Trial reportHealth communication2021
"Tobacco and Water": Testing the Health Halo Effect of Natural American Spirit Cigarette Ads and Its Relationship with Perceived Absolute Harm and Use Intentions.
Trial report in Health communication, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
19 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
- Tobacco Advertising Features That May Contribute to Product Appeal Among US Adolescents and Young Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021Trial
- Effects of cigarette greenwashing advertising on behavioral economic demand, puff topography, and health risk perception.Journal of the experimental analysis of behavior · 2026Article
- The effect on satisfaction and functional perception of showing preoperative photographs during follow-up after ingrown toenail surgery.Journal of orthopaedic surgery and research · 2026Article
- Content Analysis of Derived Intoxicating Cannabis Vape Product Attributes and Marketing In an Online Retail Environment.Substance use & misuse · 2026Article
- TAAT hemp cigarettes' unsubstantiated cessation and harm reduction claims.Tobacco control · 2025Article
- Decoding consumers' interpretations of 'additive-free' and 'tobacco & water' cigarette advertising claims.Tobacco control · 2025Article
- Age-Gating and Marketing Differences Between Storefront and Non-Storefront Cannabis Retailers.Cannabis (Albuquerque, N.M.) · 2025Article
- A Constant Error, Revisited: A New Explanation of the Halo Effect.Cognitive science · 2024Article
- 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
- Doing more with less: A proposal to advance cigarette packaging regulations in the United States.The International journal on drug policy · 2024Article
- 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 & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Tobacco Free Nicotine Vaping Products: A Study of Health Halo Effects Among Middle School Youth.Journal of health communication · 2023Article
- Natural American Spirit launches 'Sky', the brand's first commercial organic cigarette with a charcoal filter.Tobacco control · 2023Article
- Outdoor Medical Cannabis Advertising in Oklahoma: Examining Regulatory Compliance and Social Meanings in Billboard Content.Substance use & misuse · 2023Review
- 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
- COVID-19 and 'immune boosting' on the internet: a content analysis of Google search results.BMJ open · 2020Article
Corrections and comments
- Erratum issuedCorrection.2021
Authors and funding
4 authors.
Funding
Abstract
In 2015, the FDA formally warned Santa Fe Natural Tobacco Company that their "natural" and "additive-free" claims for its Natural American Spirit cigarettes conveyed reduced harm to consumers. In a settlement, Santa Fe was allowed to continue using the word "natural" in the brand name and the phrase "tobacco and water". The company also uses eco-friendly language and plant imagery and these tactics have also been shown to communicate reduced product harm. In this study, we propose the health halo effect as an overarching framework for explaining how these ad tactics mislead consumers in an effort to provide more comprehensive guidance for regulatory action. In a between-subjects experiment, 1,577 US young adults, ages 18-24, were randomly assigned to view one of five Natural American Spirit cigarette ads featuring either: 1) eco-friendly language; 2) plant imagery; 3) the phrase "tobacco and water"; 4) all of these tactics; or 5) a control condition featuring none of these tactics. In line with past research, ads with the phrase "tobacco and water" or with all the tactics together (vs. control) created a health halo effect, increasing perceptions that Natural American Spirit cigarettes were healthier and had less potential to cause disease; these tactics also had an indirect positive effect on smoking intentions through reduced perceptions of the brand's potential to cause disease and perceived absolute harm. Inconsistent with prior work, the eco-friendly language and plant imagery (vs. control) reduced healthfulness perceptions, increased perceptions of absolute harm, and had an indirect negative effect on smoking intentions. We contribute to past research showing that Natural American Spirit cigarette ad tactics mislead consumers. Inconsistent findings are explained in terms of stimuli design and processing of message features, indices of relative message persuasiveness, and multiple versus single-message designs.
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What OpenQuestion holds
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.