Natural American Spirit Brand Preference among Smokers with Mental Illness. Tobacco induced diseases Epperson, A. E., Anzai, N. E., Prochaska, J. J. 2018; 16


Despite steady declines in the US smoking prevalence over the past 50 years, Natural American Spirit cigarettes (NAS), marketed as natural and organic, have seen a 400% rise in sales. In a sample of smokers with mental illness, based on previous research, we hypothesized that preference for NAS would be associated with younger age, higher education, and a stronger health-orientation.Adult smokers were interviewed during acute psychiatric hospitalization in California between 2009-2013, reporting their preferred top 3 brands of cigarettes, smoking behaviors, self-rated health, and dietary and physical activity behaviors. The sample (N=956; M age=38.7, SD=13.5; 48.7% women) identified as 14.5% Hispanic ethnicity and 49.6% White, 23.7% African American, and 23.8% other race.NAS was identified as a top preferred brand by 15.2% of participants and was the fourth most popular brand for the sample overall. In a multivariate logistic regression, preference for NAS was significantly greater among participants who were younger (OR=0.97), had some college education or more (OR=2.64 to 4.31), ate a low-fat diet (OR=1.56) and reported better overall health (OR=1.26), p's<.05. Identifying as Hispanic ethnicity (OR=1.80) and White race (OR=3.00) also predicted NAS preference, p's<.05. NAS preference did not differ by gender or psychiatric diagnosis.Study findings indicate greater NAS brand appeal among smokers living with mental illness who are younger, more highly educated, and have a stronger orientation to health, perhaps because they perceive NAS to be a healthier cigarette to smoke. Marketing language that obscures the harms of smoking ought to be prohibited.

View details for DOI 10.18332/tid/94456

View details for PubMedID 31210981

View details for PubMedCentralID PMC6576234