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Reboussin BA, Lazard AJ, Ross JC, Sutfin EL, Romero-Sandoval EA, Suerken CK, Lake S, Horton OE, Zizzi AR, Wagoner E, Janicek A, Boucher M, Wagoner KG. A content analysis of cannabis edibles package marketing in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 130:104526. [PMID: 39032269 PMCID: PMC11348886 DOI: 10.1016/j.drugpo.2024.104526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND With states legalizing cannabis at a rapid pace, and the increasing popularity of edibles, it is important to document marketing practices to better understand how they might be appealing and misleading to consumers to guide state policymakers. METHODS A descriptive content analysis of 1229 cannabis edible packages advertised on a publicly available website between June and November 2022 and available for sale in licensed dispensaries was performed. RESULTS Healthy ingredient descriptors were the most common type of descriptor with 31 % of packages including words like "vegan", "gluten free" and "natural". Quality descriptors like "handcrafted" were on 28 % of packages. Other descriptors were focused on the consumer experience including expected effects (e.g., "relax") (27 %), taste or flavor (e.g., "sour") (21 %) and pharmacokinetics (e.g., "fast-acting") (19 %). Images of non-cannabis plants and outdoor nature settings were on half of packages. Images of the cannabis plant were on 33 % of packages. Flavor imagery including images of food were common (43 %). Other marketing appeals included images of people (15 %), animals (12 %) and space (10 %). CONCLUSIONS Package marketing used by other commercial industries was common on cannabis edible packages. Edibles marketing is distinct from other cannabis products in its ability to focus on the food ingredients which could mislead consumers into thinking the cannabis, rather than the food, is healthy or less harmful. Research examining the impact of cannabis edibles marketing strategies on appeal and harm perceptions is critically needed to guide policymakers as they establish packaging regulations to optimize public health and safety.
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Affiliation(s)
- Beth A Reboussin
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.
| | - Allison J Lazard
- University of North Carolina at Chapel Hill Hussman School of Journalism and Media, 384 Carroll Hall, Chapel Hill, NC 27599, United States
| | | | - Erin L Sutfin
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - E Alfonso Romero-Sandoval
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Cynthia K Suerken
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Shelby Lake
- University of North Carolina at Chapel Hill Hussman School of Journalism and Media, 384 Carroll Hall, Chapel Hill, NC 27599, United States
| | - Olivia E Horton
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Alexandra R Zizzi
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Emily Wagoner
- North Carolina State University Poole College of Management, 2801 Founders Dr., Raleigh, NC 27695, United States
| | - Alondra Janicek
- Wake Forest University College of Arts and Sciences, 104 Reynolda Hall, PO Box 7225, Winston-Salem, NC 27109, United States
| | - Madeleine Boucher
- Wake Forest University College of Arts and Sciences, 104 Reynolda Hall, PO Box 7225, Winston-Salem, NC 27109, United States
| | - Kimberly G Wagoner
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
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Gratale SK, Ganz O, Talbot EM, Pearson JL, Delnevo CD, Wackowski OA. L&M's foray into marketing 'natural' cigarettes. Tob Control 2024; 33:553-555. [PMID: 36697221 PMCID: PMC10366333 DOI: 10.1136/tc-2022-057770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This ad watch details new L&M cigarette marketing in the United States that now features the terms “simple” and “tobacco and water”, while continuing to highlight its affordable and premium qualities. This implicitly positions L&M as an affordable natural brand, which is new for the brand. From a public health standpoint, this warrants attention and raises concern because of the commercial success of brands positioned as “natural”, the well-documented misperceptions of “natural” tobacco as presenting fewer health risks, and the potential to attract vulnerable populations who are both cost and health conscious.
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Affiliation(s)
- Stefanie K Gratale
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Ollie Ganz
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Eugene M Talbot
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Jennifer L Pearson
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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Shadel WG, Martino SC, Setodji CM, Dunbar M, Jenson D, Wong JC, Falgoust G. Doing more with less: A proposal to advance cigarette packaging regulations in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 124:104308. [PMID: 38184903 PMCID: PMC10939880 DOI: 10.1016/j.drugpo.2023.104308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Cigarette packages are potent marketing tools. Following guidance from the WHO Framework Convention on Tobacco Control, many countries have sought to diminish this marketing power by mandating that (1) large graphic health warnings be affixed to the packages (i.e., text warnings combined with graphic images of the health consequences of smoking) and (2) all packages be fully "plain" in their design (i.e., all packages use the same drab/bland color and font type; no brand logos, other colors, or designs are permitted). Yet, the United States lags other countries in implementing regulations designed to blunt the marketing power of cigarette packages. This is not because of a lack of effort on the part of the Food and Drug Administration, the main governmental body charged with regulating tobacco products in the United States. Rather, it is because the regulatory options that that have been advanced in the country (e.g., graphic health warnings) have not been found - yet - to be legally feasible by its courts. This commentary works through some of the conceptual, practical, and legal issues regarding packaging regulations in the United States. It considers the political and bureaucratic risks involved with issuing new regulations. The overall intent is to prompt our field to think creatively about what is realistic in this regulatory space and to offer a novel perspective that may help move the United States tobacco control community forward in its efforts to reduce the promotional power of cigarette packages.
