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Washington State Department of Revenue website

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

According to Abhinav Agrawal, MD, director of interventional pulmonology and bronchoscopy at Northwell Health, One of the issues with legalization is that it contributes to the false perception that risk is low, he says

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