Unmeasured confounding can render identification strategies based on adjustment functionals invalid. We study the "Napkin" graph, a causal structure that encapsulates features of M-bias, instrumental variables, and classical back-door and front-door settings, yet identifies the average treatment effect through a nonstandard ratio of two g-formulas. We develop influence-function-based estimators for this functional, including doubly-robust one-step and targeted minimum loss-based estimators that remain asymptotically linear under slower-than-parametric nuisance estimation using machine learning. A distinguishing feature of the Napkin graph is that it imposes a generalized independence restriction, known as a Verma constraint, rather than ordinary conditional independence restrictions, on the observed data distribution. We develop semiparametric efficiency theory for causal effects under a moment restriction corresponding to this Verma constraint, characterizing the orthocomplement of the tangent space, deriving the class of influence functions, and obtaining the semiparametric efficiency bound. More broadly, our analysis provides a framework for semiparametric inference in causal models defined by Verma constraints and demonstrates how such restrictions may yield efficiency gains. Simulations confirm the estimators' theoretical properties and demonstrate substantial efficiency gains. A real-data application using the Finnish Life Course Study estimates the effect of educational attainment on income. An accompanying R package, napkincausal, implements our methods.

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