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Affiliation(s)
- William G Shadel
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States.
| | - Steven C Martino
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Claude M Setodji
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Michael Dunbar
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Desmond Jenson
- Public Health Law Center, Mitchell Hamline School of Law, Saint Paul, MN 55105, United States
| | - Jody Cs Wong
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Grace Falgoust
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
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Gratale SK, Pearson JL, Mercincavage M, Wackowski OA. Organic, Earth-Friendly Tobacco With a Charcoal Filter and Smooth Taste: A Randomized Experiment Testing Effects of Natural American Spirit's "Sky" Cigarette Advertising on Consumer Perceptions. Nicotine Tob Res 2024; 26:161-168. [PMID: 37349148 PMCID: PMC10803116 DOI: 10.1093/ntr/ntad099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION The Natural American Spirit (NAS) brand has a history of marketing tactics that may convey reduced harm. While no longer allowed to use "additive-free" or natural descriptors (except in the brand name), it continues promoting potentially misleading attributes. This study examined perceptions of NAS's newer "Sky" style, promoted as organic tobacco with a charcoal filter. AIMS AND METHODS In an online experiment, we randomized 1927 adult past 30-day tobacco or nicotine product users to one of six conditions showing Sky ads with different descriptors: (1) charcoal filter, (2) charcoal + organic, (3) charcoal + earth-friendly, (4) charcoal + smooth taste, (5) charcoal + all other descriptors, and (6) no-descriptor control (Sky ads without target descriptors). Product perceptions were compared by condition. Participants also reported perceived benefits of charcoal filters. RESULTS Overall, 28% of participants indicated Sky is less harmful and 38% believed it exposes users to fewer chemicals. Participants in the "charcoal + organic," "charcoal + earth-friendly," and the all-descriptor conditions had higher odds of believing Sky reduces chemical exposure (respectively, 43%, 40%, and 42%), relative to the no-descriptor control. Fewer control participants endorsed beliefs that Sky has a "better filter" and is "more environmentally friendly". Many believed cigarettes with charcoal filters could confer benefits relative to other cigarettes, such as reducing chemical exposure, or being cleaner, purer or safer (though research on relative safety of charcoal filters in cigarettes is inconclusive). CONCLUSIONS Sky marketing may promote misperceptions about product safety and composition, and ads using both charcoal and organic text may particularly reinforce them. IMPLICATIONS This study examined the impact of new cigarette advertising promoting the use of charcoal filters and organic tobacco along with other suggestive claims ("environmentally friendly," "smooth taste") on tobacco users' perceptions of the advertised product-NAS Sky cigarettes. Our study provides new data about positive consumer perceptions of charcoal-filtered cigarettes, and results suggest that combinations of these marketing terms evoke perceptions about reduced harm and reduced exposure to harmful chemicals that may be misleading to the public. Our findings underscore a need for additional regulatory action regarding tobacco marketing that makes use of natural-themed marketing.
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Affiliation(s)
- Stefanie K Gratale
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Jennifer L Pearson
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, NV, USA
| | - Melissa Mercincavage
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Olivia A Wackowski
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
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5
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Gratale SK, Ganz O, Wackowski OA, Lewis MJ. Naturally leading: a content analysis of terms, themes and word associations in Natural American Spirit advertising, 2000-2020. Tob Control 2023; 32:583-588. [PMID: 35022329 PMCID: PMC9273802 DOI: 10.1136/tobaccocontrol-2021-056938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Natural American Spirit (NAS) is a cigarette brand distinguished by supposed 'natural', 'additive-free' characteristics, marketing of which is tied to misperceptions of reduced harm. In 2017, NAS's manufacturer agreed (with the Food and Drug Administration) to remove 'natural'/'additive-free' from US marketing. Prior research has explored NAS marketing immediately post-agreement. This study sought to identify prominent post-agreement terms and themes and analyse how they had been used in pre-agreement ads. METHODS We conducted a content analysis of NAS ads from 2000 to 2020 (N=176), documenting prominent pre-agreement and post-agreement terms/themes and examining how they are used in NAS ads. We coded for descriptors, themes, imagery and promotions, and extended prior research by analysing how leading post-agreement terms were used in conjunction and thematically associated with 'additive-free' and 'natural' before the agreement. RESULTS Results indicated 'tobacco and water' and 'Real. Simple. Different.' increased post-agreement, as did environmental imagery. 'Organic' was prominent pre-agreement and post-agreement. The descriptors used most often in post-agreement ads almost always appeared in conjunction with (and were thematically linked to) 'natural' and 'additive-free' in pre-agreement ads. CONCLUSIONS In the years since the agreement, NAS ads have heavily relied on still-allowable descriptors that may invite reduced risk misperceptions. Notably, these descriptors were consistently used alongside the banned terminology before the agreement and presented as if affiliated conceptually, possibly prompting similar connotations. Findings indicate a continuing need for research into NAS advertising effects and a potential role for additional regulatory action.
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Affiliation(s)
- Stefanie K Gratale
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Ollie Ganz
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - M Jane Lewis
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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McQuoid J, Lowery BC, Wright LS, Cohn AM. Outdoor Medical Cannabis Advertising in Oklahoma: Examining Regulatory Compliance and Social Meanings in Billboard Content. Subst Use Misuse 2023; 58:1425-1437. [PMID: 37338932 PMCID: PMC11145737 DOI: 10.1080/10826084.2023.2223299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Medical cannabis currently dominates the U.S. cannabis advertising landscape. The public is increasingly exposed to outdoor cannabis advertising, which increases positive attitudes about and intentions to use cannabis. Research is lacking regarding outdoor cannabis advertising content. This article characterizes the content of outdoor cannabis advertising in Oklahoma, one of the fastest growing U.S. medical cannabis markets. Methods: We conducted a content analysis of cannabis advertising billboard images (n = 73) from Oklahoma City and Tulsa, photographed May 2019-November 2020. We followed a primarily inductive, iterative team approach to thematically analyze billboard content in NVIVO. We reviewed all images, identified a broad coding taxonomy, and then incorporated emergent codes and those related to advertising regulation (e.g. youth/children). We totaled frequencies of code application across billboards and reexamined billboards for final themes. Results: Major themes were social meanings related to cannabis subculture, formal medical systems, and nature, and the presence of company contact information. Minor themes related to convenience, price promotions, store proximity, U.S. affiliation, product quality, and spirituality. State advertising regulation violations were rare, with the exception of content that may promote curative or therapeutic effects (4%) and misrepresentation of product state of origin (1.4%). Conclusion: Outdoor medical cannabis advertising in Oklahoma blurs boundaries between formal medical discourses and cannabis subculture that is suspicious of messaging from authorities and regards cannabis as harmless and natural. Increased monitoring of advertising regulation compliance and greater understanding of social discourses within emerging markets is needed to promote public health within the context of cannabis advertising.
