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Natural American Spirit (NAS), a leading cigarette brand in the USA,1 markets its products using descriptors such as ‘organic’ and ‘tobacco & water’. Consumers believe that cigarettes with these and similar descriptors are more appealing, healthier and/or less harmful than cigarettes without these descriptors.2–11 Moreover, NAS advertising prominently features nature-related imagery, highlights the brand’s sustainable farming practices and exploits Native American symbolism, all of which may also misrepresent product risk.12–15 This combination of brand characteristics has yielded a consumer base that, compared with those who smoke other brands, is more likely to misunderstand the relative harm of NAS compared with other cigarettes.16 There is no evidence that smoking NAS cigarettes reduces disease risk, and emission studies find substantial variability in exposure to harmful constituents in NAS cigarettes depending on the NAS variety tested, the study’s methods and the compounds under investigation.17–23
Federal regulators have recognised that NAS uses deceptive marketing tactics and have taken limited regulatory action against the brand, resulting in the addition of disclaimer statements on packs and advertisements about the relative harm of ‘natural’ or ‘organic’ commercial tobacco, and the removal of ‘additive-free’ and some instances of ‘natural’ from NAS labelling and marketing.24 The US Food and Drug Administration’s (FDA) Center for Tobacco Products has not publicly initiated regulatory action against the use of ‘organic’, perhaps because the descriptor’s use …
Contributors JP conceived the article and lead the writing team. All authors reviewed the literature and contributed to drafts. JP is the guarantor of the article.
Funding JP, DPG, MJL and OG were supported by in part by NCI and FDA Center for Tobacco Products (CTP) under U54CA229973. DPG was supported by a grant from the Office of The Director at the National Institutes of Health (DP5OD023064). MM’s effort is supported by NIDA and FDA Center for Tobacco Products (CTP) (R01DA049814). OG was also supported in part by the Rutgers Cancer Institute of New Jersey under P30CA07270-5931. The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH or FDA.
Competing interests JP is a paid expert witness for the Plaintiffs in a Multi-District Litigation invoking American Spirit Cigarettes. MM is also a paid expert witness in litigation sponsored by the Public Health Advocacy Institute against RJ Reynolds. This arrangement has been reviewed and approved by the University of Nevada, Reno and Johns Hopkins University in accordance with their conflict of interest policies.
Provenance and peer review Not commissioned; externally peer reviewed.