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Influence of Natural American Spirit advertising on current and former smokers’ perceptions and intentions
  1. Stefanie K Gratale1,
  2. Erin K Maloney1,
  3. Angeline Sangalang2,
  4. Joseph N Cappella1
  1. 1 Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2 Department of Communication, University of Dayton, Dayton, Ohio, USA
  1. Correspondence to Stefanie K Gratale, Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA; stefanie.gratale{at}


Objective This study sought to demonstrate causal effects of exposure to Natural American Spirit (NAS) advertising content on misinformed beliefs of current and former smokers, and to empirically establish these beliefs as a mechanism driving intentions to use NAS.

Methods Our study employed a randomised experimental design with 1128 adult daily, intermittent and former smokers. We compared participants who were exposed to NAS advertisements or claims made in the advertisements with those in a no-message control group to test the effects of NAS advertising content on inaccurate beliefs about NAS and attitudes and intentions towards the product.

Results One-way analysis of variance revealed that exposure to NAS advertisements produced inaccurate beliefs about the composition of NAS cigarettes among current and former smokers (p<0.05). Planned contrasts indicated a compilation of arguments taken directly from NAS advertisements resulted in significantly greater beliefs that NAS cigarettes are healthier/safer than other cigarettes (for former smokers, t(472)=3.63, p<0.001; for current smokers, t(644)=2.86, p=0.004), demonstrating that suggestive claims used in the brand’s marketing have effects on beliefs not directly addressed in the advertisements. Regression and mediation analyses showed that health-related beliefs predict attitudes towards NAS for current and former smokers, and mediate intentions to use NAS.

Conclusions The findings of this study provide causal support for the need for further regulatory action to address the potentially harmful ramifications of claims used in NAS advertising.

  • advertising and promotion
  • tobacco industry
  • public policy
  • public opinion
  • media

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  • Contributors All four authors met the tobacco control criteria for authorship and can serve as guarantors of the paper. All authors participated in the design and administration of the study, as well as the writing and revising of the paper. SKG is the lead author.

  • Funding Data collection was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Center for Tobacco Products (CTP) of the Food and Drug Administration (FDA), under Award Number P50CA179546. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

  • Competing interests None declared.

  • Ethics approval All procedures were approved by the University of Pennsylvania Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement For this study, we also collected data on participant evaluations of the advertisements they viewed. Additional data may be available upon request from the authors and with approval of the University of Pennsylvania Tobacco Center on Regulatory Science.