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Affiliation(s)
- Julia McQuoid
- Department of Family and Preventive Medicine, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine
| | - Bryce C. Lowery
- Christopher C. Gibbs College of Architecture, University of Oklahoma
| | - LaNita S. Wright
- Department of Health Promotion and Physical Education, Kennesaw State University
| | - Amy M. Cohn
- Department of Pediatrics, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine
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Lee DN, Liu J, Keller-Hamilton B, Patterson JG, Wedel AV, Vázquez-Otero C, Stevens EM. Associations between perceived source credibility, e-cigarettes, and e-cigarette ad perceptions. Prev Med Rep 2022; 28:101862. [PMID: 35733610 PMCID: PMC9207267 DOI: 10.1016/j.pmedr.2022.101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/25/2022] [Accepted: 06/09/2022] [Indexed: 10/28/2022] Open
Abstract
The use of e-cigarettes among U.S. adults remains high, and aggressive industry advertising is a contributor. Consumer opinions of the e-cigarette industry's credibility can influence e-cigarette product and ad perceptions. The purpose of this study was to examine the association of perceived source credibility of e-cigarette ads and consumer attitudes toward e-cigarette ads and product use. In October 2021, we conducted a survey using an online convenience sample (N = 497, Mage = 31.9). Participants viewed two randomly selected e-cigarette ads and were asked questions regarding source credibility, perceptions of the ads, and e-cigarette use. Linear mixed effects models with random intercepts were used to estimate associations between perceived source credibility with perceived ad relevance, effectiveness, liking, product use interest, and e-cigarette harms perceptions. We also tested whether associations between perceived source credibility and ad and e-cigarette perceptions were moderated by e-cigarette use. Models controlled for cigarette smoking status, age, sex, race, ethnicity, sexual orientation, and income. Perceived source credibility was positively associated with increased perceived ad relevance, effectiveness, liking, and product use interest (ps < 0.001). E-cigarette use moderated associations of perceived source credibility and perceived ad relevance, perceived ad effectiveness, and interest in using e-cigarettes, with associations being strongest among never users. Findings suggest that tobacco control messaging aiming to reduce the credibility of the e-cigarette industry might be most effective among adults who have never used e-cigarettes.
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Affiliation(s)
- Donghee N. Lee
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
| | - Jessica Liu
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, The Ohio State University College of Medicine, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Joanne G. Patterson
- Division of Epidemiology, The Ohio State University College of Public Health, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Amelia V. Wedel
- Department of Clinical Psychology, Syracuse University, Syracuse, NY, USA
| | - Coralia Vázquez-Otero
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, USA
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Moran MB, Heley K, Czaplicki L, Weiger C, Strong D, Pierce J. Tobacco Advertising Features That May Contribute to Product Appeal Among US Adolescents and Young Adults. Nicotine Tob Res 2021; 23:1373-1381. [PMID: 33377146 PMCID: PMC8360628 DOI: 10.1093/ntr/ntaa275] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/23/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Cigarette advertising is a causal agent of smoking uptake among young people. Although prior research links ad receptivity to tobacco product interest and use, little is known regarding the specific advertising tactics associated with increased product appeal among young people. METHODS A national sample of 13-20 year-olds (N = 3688, youth) and 21-24 year-olds (N = 1556, young adults) in the US participated in an online survey in 2017 (mean age 18.1 years). The majority (72.0%) of youth and nearly half (44.8%) of young adults were never smokers. Participants were shown a cigarette ad, randomly assigned from a pool of 50 advertisements, and reported how much they liked the ad, and were curious about and interested in using the advertised product. All 50 advertisements were content analyzed for a variety of features. Data from the survey and content analysis were merged and mixed effects analyses used to identify the features associated with increased liking, curiosity, and interest in using, referred to collectively as product appeal. RESULTS Presence of a sweepstakes offer was associated with increased liking, curiosity and interest among youth and curiosity and interest among young adults. Outdoors settings, flora imagery, natural descriptors, and environmental themes were associated with increased appeal. Price reductions (eg, coupons) were associated with decreased appeal among youth. CONCLUSIONS This study identified several advertising tactics associated with increased appeal among youth and young adults. If additional research confirms these findings, the U.S. Food and Drug Association should consider restricting use of these tactics in tobacco advertising. IMPLICATIONS This study's findings provide insight into features of cigarette ads that appeal to youth and young adults. Overall, the presence of sweepstakes appealed to youth and young adults and outdoors and environmental themes were particularly appealing to young adults. Such tactics could serve to further brand engagement, improve brand image and lead to initiation or escalation of use. If confirmatory studies further demonstrate the effects of the tactics identified in this study on youth product appeal, U.S. Food and Drug Administration should consider using its authority to restrict the use of youth-appealing tactics.
