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American Spirit has no affiliation with any American Indian or Alaska Native tribes, however its depiction of an American Indian warrior, peace pipe, and thunderbird on its cigarette packaging caused 65% of participants in a study to believe the brand had tribal affiliations, which was associated with perceptions of decreased harm and greater intentions to purchase

Benefit outcomes that focus group participants most frequently cited as critical for decisionmaking were smoking cessation ( n = 13) and quality of life ( n = 17)

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