hewitt Associates, which for the first time will query employers about smoking surcharges in its annual healthcare survey.

Last year, at least 41 percent of employers used some type of financial incentive or penalty in their health plans, with up to 10 percent of those aimed directly at smokers, Cushman said. "With smokers costing companies about 25 percent more than nonsmokers in the area of health care, it just makes good business sense," she said.

A number of self-insured companies have added surcharges for smokers, while other firms use financial rewards for smokers who quit and employees who exercise or diet.

"In addition to employers having to pay out more in health care costs, public opinion is now solidly on the side of eliminating smoking, and workers are realizing increasingly that they are having to pay for others' lifestyle choices," said Helen Darling, president of the National Business Group on Health.

Gannet, Pepsi, and American Financial Group are among the big companies now charging extra for insuring the health of smokers; so do the states of Alabama and Georgia. "We have some strong feelings that smoking is really bad for employees, and a healthier employee is better for us," said Tara Connell, a spokeswoman for Gannett.