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Affiliation(s)
- Meghan Bridgid Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Czaplicki
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caitlin Weiger
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Strong
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
- Division of Population, Moores Cancer Center at UC San Diego Health, La Jolla, CA, USA
| | - John Pierce
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
- Division of Population, Moores Cancer Center at UC San Diego Health, La Jolla, CA, USA
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Heley K, Czaplicki L, Kennedy RD, Moran M. 'Help Save The Planet One Bidi Stick At A Time!': greenwashing disposable vapes. Tob Control 2021; 31:675-678. [PMID: 33782198 DOI: 10.1136/tobaccocontrol-2020-056425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lauren Czaplicki
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan David Kennedy
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Meghan Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Epperson AE, Wong S, Lambin EF, Henriksen L, Baiocchi M, Flora JA, Prochaska JJ. Adolescents' Health Perceptions of Natural American Spirit's On-the-Pack Eco-Friendly Campaign. J Adolesc Health 2021; 68:604-611. [PMID: 32713741 PMCID: PMC7855194 DOI: 10.1016/j.jadohealth.2020.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Natural American Spirit (NAS) cigarettes, which have recently grown in popularity, are marketed as eco-friendly and natural. The present study examined whether NAS's on-the-pack messaging influences adolescents' health perceptions of the brand. METHODS In a mixed-factor design, adolescent participants (N = 1,003, ages 13-17, 75% female) were randomized to one of the six exposure conditions. All viewed images of an NAS and a Pall Mall (comparison brand) cigarette pack, but differed in pack color (blue, green, or gold/orange) and brand viewed first. Perceptions of pack logos, addictiveness, harms to the smoker, others, and the environment were assessed directly after viewing pack images for each brand. RESULTS Adolescents who perceived NAS as more pro-environment tended to perceive NAS cigarettes to be less addictive, r = -.19, p < .01. NAS cigarettes also were perceived as less addictive and better for the environment than Pall Mall. Most (90%) participants provided nature-friendly words (e.g., environment, recycle) when asked to describe logos on the NAS packs. In adjusted models, relative to Pall Mall, NAS was perceived as healthier for smokers, healthier for smokers' family and friends, and safer for the environment. Findings did not differ by pack color and ever tobacco use. CONCLUSIONS Adolescents perceived a health advantage for NAS cigarettes with its on-the-pack, eco-friendly and pro-health marketing. The findings are consistent with prior research with adults. Given the accumulating evidence of consumer misperceptions, eco-friendly messaging on cigarettes is a public health concern that warrants further consideration for regulatory intervention.
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Affiliation(s)
- Anna E Epperson
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Samantha Wong
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Eric F Lambin
- School of Earth, Energy & Environmental Sciences, and Woods Institute for the Environment, Stanford University, Stanford, California; Georges Lemaître Earth and Climate Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Michael Baiocchi
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - June A Flora
- Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, California
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.
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11
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Vogel EA, Henriksen L, Johnson TO, Schleicher NC, Prochaska JJ. Popularity of natural American Spirit cigarettes is greater in U.S. cities with lower smoking prevalence. Addict Behav 2020; 111:106558. [PMID: 32745944 PMCID: PMC7484141 DOI: 10.1016/j.addbeh.2020.106558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/23/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Often perceived as a safer smoke, Natural American Spirit (NAS) may find particular appeal in communities with strong non-smoking norms. We hypothesized NAS would be more popular in cities with lower smoking prevalence, with the pattern unique to NAS. We tested household income, cigarette taxes, and young adult population as alternative correlates and examined brand specificity, relative to Marlboro and Pall Mall. METHODS Using proprietary, city-specific sales estimates obtained from Nielsen for 30 U.S. cities over one year (9/7/18-9/9/19), we computed cigarette sales volume as standard pack units per 10,000 adult smokers for NAS and Marlboro and Pall Mall. Linear regression models examined associations between city-level sales volume and adult smoking prevalence, median household income, the sum of state/local cigarette excise taxes, and young adult population. RESULTS NAS sales volume averaged 44,785 packs per 10,000 adult smokers (SD = 47,676). Across 30 cities, adult smoking prevalence averaged 18.0% (SD = 4.5%), median household income averaged $53,677 (SD = $14,825), cigarette excise tax averaged $2.55 (SD = $1.63), and young adult population averaged 10.6% (SD = 2.2%). NAS sales volume was greater in cities with lower adult smoking prevalence (β = -0.39, 95% CI[-0.74, -0.03], p = 0.034), a pattern that was not observed for Marlboro or Pall Mall (ps > 0.356). Marlboro (β = -0.40, 95% CI[-0.76, -0.05], p = 0.027) and Pall Mall (β = -0.48, 95% CI[-0.82, -0.14], p = 0.008) sales volumes were higher in cities where cigarette excise taxes were lower, a pattern not observed for NAS (p = 0.224). CONCLUSION NAS appears to be more popular in cities with lower smoking prevalence and may deter efforts to further decrease prevalence.
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Affiliation(s)
- Erin A Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Trent O Johnson
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA.
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12
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Smiley SL, Kim S, Mourali A, Allem JP, Unger JB, Boley Cruz T. Characterizing #Backwoods on Instagram: "The Number One Selling All Natural Cigar". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4584. [PMID: 32630567 PMCID: PMC7345638 DOI: 10.3390/ijerph17124584] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/29/2020] [Accepted: 06/06/2020] [Indexed: 11/30/2022]
Abstract
We sought to assess the proportion of Backwoods (Imperial Tobacco Group Brands LLC) cigar-related posts to Instagram that may contain misleading claims, nature-evoking imagery, and appealing flavors. Inclusion criteria for this study included an Instagram post with the hashtag "#backwoods" from 30 August to 12 September 2018. Rules were established to content analyze (n = 1206) posts. Categories included misleading packaging (i.e., the post contained an image of a Backwoods product with the descriptor "natural" on the packaging), misleading promo (i.e., the corresponding caption to the post contained hashtag(s) like "#natural", "#authentic", "#alwaystrue"), nature-evoking imagery (i.e., the post contained images of grass, water, and pastural views along with a Backwoods product), flavors (i.e., the post contained a Backwoods product with brand-specific flavors on the packaging), flavor promo (i.e., the corresponding caption to the post contained hashtag(s) of Backwoods' brand-specific flavors), marijuana-related (i.e., the post contained an image of marijuana next to a Backwoods pack, rolled cigars visibly contained marijuana, or hollowed-out cigars next to marijuana), smoking (the post contained an image of smoke or a lit cigar), brand-specific promo (i.e., the post contained an image of a Backwoods t-shirt, sweatshirt, hat, etc.), and perceived gender. Among the posts analyzed, 645 (53.5%) were marijuana-related, 564 (46.8%) were flavors, 463 (38.4%) were misleading packaging, 335 (27.8%) were flavor promo, 309 (25.6%) were misleading promo, 188 (15.6%) were nature-evoking imagery, 165 (13.7%) were smoking, 157 (13.0%) were brand-specific promo, and 239 (19.8%) were perceived male gender. Backwoods cigar-related posts to Instagram often contained misleading images and promotions of a "natural" tobacco product, images of marijuana use (in the form of blunt-making), brand-specific flavors, smoking, and promotional merchandise. Misleading images and the depictions of marijuana use in addition to the variety of flavor options may increase product appeal to consumers. These results underscore the need for comprehensive regulation of cigar products similar to cigarettes.
