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With these results additionally showing unique mortality effects, its time for menthol cigarettes to be regulated to help save lives. While smoking rates have declined in some groups, menthol cigarettes continue to rise in popularity, particularly among populations targeted by tobacco industry marketing, including Black Americans, women, and youth

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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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