CINCINNATI — Smokers squeezed by soaring cigarette costs and workplace smoking bans increasingly are being hit with another cost increase — this time for health insurance.

A growing number of private and public employers are requiring employees who use tobacco to pay higher premiums, hoping that will motivate more of them to stop smoking and lower healthcare costs for the companies and their workers.

Meijer Inc., Gannett Co., American Financial Group Inc., PepsiCo Inc. and Northwest Airlines are among companies already charging or planning to charge smokers higher premiums. The amounts range from about $20 to $50 a month.

"With healthcare 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, a human resources consulting and services firm.

She said the practice of smoker surcharges is becoming such a significant trend that this year, it will be part of Hewitt's annual survey of companies' current and future healthcare plans.

Cushman said a general benefits survey of 950 U.S.-based employers last year showed that at least 41 percent used some form of financial incentives or penalties in their healthcare plans.

She estimates that at least 8 percent to 10 percent of the businesses probably aimed some of the incentives or penalties at smokers and says that percentage is growing.

"With smokers costing companies about 25 percent more than nonsmokers in the area of healthcare, it just makes good business sense," she said.

The companies imposing the surcharges are mostly self-insured, with employers and employees sharing the insurance premium costs.

Other companies or insurance plans have offered workers financial rewards for exercising, dieting or other healthy behaviors.

The Centers for Disease Control and Prevention estimates $92 billion in lost wages annually in the United States from smokers who die prematurely.

"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, a nonprofit agency representing more than 200 of the nation's large employers.

Gannett Co., the nation's largest newspaper publisher, this year began charging its employees who smoke an extra $50 a month for the company's insurance coverage.

"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 the McLean, Va.-based company.

PepsiCo Inc., based in Purchase, N.Y., has been charging employees who use tobacco $100 annually for a couple of years, and Grand Rapids, Mich.-based Meijer Inc. started charging smokers $25 a month this year. That fee is dropped if smokers complete a smoking-cessation program, said Meijer spokeswoman Judith Clark.

Cincinnati-based American Financial Group holding company and its subsidiaries waive the $37.92 monthly fee for a year if smokers make a good-faith effort and complete the company's stop-smoking program, said Scott Beeken, a vice president with the Great American Insurance Group subsidiary. If the employee starts smoking, the fee would be reinstated the next year.

Public employers also are requiring smokers to pay for their habit. The state of Alabama on Oct. 1 began charging $20 a month extra per employee insurance contract. Georgia charges $40 a month for smokers covered under the state's health plan. Employees caught lying on their insurance form could lose their insurance for a year.

TREND: Companies charge their employees who smoke more for health insurance than they charge nonsmokers.

WHY: To improve employees' health; to lower company's health care costs.

CONCERNS: Some smokers say the charges represent too much intrusion into their lives off the job.