TY - JOUR T1 - Following in the footsteps of Natural American Spirit: the emergence of Manitou cigarettes JF - Tobacco Control JO - Tob Control DO - 10.1136/tobaccocontrol-2020-055614 SP - tobaccocontrol-2020-055614 AU - Ollie Ganz AU - Cristine D Delnevo AU - M Jane Lewis Y1 - 2020/04/15 UR - http://tobaccocontrol.bmj.com/content/early/2020/04/15/tobaccocontrol-2020-055614.abstract N2 - Natural American Spirit (NAS) is a premium cigarette brand that is manufactured by Santa Fe Natural Tobacco Company (SFNTC), which has been a subsidiary of Reynolds American (RAI) since 2002. NAS’s marketing strategy has included the use of descriptors such as ‘natural’, ‘organic’ and ‘additive-free’ and nature-related imagery,1 which have been shown to mislead consumers to believe that NAS is less harmful than other cigarette brands.2 3 The NAS marketing strategy has been successful, as NAS is one of the only major cigarette brands that increased its market share in the USA over the past two decades, amidst overall population-level declines in cigarette smoking.4–6The Tobacco Control Act of 2009 banned tobacco companies from making reduced harm claims, such as describing their products as ‘light’ or ‘mild’, without submitting a modified risk tobacco product application and obtaining an order from the US Food and Drug Administration (FDA) to make such claims. In 2015, FDA sent a warning letter to RAI/SFNTC for using descriptors in NAS’s labelling or advertising that communicated that ‘(1) the product presents a lower risk of tobacco-related disease or is less harmful than one or more other commercially marketed tobacco products; (2) the product or its smoke contains a reduced level of a substance or presents a reduced exposure to a substance or (3) the product or its smoke does not contain or is free of a substance’, without an … ER -