Cigarettes with ultralow nicotine levels are now being called the game-changer in the fight against smoking. If you are having trouble in quitting smoking, then, it is for you, that soon the Biden White House is expected to formally propose a plan that will order cigarette nicotine levels to be reduced, reports The Washington Post. For now though, it has been a failure, as these cigarettes, also known as VLN cigarettes that stands for very low nicotine are only available in 5,100 stores in 26 states. This is a very small fraction of the overall market for cigarettes. The company that makes it, 22nd Century, is struggling not because of the low supply, but also from the advocates who have long believed slashing nicotine levels altogether.

The Advent and ideation

Nicotine is a chemical that is produced naturally from tobacco that makes the cigarette and also keeps people hooked. While it is believed that it makes people alert, and get the "hit" to keep them going, it exposes the users to harmful substances, carcinogens, and increases the risk of heart disease, lung cancer, and other illness.

Ultralow-nicotine cigarettes, like the VLN brand, contain about 95% less nicotine than the regular cigarettes. The idea is quite simple: without the addictive grip of nicotine, smokers will find it easier to quit. Research too has shown some promise. For instance, the studies funded by the National Institute on Drug Abuse revealed that very low nicotine cigarettes reduced addiction potential significantly without having users to increase their smoking frequency. However, the problem is, why would anyone choose for a low-nicotine that does not make them feel the same way, when the high-nicotine cigarette is right next to it, making them feel the same way, with the same alertness, sold at the same price.

“It’s very hard to imagine someone actively choosing to continue to use a low-nicotine product for the same price when a high-nicotine product is right next to it,” said Eric Donny, a Wake Forest University School of Medicine nicotine researcher.

No wonder, the experiment with low nicotine product by Philip Morris' Next cigarettes in the 1980s and Vector Tobacco's Quest brand in the early 2000s, flopped.

FDA's Role in the Push

The Food and Drug Administration (FDA) has supported the development of such products, even allowing VLN cigarettes to be marketed as lower-risk options. However, these products remain a niche market, available in only a fraction of U.S. stores.

Recently, the Biden administration has considered a bold step—mandating a dramatic reduction in nicotine levels for all cigarettes sold in the United States. Supporters believe this move could save millions of lives, while critics, including tobacco companies, warn of potential unintended consequences.

What Could Be The Challenges?

Resistance from Big Tobacco Companies: They could argue that slashing nicotine levels could backfire. Their claim is, smokers will turn to black markets or smoke more to satisfy their cravings, which may lead to greater exposure to harmful substances.

Consumer Reluctance: History is proof to the instances of smokers being hesitant to embrace the low-nicotine products.

Political Hurdle: It may face political roadblocks, as under the Trump administration, plans to cut nicotine were shelved.

Could Low-Nicotine Cigarettes Be The Solution?

Advocates believe that ultralow-nicotine cigarettes could be a game-changer, comparing them to decaf coffee or non-alcoholic beer—products that reduce harm while offering a similar experience.

Some experts warn that a black market for traditional cigarettes could undermine these efforts. They also stress the need for safer alternatives, such as vaping products, to support smokers transitioning away from traditional cigarettes.

India’s Ministry of Health and Family Welfare (MoHFW) has released the National Family Health Survey-6 (NFHS-6), showing major improvements in maternal healthcare, nutrition, immunization, and family planning across the country.

The nationwide survey, which covered nearly 6.79 lakh households across 715 districts, highlighted stronger healthcare access and improved outcomes for women and children in the country.

Key Findings of NFHS-6

The NFHS-6 was conducted during 2023-24 by MoHFW with the International Institute for Population Sciences (IIPS), Mumbai as the nodal agency.

Maternal Care

NFHS-6 recorded notable gains in maternal and child healthcare services nationwide. Nearly 96 per cent of pregnant women received antenatal care (ANC), while mothers receiving ANC during the first trimester increased from 70.0 per cent to 76.2 per cent.

The percentage of mothers receiving at least four ANC visits also rose from 58.5 per cent to 65.2 per cent, reflecting improved continuity of maternal healthcare services.

