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After viewing the ad, participants reported perceptions of Natural American Spirit cigarettes attributes, perceptions of absolute harm, and intention to use the product

However, while medical product manufacturers are generally required to meet a standard of safety and effectiveness to receive premarket approval from FDA, tobacco product manufacturers are instead generally required to meet a standard of "appropriate for the protection of public health" to receive marketing authorization

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However, long-term smoking can lead to structural changes in the vocal cords that may not fully reverse