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Affiliation(s)
- Sabrina L. Smiley
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032-3628, USA; (S.K.); (A.M.); (J.-P.A.); (J.B.U.); (T.B.C.)
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13
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Ganz O, Delnevo CD, Lewis MJ. Following in the footsteps of Natural American Spirit: the emergence of Manitou cigarettes. Tob Control 2020; 29:e165-e167. [PMID: 32300024 DOI: 10.1136/tobaccocontrol-2020-055614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ollie Ganz
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA .,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - M Jane Lewis
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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14
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Stevens EM, Johnson AL, Leshner G, Sun F, Kim S, Leavens ELS, Tackett AP, Hébert ET, Wagener TL. People in E-Cigarette Ads Attract More Attention: An Eye-Tracking Study. TOB REGUL SCI 2020; 6:105-117. [PMID: 33816715 PMCID: PMC8018674 DOI: 10.18001/trs.6.2.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Minimally regulated electronic cigarettes (e-cigarette) advertising may be one potential factor driving the increasing prevalence of young adult e-cigarette use. Using eye-tracking, the current study examined which e-cigarette advertising features were the most appealing to young adults as a first step to examine how e-cigarette advertising may be regulated. METHODS Using a within-subjects design, 30 young adults (M age = 20.0 years) viewed e-cigarette ads in a laboratory. Ad features or areas of interest (AOIs) included: 1) brand logo, 2) product descriptor, and 3) people. During ad viewing, eye-tracking measured participants' dwell time and time to first fixation for each AOI as well as each ad brand. Harm perceptions pre- and post-viewing were measured. RESULTS Participants spent the longest dwell time on people (M = 2701 ms), then product descriptors (M = 924 ms), then brand logos (M = 672 ms; ps < .001). They also fixated fastest on AOIs in that order. Participant sex significantly impacted dwell time of ad brand, and harm perceptions decreased after viewing the ads (ps < .05). CONCLUSIONS This study provides initial evidence about which e-cigarette ad features may appeal most to young adults and may be useful when designing evidence-based policy.
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Affiliation(s)
- Elise M Stevens
- Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard University, Boston, MA
| | - Amanda L Johnson
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Glenn Leshner
- Edward L. and Thelma Gaylord Chair in journalism, Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, OK
| | - FuWei Sun
- Department of Journalism, Fu Hsing Kang College, National Defense University, Taiwan
| | - Seunghyun Kim
- Department of Marketing and Advertising, College of Business, University of Arkansas at Little Rock, Little Rock, AK
| | - Eleanor L S Leavens
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Alayna P Tackett
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Emily T Hébert
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Theodore L Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University, Columbus, OH
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15
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Attitudinal Spillover from Misleading Natural Cigarette Marketing: An Experiment Examining Current and Former Smokers' Support for Tobacco Industry Regulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193554. [PMID: 31547517 PMCID: PMC6801407 DOI: 10.3390/ijerph16193554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 11/17/2022]
Abstract
This research examined the influence of natural cigarette advertising on tobacco control policy support, and the potential for misbeliefs arising from exposure to cigarette marketing to affect such support. Ample research indicates that natural cigarettes such as Natural American Spirit (NAS) are widely and erroneously perceived as safer than their traditional counterparts because of their marketed “natural” composition. Yet regulatory action regarding natural cigarette marketing has been limited in scope, and little research has examined whether misleading product advertising affects support for related policy, an important component of the policy process. Here, we administered a large-scale randomized experiment (n = 1128), assigning current and former smokers in the United States to an NAS advertising condition or a control group and assessing their support for tobacco industry regulation. Results show that exposure to NAS advertising reduces support for policies to ban potentially misleading terminology from cigarette advertising, and these effects are stronger for daily smokers. Further, misinformed beliefs about the healthy composition of NAS partially mediate effects on policy support. Yet interestingly, exposure to NAS marketing does not reduce support for policies to establish standards for when certain terms are permissible in cigarette advertising. The results of this analysis indicate potential spillover effects from exposure to NAS advertising in the realm of support for regulatory action pertaining to tobacco industry marketing.