Institutional deliveries increased from 88.6 per cent to 90.6 per cent, bringing India closer to universal institutional delivery coverage.

Maternal nutrition indicators also improved significantly. Women consuming iron folic acid supplements for 100 days or more during pregnancy increased from 44.1 per cent to 54.9 per cent. Those consuming supplements for 180 days or more rose from 26.0 per cent to 37.8 per cent.

Family Planning

India’s Total Fertility Rate (TFR) remained stable at 2.0, while the Contraceptive Prevalence Rate (CPR) increased from 66.7 per cent to 69.1 per cent.

The findings reflect improved access to family planning services and the continued impact of government programs, including Mission Parivar Vikas.

Child Immunization

India also recorded progress towards universal immunization coverage. Full vaccination coverage among children aged 12-23 months increased from 83.8 per cent to 87.1 per cent based on vaccination cards.

More than 95 per cent of children received vaccinations through public health facilities, highlighting continued trust in the public healthcare system.

Coverage of major vaccines improved significantly. Rotavirus vaccination coverage surged from 36.4 per cent to 85.4 per cent, while coverage of the second dose of measles-containing vaccine increased from 58.6 per cent to 71.8 per cent.

The survey also found improvement in child health indicators. Symptoms of acute respiratory infection (ARI) among children declined from 2.8 per cent to 1.9 per cent, while severe diarrhea prevalence fell to 0.5 per cent.

The gains were attributed to stronger last-mile healthcare delivery, improved cold chain systems, digital tracking through U-WIN, and active community participation under the Universal Immunization Program.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

Child Nutrition Outcomes

NFHS-6 also reported encouraging progress in child nutrition indicators. More than 95 per cent of children under six months were breastfed during the survey period. The percentage of children breastfed within one hour of birth increased from 41.8 per cent to 50.1 per cent.

Stunting among children under five years declined sharply from 35.5 per cent to 29.3 per cent, indicating improvement in long-term nutritional outcomes.

Severe wasting declined from 7.7 per cent to 5.2 per cent, while underweight prevalence among children under five registered a marginal decline from 32.1 per cent to 31.8 per cent.

Infant and young child feeding practices also improved. Children aged 6-8 months receiving solid or semi-solid food along with breastmilk increased from 45.9 per cent to 59.5 per cent.

Amid the ongoing deadly Ebola outbreak, the World Health Organization (WHO) has identified experimental treatments and vaccine candidates for the Bundibugyo strain, which currently has no approved vaccine or antiviral treatment.

The global health agency convened several expert and advisory groups and recommended prioritizing treatment of Bundibugyo cases with:

• Mapp Biopharmaceutical's MBP134
• Regeneron’s maftivimab
• Gilead Sciences’ antiviral remdesivir

In addition, the WHO also advised evaluating combination therapy using a monoclonal antibody together with remdesivir.

The advisory groups recommended that all identified products should be used exclusively within clinical trials to generate robust data and ensure safe, ethical, and effective research.

Preventive Therapies, Vaccine Candidates

Beyond treatment, the WHO also proposed therapies for the prevention of Bundibugyo cases.

• For post-exposure prophylaxis among contacts of confirmed and probable cases, the oral antiviral obeldesivir was identified as a priority candidate.

• The expert groups also identified the single-dose rVSV Bundibugyo vaccine, being developed by the International AIDS Vaccine Initiative (IAVI), as the most promising vaccine candidate.

The development of the vaccine is expected to take approximately 7–9 months before it can be assessed through clinical trials for its ability to prevent Bundibugyo disease (BDV).

• Another vaccine candidate, ChAdOx1 Bundibugyo — being developed by Oxford University and the Serum Institute of India — could potentially become available within 2–3 months for efficacy assessment through a clinical trial. However, additional animal data are still required to support and confirm further prioritization.

• The experts also reviewed the potential role of Merck's Ervebo, the only licensed Ebola vaccine currently available.

The WHO stated that Ervebo should not be used outside carefully designed research settings so that its performance against Bundibugyo disease can be properly assessed.

