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Real. Simple. Deadly. a Pilot Test of Consumer Harm Perceptions in Response to Natural American Spirit Advertising

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Real. Simple. Deadly. a Pilot Test of Consumer Harm Perceptions in Response to Natural American Spirit Advertising Real. Simple. Deadly. A Pilot Test of Consumer Harm Perceptions in Response to Natural American Spirit Advertising Meghan Bridgid Moran, PhD Jennifer L. Pearson, PhD, MPH, PhD Objectives: In 2016, the US Food and Drug Administration (FDA) and Santa Fe Natural Tobacco Company entered into a settlement agreement restricting use of the terms “additive free” and “natural” in American Spirit ads. In 2017, American Spirit launched a new campaign using the tagline “Real. Simple. Different.” featuring the text, “Tobacco Ingredients: Tobacco & Water.” The purpose of this study is to compare the effect of the old and new advertising tactics on perceived harm. Methods: We randomized 482 US young adults recruited via Amazon Mechanical Turk to view the old American Spirit ad messages, new American Spirit ad messages, or a control ad. Re- sults: Participants who viewed an ad featuring the new “Real. Simple. Different.” and “Tobacco & Water” phrases had a higher odds of perceiving the product as less harmful than other cigarettes (OR = 2.93) compared to a control ad, but a lower odds of perceiving reduced harm compared to an ad featuring the old phrases “Additive free. Natural.” and “Tobacco & Water.” Conclusions: Though an improvement on the old American Spirit ad, the tested new American Spirit ad still conveys inaccurate reduced harm to consumers. Key words: tobacco marketing; advertising; perceived risk; cigarettes; American Spirit; cigarette descriptor Tob Regul Sci.™ 2019;5(4):360--368 DOI: https://doi.org/10.18001/TRS.5.4.6 he tobacco industry has a long history of harm perceptions.8 Accordingly, the US Food and using deceptive marketing tactics to portray Drug Administration (FDA) sent a warning letter their products as less harmful. Terms such to Santa Fe Natural Tobacco Company (SFNTC), Tas “light,” “low,” “mild,” and “smooth” all contrib- manufacturer of NAS cigarettes, regarding use of ute to inaccurate perceptions that one cigarette these terms and the 2 parties reached an agreement brand is less harmful than other brands,1-5 and as in 2017 in which use of the term “additive-free” such, use of these terms has been restricted.6 More would cease, and use of the term “natural” would recently, Natural American Spirit brand cigarettes be restricted, other than in the brand name. (hereafter referred to as NAS) has used the terms Natural American Spirit advertises their ciga- “natural” and “additive-free” to describe its ciga- rettes using a range of tactics that could portray rettes. Natural American Spirit cigarettes were in- the product as natural and additive-free without troduced to the United States (US) market in 1985 explicitly using those terms.9,10 Moreover, NAS ad- and research has found that smokers of NAS ciga- vertisements frequently feature the term “Tobacco rettes are over 22 times more likely to perceive this & Water,” implying that there are no other ingre- brand as less harmful than other brands.7 More- dients besides tobacco and water.9,10 In 2017, NAS over, the descriptors “natural” and “additive-free” released a new advertising campaign featuring the contribute significantly to these inaccurate reduced tagline, “Real. Simple. Different.” (upper left ad in Meghan Bridgid Moran, Assistant Professor, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Balti- more, MD. Jennifer L. Pearson, Assistant Professor, Division of Social & Behavioral Health/Health Administration and Policy, School of Community Health Sciences, University of Nevada-Reno, Reno, NV. Correspondence Dr Moran; [email protected] 360 Moran & Pearson Figure 1). In addition to this tagline, this campaign parison brand due to its similarity to NAS in pack continues to feature the term, “Tobacco ingredi- branding (Native American imagery, pack color) ents: Tobacco & Water.” and its unfamiliarity among American consumers. The purpose of the current study was to examine We examined the effect of product brand (Seneca whether the terms “Real. Simple. Different.” and or NAS) on product risk perceptions as a secondary “Tobacco ingredients: Tobacco & Water” conveyed point of inquiry. inaccurate perceptions of reduced harm. We ad- dressed 3 sets of research questions. METHODS Because tobacco companies are prohibited from Sample marketing products as modified risk unless granted Young adults aged 18-24 years (N = 495) were a prior permissive order [ref: TCA], we sought to recruited using Amazon Mechanical Turk (AMT). understand whether the components of NAS’ new AMT is a platform in which users can complete marketing campaign similarly conveyed inaccurate small tasks, such as taking a survey, for financial reduced risk. We asked, compensation. AMT is an efficient and cost-effec- RQ1: Compared to a control ad featuring no tive mode of data collection, and recent work has text or