Anna E Epperson1, Samantha Wong2, Eric F Lambin3, Lisa Henriksen2, Michael Baiocchi2, June A Flora4, Judith J Prochaska5. 1. Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California. 2. Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California. 3. 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. 4. Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, California. 5. Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California. Electronic address: jpro@stanford.edu.
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.
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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