SHORT REPORT
Natural American Spirit brand preference among smokers with mental illness
 
More details
Hide details
1
Stanford Prevention Research Center, Stanford University, Stanford, CA, United States
CORRESPONDING AUTHOR
Anna E. Epperson   

Stanford Prevention Research Center, Stanford University, 1265 Welch Road, Suite 300, 94305- 5411 Stanford, CA, United States
Publish date: 2018-09-17
 
Tob. Induc. Dis. 2018;16(September):42
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Despite a steady decline 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.

Material and Methods:
Adult smokers were interviewed during acute psychiatric hospitalization in California between 2009–2013, reporting their preferred top three brands of cigarettes, smoking behaviors, self-rated health, and dietary and physical activity behaviors. The sample (N=956; Mean age=38.7 years, SD=13.5; 48.7% women) identified as 14.5% Hispanic ethnicity, 49.6% White, 23.7% African American, and 23.8% other.

Results:
NAS was identified as a top preferred brand by 15.2% of the 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), with p<0.05. Identifying as Hispanic (OR=1.80) or White (OR=3.00) also predicted NAS preference, p<0.05. NAS preference did not differ by gender or psychiatric diagnosis.

Conclusions:
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.

 
REFERENCES (15)
1.
U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Published, 2014. Accessed December 13, 2017.
 
2.
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: A population-based prevalence study. JAMA. 2000;284:2606-2610. doi:10.1001/jama.284.20.2606
 
3.
Hall SM, Prochaska JJ. Treatment of smokers with co-occurring disorders: emphasis on integration in mental health and addiction treatment settings. Annu Rev Clin Psychol. 2009;5:409-431. doi:10.1146/annurev.clinpsy.032408.153614
 
4.
Sharma A, Fix BV, Delnevo C, Cummings KM, O'Connor RJ. Trends in market share of leading cigarette brands in the USA: National Survey on Drug Use and Health 2002-2013. BMJ Open. 2016;6:e008813. doi:10.1136/bmjopen-2015-008813
 
5.
Pearson JL, Johnson A, Villanti A, et al. 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. 2017;26:e61-e67. doi:10.1136/tobaccocontrol-2016-053265
 
6.
Schleicher N, Johnson T, Rigdon J, et al. California Tobacco Retail Surveillance Study, 2017. https://www.cdph.ca.gov/Progra.... Published, 2017. Accessed June 25, 2018.
 
7.
Reynolds American Inc. Business Update. https://s2.q4cdn.com/129460998... doc_presentations/2016/RAI-2016-Barclays-Global-CS-Conf-Presentation.pdf. Published September, 2016. Accessed July 22, 2018.
 
8.
Leas EC, Ayers JW, Strong DR, Pierce JP. Which cigarettes do Americans think are safer? A population-based analysis with wave 1 of the PATH study. Tob Control. 2017;26:e59-e60. doi:10.1136/tobaccocontrol-2016-053334
 
9.
Prochaska JJ, Hall SM, Bero L. Tobacco use among individuals with schizophrenia: what role has the tobacco industry played? Schizophr Bull. 2008;34:555-567. doi:10.1093/schbul/sbm117
 
10.
Schuck RK, Dahl A, Hall SM, et al. Smokers with serious mental illness and requests for nicotine replacement therapy post-hospitalization. Tob Control. 2016;25:27-32. doi:10.1136/tobaccocontrol-2014-051712
 
11.
Sheehan DV, Lecrubier Y, Sheehan KH, et al. The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:22-33.
 
12.
Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity. Medical Care. 1996;34:220-233. doi:10.1097/00005650-199603000-00003
 
13.
Oppezzo MA, Michalek AK, Delucchi K, Baiocchi MTM, Barnett PG, Prochaska JJ. Health-related quality of life among veterans in addictions treatment: identifying behavioral targets for future intervention. Qual Life Res. 2016;25(8):1949-1957. doi:10.1007/s11136-016-1236-3
 
14.
Heatherton TF, Kozlowski LT, Frecker RC, Rickert W, Robinson J. Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. Br J Addict. 1989;84:791-800. doi:10.1111/j.1360-0443.1989.tb03059.x
 
15.
Johnston ME, Dunn WL. Market Potential of a Health Cigarette. Ness Motley Law Firm Documents. https://www.industrydocumentsl.... Published June, 1966. Accessed July 22, 2018.
 
eISSN:1617-9625