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16
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Epperson AE, Lambin EF, Henriksen L, Baiocchi M, Flora JA, Prochaska JJ. Natural American Spirit's pro-environment packaging and perceptions of reduced-harm cigarettes. Prev Med 2019; 126:105782. [PMID: 31325524 DOI: 10.1016/j.ypmed.2019.105782] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/04/2019] [Accepted: 07/17/2019] [Indexed: 11/27/2022]
Abstract
Natural American Spirit (NAS) cigarettes feature a pro-environment marketing campaign on the packs. The NAS "Respect for the Earth" campaign is the first example of on-the-pack corporate social responsibility advertising. In a randomized survey design, we tested perceptions of NAS relative to other cigarette brands on harms to self, others, and the environment. Never (n = 421), former (n = 135), and current (n = 358) US adult smokers were recruited for an online survey from January through March 2018. All participants viewed packs of both NAS and Pall Mall. Participants were randomized to view NAS vs. Pall Mall and to pack color (blue, green, or yellow/orange), which was matched between brands. Survey items assessed perceptions of health risk of the cigarette brand to self, others, and the environment and corporate perceptions. Consistently on all measures, NAS cigarettes were rated as less harmful for oneself, others, and the environment relative to Pall Mall (p's < .001). Though Reynolds American owns both brands, participants rated the company behind NAS as more socially responsible than the company behind Pall Mall, F[1, 909] = 110.25, p < .001. The NAS advantage was significant irrespective of smoking status, pack color, and brand order, with findings stronger for current than never smokers. Pro-environmental marketing on NAS cigarette packs contributes to misperceptions that the product is safer for people and the environment than other cigarettes and made by a company that is more socially responsible. Stricter government regulations on the use of pro-environment terms in marketing that imply modified risk are needed.
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Affiliation(s)
- Anna E Epperson
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Eric F Lambin
- School of Earth, Energy & Environmental Sciences, Woods Institute for the Environment, Stanford University, Stanford, CA, USA; Georges Lemaître Earth and Climate Research Centre, Earth and Life Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Baiocchi
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - June A Flora
- Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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17
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Baig SA, Byron MJ, Lazard AJ, Brewer NT. "Organic," "Natural," and "Additive-Free" Cigarettes: Comparing the Effects of Advertising Claims and Disclaimers on Perceptions of Harm. Nicotine Tob Res 2019; 21:933-939. [PMID: 29529277 PMCID: PMC6588395 DOI: 10.1093/ntr/nty036] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/25/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The US Tobacco Control Act restricts advertising or labeling that suggests one tobacco product is less harmful than another. We sought to examine how "organic," "natural," and "additive-free" advertising claims and corresponding disclaimers affect perceptions of cigarettes' harm. METHODS Participants were a national probability sample of adults in the United States (n = 1114, including 344 smokers). We conducted a 5 (claim) × 2 (disclaimer) between-subjects factorial experiment. Participants viewed a Natural American Spirit cigarettes ad claiming they were "organic," "natural," "additive-free," "light," or "regular;" and with or without a corresponding disclaimer. The outcome was perceived harm of the advertised cigarettes. Among smokers, we also assessed interest in switching within their current brand to cigarettes with this characteristic (eg, "additive-free"). RESULTS Claims in the ad had a large effect on perceived harm (Cohen's d = 0.87, 95% CI = 0.47 to 1.29). Claims of cigarettes being "organic," "natural," or "additive-free" reduced perceived harm from the advertised cigarettes, as compared with "regular" and "light" claims. Disclaimers had a small effect, increasing perceived harm (d = 0.25, 95% CI = 0.08 to 0.41). The problematic claims also increased smokers' interest in switching. Disclaimers had no effect on smokers' interest in switching. CONCLUSIONS "Organic," "natural," and "additive-free" claims may mislead people into thinking that the advertised cigarettes are less harmful than other cigarettes. Disclaimers did not offset misperceptions of harm created by false claims. The US Food and Drug Administration should restrict the use of these misleading claims in tobacco advertising. IMPLICATIONS "Organic," "natural," and "additive-free" cigarette advertising claims decrease perceptions of harm among the public and increase interest in switching to such cigarettes among smokers. Disclaimers do not counteract the reduced perceptions of harm or increased interest in switching to these cigarettes. The US Food and Drug Administration should restrict the use of "organic," "natural," and "additive-free" claims in tobacco marketing.
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Affiliation(s)
- Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - M Justin Byron
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Allison J Lazard
- School of Media and Journalism, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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18
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Baig SA, Byron MJ, Pepper JK, Brewer NT. Interest in "organic," "natural," and "additive-free" cigarettes after hearing about toxic chemicals in cigarette smoke. PLoS One 2019; 14:e0212480. [PMID: 30840639 PMCID: PMC6402619 DOI: 10.1371/journal.pone.0212480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 02/04/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The US Family Smoking Prevention and Tobacco Control Act requires the government to disseminate information about the toxic chemicals in cigarette smoke. We sought to understand how the descriptors "organic," "natural," or "additive-free" affect smokers' interest in cigarettes in the context of information about chemicals in cigarette smoke. METHODS Participants were a national probability sample of 1,101 US adult (ages ≥18) smokers recruited in 2014-2015. A between-subjects experiment randomized participants in a telephone survey to 1 of 4 cigarette descriptors: "organic," "natural," "additive-free," or "ultra-light" (control). The outcome was expected interest in cigarettes with the experimentally assigned descriptor, after learning that 2 chemicals (hydrogen cyanide and lead) are in cigarette smoke. Experimental data analysis was conducted in 2016-2017. RESULTS Smokers indicated greater expected interest in "organic," "natural," and "additive-free" cigarettes than "ultra-light" cigarettes (all p <.001) after learning that hydrogen cyanide and lead were in cigarette smoke. Smokers who intended to quit in the next 6 months expressed greater expected interest in the 4 types of cigarettes ("organic," "natural," "additive-free," and "ultra-light") compared to smokers not intending to quit (p <.001). CONCLUSIONS Smokers, especially those intending to quit, may be more inclined towards cigarettes described as "organic," "natural," and "additive-free" in the context of chemical information. An accumulating body of evidence shows that the US should fully restrict use of "organic" and "natural" descriptors for tobacco products as it has done for "additive-free" and "light" descriptors.