claims, are ads featuring either the terms found that correlational research conducted with (1) “Real. Simple. Different.” (2) “Tobacco in- samples recruited via AMT produces similar results gredients: Tobacco & Water,” or (3) both terms to studies conducted with traditional and more more likely to produce inaccurate reduced harm expensive samples.12,13 Thirteen participants who perceptions? did not answer the survey item on the primary out- We also sought to examine how consumer risk come (perceived harm) were not included in the perceptions in response to NAS’ new marketing analysis, for a final analytic sample size of 482. campaign compared to risk perceptions in response to NAS’ now-restricted tactics. Experimental Procedure RQ2: Compared to an ad featuring the term We implemented a 6 (ad tactic) x 2 (brand) be- “Additive Free. Natural” only, are ads featuring tween-subjects experiment. Participants were ran- either the terms 1a) “Real. Simple. Different.” (2) domized to view one of 12 ads (Figure 1). Ads were “Tobacco ingredients: Tobacco & Water,” or (3) modeled off of an NAS ad (the original ad is Ad #1 both terms more likely to produce inaccurate re- in the top left of Figure 1). The first ad condition duced harm perceptions? featured the claims “Real. Simple. Different.” and Additionally, to more precisely examine the effect “When it comes to crafting real taste in our blends, of NAS’ campaign components, we asked: 2 ingredients are all we’ve ever needed. Tobacco In- RQ3: Compared to an ad featuring the term gredients: Tobacco & Water” (hereafter this claim “Additive Free. Natural” and the term “Tobacco is referred to as “Tobacco & Water”). The second Ingredients: Tobacco & Water,” are ads featuring condition contained only the “Real. Simple. Dif- either the terms (1) “Real. Simple. Different.” (2) ferent.” claim. The third condition contained only “Tobacco ingredients: Tobacco & Water,” or (3) the “Tobacco & Water” claim. The fourth ad con- both terms more likely to produce inaccurate re- dition contained the words “Additive Free. Natu- duced harm perceptions? ral.” and the “Tobacco & Water” claim. The fifth These research questions were addressed using 2 ad condition contained only the words “Additive cigarette brands, Seneca, a Canadian brand manu- Free. Natural.” The sixth ad condition contained factured by Grand River Enterprises that uses Na- none of this language and featured only a picture tive American imagery. Tactics were tested on the of the pack on the ad’s background. unfamiliar comparison brand Seneca as well as for NAS because prior research7,11 has found a brand- Measures level effect in which NAS cigarettes are perceived The outcome of interest, perceived harm, was as- to be less harmful than other brands, regardless of sessed by asking participants, “Compared to other advertising tactics. Seneca was chosen as a com- cigarettes, how harmful do you think this product Tob Regul Sci.™ 2019;5(4):360-368 DOI: https://doi.org/10.18001/TRS.5.4.6 361 Real. Simple. Deadly. A Pilot Test of Consumer Harm Perceptions in Response to Natural American Spirit Advertising Figure 1 Experimental Stimuli Note. ‘Tobacco & Water’ text on ads 1, 3, 4, 7, 9, and 10 reads: “When it comes to crafting real taste in our blends, two ingredi- ents are all we’ve ever needed. Tobacco Ingredients: Tobacco & Water.” Warnings on all ads are: “SURGEON GENER- AL’S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy.” (Left) and “Natural American Spirit [Seneca] cigarettes are not safer than other cigarettes.” 362 Moran & Pearson is to your health?” (a lot less harmful, a little less harmful, about the same, a little more harmful, a Table 1 lot more harmful, or don’t know).” Responses were Participant Characteristics (N = 482) dichotomized so that a code of ‘1’ represented per- N Percentage ceived less harm (a little or a lot less harmful) and a code of ‘0’ represented equal or more perceived Gender harm (about the same, a little, or a lot more harm). Female 197 40.9 This outcome was chosen due to its regulatory rel- Male 280 58.1 evance and its importance for public health. Inac- Another gender 4 0.8 curate harm perception (ie, wrongly perceiving a Missing 1 0.2 product that has not been deemed a modified risk tobacco product as less harmful than others on Race/ethnicity the market) is a key outcome related to the FDA’s Non-Hispanic white 319 66.2 ability to regulate tobacco marketing, and reduced Non-Hispanic black 45 9.3 perceived harm relative to other cigarette brands is Hispanic 68 14.1 an inaccurate product perception and could affect Other non-Hispanic 49 10.2 intention to use the brand or switch brands rather than quit smoking.14-16 Participants’ smoking status Missing 1 0.2 was characterized as current smoker (had smoked Education >100 lifetime cigarettes and now smoked some or HS degree or less 64 13.3 all days), former smoker (had smoked > 100 life- Some college/associate’s 175 36.3 time cigarettes and did not currently smoke), or Bachelor’s degree or more 241 50.0 non-smoker (had not smoked 100 lifetime ciga- rettes).
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