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"A long-term study found that people who smoked between 1-4 cigarettes a day have significantly higher risk of dying from all causes than non-smoker," he adds

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[14] In response, Robin Sommers, the CEO and majority owner of Santa Fe Natural Tobacco Company, stated that "Native Americans are not a target market for American Spirit", stating that the use of this imagery was due to the company's goal to bring tobacco usage more in line with a perceived "moderation" by Indigenous peoples in the 15th century and that proceeds from sales support Native communities

It also contributes to heart disease, stroke and lung disease