The price of Natural American Spirit relative to other cigarette brands.

Introduction: American Spirit cigarettes feature American Indian/Alaska Native (AI/AN) imagery in the branding, are marketed as environmentally friendly, without additives, and four varieties contain organic tobacco. This study is the first to examine retail price of American Spirit relative to other cigarette brands and to assess how its price varies by neighborhood demography.

Methods: In a random sample of licensed tobacco retailers (n=1277), trained data collectors recorded availability and price of American Spirit, Pall Mall, Newport, Marlboro and the cheapest cigarettes regardless of brand. Data were collected in January-March 2017 in California, the state with the largest AI/AN population. Paired t-tests assessed prices (before sales tax) of American Spirit relative to others. Ordinary least squares regressions modeled prices as a function of neighborhood demography, adjusting for store type.

Results: American Spirit was sold in 77% of stores at an average price of $7.03 (SD=0.66), which was $0.75 to $1.78 (12.0% to 34.4%) higher than Pall Mall, Newport, and Marlboro in the same stores. American Spirit cost significantly less in neighborhoods with a higher proportion of school-age residents, however this pattern was not unique to that brand. Contrary to expectation, American Spirit did not cost less in neighborhoods with a higher proportion of AI/ANs.

Conclusion: This study is the first to document lower prices for American Spirit in neighborhoods with a higher proportion of school-age youth. Future research should consider whether the ultra-premium price of American Spirit contributes to misperceptions that the brand is organic and less harmful than other cigarettes.

Implications: In a large random sample of licensed tobacco retailers in California, American Spirit cost significantly more than other brands, 12.0% to 34.4% more than Pall Mall, Newport, and Marlboro in the same stores. After controlling for store type, American Spirit price was significantly lower in neighborhoods with a higher proportion of school-age residents. Research about how an ultra-premium price contributes to misperceptions that all American Spirit varieties are organic and the brand is less harmful, less addictive than other cigarette brands would be informative for ongoing litigation and product regulation.