title: Misperceptions of harm among Natural American Spirit smokers: results from wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014).
abstract: This study estimated differences in cigarette harm perceptions among smokers of the Natural American Spirit (NAS) brand-marketed as 'natural', 'organic' and 'additive-free'-compared to other smokers, and examined correlates of NAS use.
  
  
  
  Data were drawn from wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of US adults (2013-2014). Weighted analyses using a subset of current adult smokers (n=10 565) estimated the prevalence of NAS use (vs all other brands) and examined associations between NAS use and sociodemographics, tobacco/substance use, tobacco harm perceptions, quit intentions, quit attempts and mental/behavioural health.
  
  
  
  Overall, 2.3% of adult smokers (920 000 people in the USA) reported NAS as their usual brand. Nearly 64% of NAS smokers inaccurately believed that their brand is less harmful than other brands compared to 8.3% of smokers of other brands, after controlling for potential confounders (aOR 22.82). Younger age (18-34 vs 35+; aOR 1.54), frequent thinking about tobacco harms (aOR 1.84), past 30-day alcohol use (aOR 1.57), past 30-day marijuana use (aOR 1.87) and sexual orientation (lesbian, gay, bisexual, 'other' or 'questioning' vs heterosexual; aOR 2.07) were also associated with increased odds of smoking NAS.
  
  
  
  The majority of NAS smokers inaccurately believes that their cigarettes are less harmful than other brands. Given the brand's rapid growth and its more common use in vulnerable groups (eg, young adults, lesbian, gay, bisexual, 'other' or 'questioning' adults), corrective messaging and enforcement action are necessary to correct harm misperceptions of NAS cigarettes.
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.|Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Jennifer L
authors.identifier: 0000-0002-1400-5932
authors.initials: JL
authors.lastname: Pearson
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.|Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Andrea
authors.identifier: 0000-0003-3104-966X
authors.initials: A
authors.lastname: Villanti
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Glasser
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Collins
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.|Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Cohn
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.
authors.forename: Shyanika W
authors.initials: SW
authors.lastname: Rose
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.|Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Niaura
authors.affiliation: Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.|Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.|Westat, Rockville, Maryland, USA.
authors.forename: Cassandra A
authors.initials: CA
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010465:Perception; D012725:Sexual Behavior; D000074285:Smokers / Q000523:psychology* / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D062789:Tobacco Products / Q000009:adverse effects / Q000032:analysis*; D055815:Young Adult
keywords: Advertising and Promotion; Packaging and Labelling; Tobacco industry