Adding further to the literature, we hypothesized that variables that reflect a stronger health orientation would be associated with NAS brand preference in this sample. Based on the literature in the general population, we hypothesized that NAS would be more popular among younger and better educated smokers with mental illness. No study to date, however, has examined the extent to which NAS is a brand of preference among smokers with mental illness. Smokers with mental illness represent a large proportion of the tobacco market and have been historically targeted by the tobacco industry 9. In the national Population Assessment of Tobacco and Health (PATH) Survey, 2.3% of adult smokers reported NAS as their preferred brand, and NAS smokers were 22 times more likely to rate their brand of cigarettes as less harmful relative to smokers of other brands preference for NAS was more likely among men and younger, White, more highly educated smokers 5. Previous research indicates that cigarettes marketed as ‘natural’ are perceived as less likely to cause disease and less harmful to overall health 8. Prefer this brand of cigarettes 5 the brand is at the top three for sales in California 6 and has a 10.2% market share in San Francisco 7. This is a super-premium brand, manufactured by Reynolds American that has a higher average price, but nearly 1 million adult smokers in the US Though just as harmful as other commercially available cigarette brands, Natural American Spirit TM (NAS) cigarettes, marketed as ‘natural’ and ‘organic’, have uniquely seen a 400% rise in US sales since 2002 4. Smokers with mental illness face significant tobacco-related social, economic, and health disparities and are at greater risk of developing heart disease, lung disease, and tobacco-related cancers 2, 3. In particular, the smoking prevalence is two- to four-fold greater among individuals with mental illness relative to the general population, and over 40% of cigarettes sold in the US are sold to persons with mental illness or substance-use disorders 2. The prevalence of cigarette smoking among US adults has declined, however, public health gains have not been experienced equally 1. Marketing language that obscures the harms of Living with mental illness who are younger, more highly educated, and haveĪ stronger orientation to health, perhaps because they perceive NAS to be a Conclusions: Study findings indicate greater NAS brand appeal among smokers NAS preference did notĭiffer by gender or psychiatric diagnosis. (OR=3.00) also predicted NAS preference, p<0.05. Identifying as Hispanic (OR=1.80) or White (OR=2.64 to 4.31), ate a low-fat diet (OR=1.56) and reported better overall Participants who were younger (OR=0.97), had some college education or more

Logistic regression, preference for NAS was significantly greater among

Results: NAS was identified as a top preferred brand by 15.2% of the participantsĪnd was the fourth most popular brand for the sample overall. Identified as 14.5% Hispanic ethnicity, 49.6% White, 23.7% African American,Īnd 23.8% other. In California between 2009–2013, reporting their preferred top three brands ofĬigarettes, smoking behaviors, self-rated health, and dietary and physical activityīehaviors. Material and Methods: Adult smokers were interviewed during acute psychiatric hospitalization Would be associated with younger age, higher education, and a stronger health-orientation. Illness, based on previous research, we hypothesized that preference for NAS ‘organic’, have seen a 400% rise in sales. Introduction: Despite a steady decline in the US smoking prevalence over the pastĥ0 years, Natural American Spirit cigarettes (NAS), marketed as ‘natural’ and

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