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Affiliation(s)
- Sabeeh A. Baig
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, United States of America
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - M. Justin Byron
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
- Department of Family Medicine, UNC School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Jessica K. Pepper
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Noel T. Brewer
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
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19
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Gratale SK, Maloney EK, Cappella JN. Regulating language, not inference: an examination of the potential effectiveness of Natural American Spirit advertising restrictions. Tob Control 2019; 28:e43-e48. [DOI: 10.1136/tobaccocontrol-2018-054707] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 11/04/2022]
Abstract
ObjectiveIn 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.MethodsIn 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.ResultsOne-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.ConclusionThe 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.
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20
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Basáñez T, Majmundar A, Cruz TB, Unger JB. Vaping associated with healthy food words: A content analysis of Twitter. Addict Behav Rep 2018; 8:147-153. [PMID: 30320201 PMCID: PMC6180293 DOI: 10.1016/j.abrep.2018.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/21/2018] [Accepted: 09/21/2018] [Indexed: 01/01/2023] Open
Abstract
E-cigarettes were initially introduced as a less harmful alternative to combustible cigarettes, but marketing efforts may now be exceeding these claims by associating e-cigarettes with words related to healthy foods. These associations could mislead people to assume vaping is a healthy practice. Tweets from January to March 2017 were obtained from the Twitter Streaming Application Programming Interface (API) to assess content about vaping linked to healthy food words. Tweets were classified into one of nine categories along with their source (marketer vs. non-marketer). We content analyzed original English language public postings on Twitter that included vaping-related keywords and at least one of eight co-occurring healthy food-related labels (e.g., 'natural,' 'vitamin,' 'vegan,' and 'organic') (N = 1205). Chi-square analyses compared themes by message source. Findings suggest vaping is being marketed in ways that could paradoxically lead consumers to believe that e-cigarettes are health-enhancing. We found more tweets representing vaping as health-enhancing (9%) than referring to it as a smoking-cessation device (1%). The largest category of tweets referred to vaping as harmless (28%) and therefore compatible with a healthy lifestyle. Tweets presenting vaping as harmless or with a sensation theme were more likely to be authored by marketers than by non-marketers. Food and drug regulation needs to be more vigilant to prevent misleading advertising from e-cigarette marketers.
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Affiliation(s)
- Tatiana Basáñez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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21
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Leas EC, Pierce JP, Dimofte CV, Trinidad DR, Strong DR. Standardised cigarette packaging may reduce the implied safety of Natural American Spirit cigarettes. Tob Control 2018; 27:e118-e123. [PMID: 29255011 PMCID: PMC7392163 DOI: 10.1136/tobaccocontrol-2017-053940] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 10/30/2017] [Accepted: 11/14/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Over two-thirds of Natural American Spirit (NAS) smokers believe their cigarettes might be 'less harmful', but toxicological evidence does not support this belief. We assessed whether standardised packaging could reduce the possibility of erroneous inferences of 'safety' drawn from NAS cigarette packaging. METHODS US adult smokers (n=909) were recruited to a between-subject survey experiment (3 brands×3 packaging/labelling styles) through Amazon Mechanical Turk and rated their perception of whether a randomly assigned cigarette package conveyed that the brand was 'safer' on a three-item scale (Cronbach's α=0.92). We assessed whether NAS packs were rated higher on the 'implied safety' scale than two other brands and estimated the effect that plain packaging (ie, all branding replaced with a drab dark brown colour) and Australian-like packaging (ie, all branding replaced with a drab dark brown colour and a graphic image and text on 75% of the pack surface) had on perceptions of the NAS cigarette package. RESULTS Smokers' ratings of the standard NAS pack on the implied safety scale (mean=4.6; SD=2.9) were 1.9 times (P <0.001) higher than smokers' ratings of a Marlboro Red pack (mean=2.4; SD=2.3) and 1.7 times (P <0.001) higher than smokers' ratings of a Newport Menthol pack (mean=2.7; SD=2.4). These perceptions of implied safety were lower when plain packaging was used (Cohen's d=0.66; P <0.001) and much lower when Australian-like packaging was used (Cohen's d=1.56; P <0.001). CONCLUSION The results suggest that NAS cigarette packaging conveys that its cigarettes are 'safer' and that such perceptions are lower with standardised packaging, both with and without warning images.
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Affiliation(s)
- Eric Craig Leas
- Department of Family Medicine and Public Health, University of California: San Diego, La Jolla, California, USA
- UC San Diego Moores Cancer Center, University of California: San Diego, La Jolla, California, USA
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California: San Diego, La Jolla, California, USA
- UC San Diego Moores Cancer Center, University of California: San Diego, La Jolla, California, USA
| | - Claudiu V Dimofte
- Department of Marketing, San Diego State University, San Diego, California, USA
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California: San Diego, La Jolla, California, USA
- UC San Diego Moores Cancer Center, University of California: San Diego, La Jolla, California, USA
| | - David R Strong
- Department of Family Medicine and Public Health, University of California: San Diego, La Jolla, California, USA
- UC San Diego Moores Cancer Center, University of California: San Diego, La Jolla, California, USA
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22
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Epperson AE, Prochaska JJ, Henriksen L. The flip side of Natural American Spirit: corporate social responsibility advertising. Tob Control 2018; 27:355-356. [PMID: 28237942 PMCID: PMC5572748 DOI: 10.1136/tobaccocontrol-2016-053576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Anna E Epperson
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
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23
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D'Silva J, O'Gara E, Villaluz NT. Tobacco industry misappropriation of American Indian culture and traditional tobacco. Tob Control 2018; 27:e57-e64. [PMID: 29459389 PMCID: PMC6073916 DOI: 10.1136/tobaccocontrol-2017-053950] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 12/18/2017] [Accepted: 01/03/2018] [Indexed: 12/03/2022]
Abstract
Objective Describe the extent to which tobacco industry marketing tactics incorporated American Indian culture and traditional tobacco. Methods A keyword search of industry documents was conducted using document archives from the Truth Tobacco Documents Library. Tobacco industry documents (n=76) were analysed for themes. Results Tobacco industry marketing tactics have incorporated American Indian culture and traditional tobacco since at least the 1930s, with these tactics prominently highlighted during the 1990s with Natural American Spirit cigarettes. Documents revealed the use of American Indian imagery such as traditional headdresses and other cultural symbols in product branding and the portrayal of harmful stereotypes of Native people in advertising. The historical and cultural significance of traditional tobacco was used to validate commercially available tobacco. Conclusions The tobacco industry has misappropriated culture and traditional tobacco by misrepresenting American Indian traditions, values and beliefs to market and sell their products for profit. Findings underscore the need for ongoing monitoring of tobacco industry marketing tactics directed at exploiting Native culture and counter-marketing tactics that raise awareness about the distinction between commercial and traditional tobacco use. Such efforts should be embedded within a culturally sensitive framework to reduce the burden of commercial tobacco use.
