title: Adolescents' and adults' perceptions of 'natural', 'organic' and 'additive-free' cigarettes, and the required disclaimers.
abstract: We sought to investigate adolescents' and adults' perceptions of an American Spirit advertisement with 'natural', 'organic' and 'additive-free' descriptors and related disclaimers.
  
  
  
  We conducted nine focus group discussions in the Southern USA, with 59 participants aged 13-64 years (30 male, 29 female), stratified by age, smoking status and susceptibility to smoking. We conducted thematic content analysis of the transcripts.
  
  
  
  Many participants were sceptical or confused about the 'natural', 'organic' and 'additive-free' descriptors. Many participants viewed American Spirit cigarettes as being less, or possibly less harmful than other cigarettes, even though the ad contained disclaimers explicitly stating that these cigarettes are not safer. Some participants said that people tend to ignore disclaimers, a few expressed doubt that the disclaimers were fully true, and others did not notice the disclaimers. A few smokers said they smoke American Spirit cigarettes because they think they are not as bad for them as other cigarettes.
  
  
  
  Disclaimers intended to prevent consumers from attributing a health benefit to cigarettes labelled as 'natural', 'additive-free', or 'organic' may be insufficient. A ban on these descriptors may be a more appropriate remedy than disclaimers.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: M Justin
authors.initials: MJ
authors.lastname: Byron
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Sabeeh A
authors.initials: SA
authors.lastname: Baig
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Moracco
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D000074285:Smokers / Q000523:psychology* / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D019460:Tobacco Industry / Q000379:methods; D062789:Tobacco Products / Q000009:adverse effects / Q000032:analysis*; D014481:United States; D055815:Young Adult
keywords: Advertising and Promotion; Packaging and Labelling; Public opinion; Public policy; Tobacco industry