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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

: The association of race with timeliness of care and survival among Veterans Affairs health care system patients with late-stage non-small cell lung cancer

The two modes of data collection show good comparability on key sociodemographic and smoking variables [37, 38]

If these symptoms are particularly uncomfortable or persistent, speak to a pharmacist or doctor. Dr Bhavini Shah Mental, emotional, or behavioural symptoms Nicotine withdrawal can influence our mental wellbeing