Use of imagery and text that could convey reduced harm in American Spirit advertisements.

BACKGROUND In 2015, the US Food and Drug Administration issued warning letters to three tobacco companies regarding use of the terms 'natural' and/or 'additive-free' to describe their products, as these terms inaccurately convey reduced harm. Yet, tobacco companies engage in a variety of alternate techniques to attempt to convey the same 'natural' (and thus reduced harm) message. It is critical to monitor these practices to inform regulatory action. OBJECTIVE To describe the marketing techniques used in Natural American Spirit (American Spirit) ads that could convey a natural and less harmful product image. METHODS Trained coders content analysed 142 American Spirit ads from 2012 to 2016. RESULTS In addition to use of the terms 'natural' and 'additive-free', American Spirit ads engage in a variety of other linguistic and iconic techniques that could convey reduced harm, such as references to small, local or organic farming, eco-friendly practices, and plant, farming and other nature-related imagery. CONCLUSIONS American Spirit ads use a wide range of marketing techniques to convey a natural product image, which could subsequently communicate reduced harm.