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Targeted marketing and policy failures have also contributed to American Indian health inequities In addition to not having access to traditional tobacco, American Indian communities have been specifically targeted by the tobacco industrys marketing tactics for decades (for example, American Spirit tobacco labeling)

They have more of the familiar throat feel of a 50mg disposable but less than half the nicotine content

Enterprising manufacturers have exploited this loophole by marketing pan masala (sans tobacco) and zarda (a loose tobacco product) as separate entities

But tragically, in the later years of his life, actor John Wayne went through a bevy of health issues including one that resulted in the removal of an entire lung, according to The Washington Post