Objective In 2017, the United States Food and Drug Administration (FDA) reached an agreement with Santa Fe Natural Tobacco Company (SFNTC) stipulating that SFNTC will remove ‘natural’ and ‘additive-free’ from Natural American Spirit (NAS) marketing to combat misperceptions that NAS is a healthier cigarette. The purpose of this study was to assess experimentally the potential effectiveness of the agreement in addressing NAS misperceptions.
Methods In an online experiment, 820 current and former smokers were assigned randomly to advertising conditions with existing claims from NAS advertisements, modified claims or a no-exposure control. Advertising conditions included (1) ‘original’ NAS advertising text before the agreement; (2) ‘2017 agreement’ language permissible under the FDA–SFNTC agreement (removing ‘natural’, ‘additive-free’); (3) more restrictive (‘stricter’) language representing additional regulation (removing ‘natural’ from the brand name and the phrases ‘tobacco+water’, ‘no chemicals’). Participants completed outcome measures assessing misinformed beliefs and intentions towards NAS.
Results One-way ANOVA showed that relative to the ‘original’ language, the ‘2017 agreement’ language reduced misconceptions about NAS addictiveness, but not about health or constituent composition. Yet ‘stricter’ language significantly reduced all categories of misinformed beliefs, which in turn mediated effects on (lower) intentions to use NAS.
Conclusion The 2017 agreement helps dispel some misconceptions about NAS addictiveness, but does not sufficiently rectify misinformation about health or composition. Since ‘stricter’ language more effectively corrects misinformed beliefs, our results suggest the need for further regulations in addressing misinformation that drives intentions towards NAS.
- public policy
- tobacco industry
- advertising and promotion
- public opinion
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Patient consent for publication Not required.
Contributors All authors participated in the design of this study. The first author was the lead author in writing this study.
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.
Disclaimer 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 Procedures were approved by the University of Pennsylvania Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note Based on the EQUATOR Reporting Guidelines Decision Tree, the authors believe a checklist is not required.
Presented at Findings from this research were presented at a poster session at the June 2018 Tobacco Regulatory Science meeting in Bethesda, Maryland.
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