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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

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In the study, both groups had nicotine patches for two weeks prior to their quit date, and they also had counseling after they stopped smoking