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Affiliation(s)
- Joanne D'Silva
- Research Department, ClearWay Minnesota, Minneapolis, Minnesota, USA.,Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Erin O'Gara
- Research Department, ClearWay Minnesota, Minneapolis, Minnesota, USA
| | - Nicole T Villaluz
- Community Development Department, ClearWay Minnesota, Minneapolis, Minnesota, USA.,Hidatsa/Assiniboine/Chamorro, USA
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Sanders-Jackson A, Tan ASL, Yie K. Effects of health-oriented descriptors on combustible cigarette and electronic cigarette packaging: an experiment among adult smokers in the United States. Tob Control 2017; 27:534-541. [DOI: 10.1136/tobaccocontrol-2017-053795] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/15/2017] [Accepted: 08/23/2017] [Indexed: 01/07/2023]
Abstract
ObjectiveCertain tobacco companies use health-oriented descriptors (eg, 100% organic) on product packaging and advertising of combustible cigarettes or electronic cigarettes (e-cigarettes) that create a ‘health halo’ around smoking and vaping. Previous observational research suggests that such language may be associated with more favourable attitudes and reduced risk perceptions toward these brands compared with others. This study aimed to determine the effects of health-oriented descriptors on smokers’ attitude toward the brand, perception of packaging information, comparative harm versus other brands and intention to purchase either combustible cigarettes or e-cigarettes.MethodUS adult smokers were randomly assigned to view either a health-oriented language package (‘100% organic,’ ‘all natural’ or ‘no additives’), traditional marketing language package (‘fine quality,’ ‘premium blend’ or ‘100% original’) or a no-language package of a combustible cigarette brand (Study 1, n=405) or an e-cigarette brand (Study 2, n=396) in an experimental design.ResultsStudy 1: Participants in the health-oriented condition reported more favourable perceptions toward the package information, lower comparative harm and higher intention to purchase combustible cigarettes versus the no language control. In addition, participants in the health-oriented condition reported more positive attitude toward the brand and lower comparative harm versus the traditional marketing condition. Study 2: Compared with the traditional marketing condition, participants in the health-oriented condition reported greater intention to purchase Absolute e-cigarettes. There were no significant differences in attitude toward the brand, perception of packaging information and comparative harm versus other brands across conditions.ConclusionsThe effect of health-oriented language was significant for combustible cigarettesand e-cigarette packages. Policies to restrict health-oriented language on cigarette and e-cigarette packaging are recommended.
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Epperson AE, Henriksen L, Prochaska JJ. Natural American Spirit Brand Marketing Casts Health Halo Around Smoking. Am J Public Health 2017; 107:668-670. [PMID: 28398789 PMCID: PMC5388969 DOI: 10.2105/ajph.2017.303719] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Anna E Epperson
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Lisa Henriksen
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Judith J Prochaska
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Pearson JL, Johnson A, Villanti A, Glasser AM, Collins L, Cohn A, Rose SW, Niaura R, Stanton CA. Misperceptions of harm among Natural American Spirit smokers: results from wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014). Tob Control 2016; 26:e61-e67. [PMID: 27924008 DOI: 10.1136/tobaccocontrol-2016-053265] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/05/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This study estimated differences in cigarette harm perceptions among smokers of the Natural American Spirit (NAS) brand-marketed as 'natural', 'organic' and 'additive-free'-compared to other smokers, and examined correlates of NAS use. METHODS Data were drawn from wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of US adults (2013-2014). Weighted analyses using a subset of current adult smokers (n=10 565) estimated the prevalence of NAS use (vs all other brands) and examined associations between NAS use and sociodemographics, tobacco/substance use, tobacco harm perceptions, quit intentions, quit attempts and mental/behavioural health. RESULTS Overall, 2.3% of adult smokers (920 000 people in the USA) reported NAS as their usual brand. Nearly 64% of NAS smokers inaccurately believed that their brand is less harmful than other brands compared to 8.3% of smokers of other brands, after controlling for potential confounders (aOR 22.82). Younger age (18-34 vs 35+; aOR 1.54), frequent thinking about tobacco harms (aOR 1.84), past 30-day alcohol use (aOR 1.57), past 30-day marijuana use (aOR 1.87) and sexual orientation (lesbian, gay, bisexual, 'other' or 'questioning' vs heterosexual; aOR 2.07) were also associated with increased odds of smoking NAS. CONCLUSIONS The majority of NAS smokers inaccurately believes that their cigarettes are less harmful than other brands. Given the brand's rapid growth and its more common use in vulnerable groups (eg, young adults, lesbian, gay, bisexual, 'other' or 'questioning' adults), corrective messaging and enforcement action are necessary to correct harm misperceptions of NAS cigarettes.
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Affiliation(s)
- Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amanda Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Andrea Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allison M Glasser
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Lauren Collins
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Amy Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Shyanika W Rose
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Raymond Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cassandra A Stanton
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.,Westat, Rockville, Maryland, USA
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