Meanwhile, Regeneron said in a statement that supplies of maftivimab are already available in the Democratic Republic of Congo, if the WHO decides to utilize the treatment immediately or include it as part of additional studies.

Read More: Donald Trump Says Health Check-Up Went 'Perfectly'

Russian Vaccine For New Strain

Meanwhile, Russia has claimed that its scientists have developed a novel vaccine against a new Ebola strain.

According to Russian Health Minister Murashko, "the vaccine may also protect against the rare Bundibugyo strain linked to the current outbreak in the DR Congo".

It is because the "genetic similarity between this virus variant and the vaccine strain is about 60-70%," Alexander Gintsburg, scientific director of the Gamaleya National Center of Epidemiology and Microbiology, was quoted as saying GxP News.

The rare Bundibugyo strain has so far caused over 900 cases and more than 200 deaths in the Democratic Republic of the Congo and Uganda.

Ahead of World No Tobacco Day (WNTD) 2026, India has launched the pilot phase of the Tobacco-Free Educational Institutions (ToFEI) Application.

Union Health Secretary Punya Salila Srivastava today launched the application under the National Tobacco Control Programme (NTCP) at Kartavya Bhawan, reaffirming India’s commitment towards protecting present and future generations from the devastating health, social, economic and environmental consequences of tobacco and nicotine addiction.

The pilot project will be rolled out in three states — Rajasthan, Meghalaya, and Maharashtra. It is expected to help assess operational feasibility, strengthen implementation and reporting mechanisms, and inform future nationwide expansion of the platform.

What Is ToFEI?

ToFEI guidelines are a set of standards established by the government to protect minors from tobacco addiction. It requires campuses to display warning signage, assign tobacco monitors, maintain a 100-yard tobacco-free zone, and regularly organize awareness activities.

The digital application of ToFEI is aimed at strengthening the implementation and monitoring of these tobacco-free norms across schools and colleges in the country.

Also read: Herbal Cigarettes Not Safe, Found High In Fine Particles And Lead: Study

The application will facilitate:

• Self-assessment and reporting by educational institutions
• Monitoring of compliance with ToFEI guidelines
• Implementation of tobacco control signage requirements
• Prohibition of the sale of tobacco products within 100 yards of educational institutions
• Awareness and sensitization activities for students and teachers
• Strengthening enforcement of tobacco-free campus measures

SOP for Tobacco Product Sample Collection

The government also released the Standard Operating Procedure (SOP) for Sample Collection of Tobacco Products, aimed at strengthening surveillance, regulatory compliance, and quality assurance related to tobacco products.

The SOP provides standardized procedures for:

• Collection
• Handling
• Storage
• Transportation
• Documentation of tobacco product samples.

Also read: Global Temperatures Likely To Stay Near Record Levels For Next Five Years: WMO

“Tobacco and nicotine products are often designed and marketed in ways that make them appear attractive, particularly to youth, through appealing flavors, packaging, surrogate advertising, and portrayals on social media and digital platforms,” Srivastava said.

The Union Health Secretary further stated that tobacco use contributes significantly to cancers, cardiovascular diseases, stroke, chronic respiratory illnesses, and several other non-communicable diseases (NCDs), which account for a major proportion of mortality and disability in the country.

Highlighting India’s continued leadership in advancing evidence-based tobacco control policies, she noted that over 2,000 Tobacco Cessation Centers have been established across the country in district hospitals, medical colleges, dental colleges, AYUSH institutions, NCD clinics, and other healthcare facilities.

She also emphasized the importance of encouraging educational institutions and campuses to adopt and sustain tobacco-free practices.

Tobacco Prevalence In India

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India is the world’s second-largest consumer and producer of tobacco. A variety of tobacco products are available at very low prices across the country.

Nearly 267 million adults aged 15 years and above in India — around 29 per cent of all adults — use tobacco, according to the Global Adult Tobacco Survey India 2016-17.

The most prevalent form of tobacco use in India is smokeless tobacco, with commonly used products including khaini, gutkha, betel quid with tobacco, and zarda. Smoking forms of tobacco include bidi, cigarettes, and hookah.