ArticleHealth education & behavior : the official publication of the Society for Public Health Education2019
"The Packaging Is Very Inviting and Makes Smokers Feel Like They're More Safe": The Meanings of Natural American Spirit Cigarette Pack Design to Adult Smokers.
Article in Health education & behavior : the official publication of the Society for Public Health Education, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- Greenwashed Cigarette Ad Text and Imagery Produce Inaccurate Harm, Addictiveness, and Nicotine Content Perceptions: Results From a Randomized Online Experiment.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Does Reducing the Size of the Tobacco Power Wall Affect Young People's Risk of Future Use of Tobacco Products? An Experimental Investigation.Journal of studies on alcohol and drugs · 2024Trial
- Acute effects of charcoal filters and package color on cigarette perceptions and use behaviors: Results from a randomized pilot study examining Natural American Spirit "Sky".Drug and alcohol dependence · 2024Trial
- "Tobacco and Water": Testing the Health Halo Effect of Natural American Spirit Cigarette Ads and Its Relationship with Perceived Absolute Harm and Use Intentions.Health communication · 2021Trial
- 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 · 2019Trial
- Effects of cigarette greenwashing advertising on behavioral economic demand, puff topography, and health risk perception.Journal of the experimental analysis of behavior · 2026Article
- A descriptive content analysis of greenwashing tactics used in US cigarette advertisements between 2019-2023.Tobacco prevention & cessation · 2026Article
- Qualitative perspective on nicotine pouches from adults who smoke cigarettes in North Carolina.Tobacco control · 2025Article
- From "Additive-Free" to "Tobacco & Water": Assessing the Impact of Marketing Claim Changes on Natural American Spirit and L&M Cigarettes.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Oral nicotine marketing claims in direct-mail advertising.Tobacco control · 2022Article
- The "Organic" Descriptor and Its Association With Commercial Cigarette Health Risk Expectancies, Subjective Effects, and Smoking Topography: A Pilot Human Laboratory Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Article
- Following in the footsteps of Natural American Spirit: the emergence of Manitou cigarettes.Tobacco control · 2020Article
- Inferences beyond a claim: a typology of potential halo effects related to modified risk tobacco product claims.Tobacco control · 2020Article
- Assessing cigarette packaging and labelling policy effects on early adolescents: results from a discrete choice experiment.Tobacco control · 2020Article
- Selling tobacco: A comprehensive analysis of the U.S. tobacco advertising landscape.Addictive behaviors · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND/
aimsThe aim of this investigation was to identify which design elements on Natural American Spirit packs are salient to (i.e., noticed by) U.S. adult smokers and what meanings smokers derive from these elements.
methodWe conducted a secondary analysis of qualitative data from a study of cigarette packaging design. U.S. adult smokers ( n = 33) from all nine census regions participated in six telephone-based focus groups in March 2017. We used constant comparison analysis to identify key themes.
resultsFour themes were identified, two focused on salient design elements and two focused on design element meanings. The themes of "bright and flashy color" and "the American Indian logo" were identified as key design elements, while the themes of "healthy and safer" and "targeting at-risk smokers" were identified as meanings smokers derived from design elements.
conclusionsPack design elements influence smokers' perceptions about reduced health risk of Natural American Spirit cigarettes and may be especially dangerous to vulnerable populations, including young adults and American Indians. Findings from this study suggest that the banning of text descriptors may not be enough to address misconceptions about "healthier" cigarettes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.