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.

A US doctor infected with the Ebola virus, while treating patients infected with the deadly disease in Democratic Republic of the Congo has been admitted to Berlin's Charité hospital today.

The German Health Ministry acquiesced to a request from the United States for the patient to be treated in Germany rather than the United States due to the shorter travel time from Uganda and the Charité's experience in dealing with Ebola, Deutsche Welle reported.

The patient was flown to Berlin on a special medical aircraft and was then driven to the hospital in a specially designed vehicle escorted by police. The aircraft also carried six other people with whom the infected man had contact.

The German Health Ministry has reassured the public that there is no danger of the deadly virus spreading to the general population.

The Charité hospital specializes in the treatment of such cases and the patient is being housed in a completely isolated ward, separate from the rest of the clinic, the report said.

The German Health Ministry, however, noted that the mortality rate following modern treatment and specialist monitoring at a clinic like Berlin's Charité drops from around 60 per cent to 20 per cent-30 per cent.

Ebola Cases Rise To Over 130: WHO Considers Use Of Experimental Vaccines

Also read: UK Scientists Begin Drug Trial To Mend Broken Heart Syndrome

Tedros Adhanom Ghebreyesus said there had been at least 500 suspected cases of Ebola and 130 suspected deaths due to the Bundibugyo strain in DR Congo since the new outbreak began in April.

Global health leaders are also considering whether vaccines or medicines still in development could be used to fight Ebola. Dr Mesfin Teklu Tessema, senior director of health at the International Rescue Committee, which works in the DRC’s Ituri Province, where most cases have been reported, told the The Guardian he expected current known cases were “the tip of the iceberg”.

Spread across the porous border to South Sudan, he said, was probably “a matter of when”. He warned that a weak public health infrastructure there meant “we are actually flying blind”.

A WHO official in Ituri province said the outbreak could take a long time to bring under control.

“I don’t think that in two months we will be done with this outbreak,” Anne Ancia, the WHO’s representative for the DRC, told reporters in Geneva at the World Health Assembly, pointing to a recent Ebola outbreak that took two years to end. Nearly 2,300 people died between 2018 and 2020 in the deadliest outbreak in the DRC to date.

“At the international level, [we are] looking at what candidate vaccines or treatment are available and if any could be of use in this outbreak,” Ancia added.

Australia has seen more than 220 cases of diphtheria so far this year, the biggest outbreak of the disease since national records began in 1991.

The Northern Territory has the largest number of positive cases at 133, followed by 82 in Western Australia, six in South Australia, and fewer than five in Queensland.

In response to the outbreak, the federal and state governments have mobilized, and the Commonwealth is preparing a support package to bolster vaccination rates for a disease once considered almost eradicated, ABC News reported.

Authorities are also waiting on the outcome of an investigation into a reported diphtheria-related death in the NT, which would be the first death from the disease in almost a decade.

Federal health minister Mark Butler said the numbers were “very concerning.”

“To put that in context, we've been recording case numbers nationally for about 35 years, and this, by a very big distance, is the biggest outbreak of diphtheria we've ever seen,” he said.

The cases are rising amid falling vaccination rates on the continent.

“I want to say this is not just very serious in terms of its numbers, but the vast majority of new cases we're seeing are respiratory diphtheria, which is far more serious in terms of its potential — about 25 per cent of cases are being hospitalized,” Butler said at a press conference on the NSW Central Coast.

Also read: US Doctor With Ebola Admitted To Hospital In Germany

2 Different Diphtheria Strains Identified

Two strains of diphtheria have been identified in Australia: respiratory and cutaneous. While respiratory diphtheria can affect the nose, throat, and airways, cutaneous affects the skin, causing pus-filled blisters on the skin or large ulcers surrounded by red, sore-looking skin.

The respiratory strain also spreads through droplets from coughing or sneezing, or direct contact with infected wounds.

Even with treatment, one in 10 people with respiratory symptoms die, according to the Australian CDC.

What Is Diphtheria?

As per the World Health Organization (WHO), diphtheria is a disease caused by the Corynebacterium diphtheriae bacterium that affects the upper respiratory tract and, less often, the skin. It also produces a toxin that damages the heart and the nerves. While it is a vaccine-preventable disease, multiple doses are needed to produce and sustain immunity.

Diphtheria has remained a leading cause of childhood death globally. But vaccination has long prevented mortality among children.

Those who are not immunized remain at risk. WHO also mentions that diphtheria can be fatal in 30 per cent of cases, with young children at higher risk of dying if they are unvaccinated and are not receiving proper treatment.

In 2023, an estimated 84 per cent of children worldwide received the recommended 3 doses of diphtheria-containing vaccine during infancy, leaving 16 per cent with no or incomplete coverage.

According to Australia’s Department of Health and Aged Care, between 1926 and 1935, more than 4,000 Australians died from diphtheria.

Vaccination started in Australia in the 1930s, and the disease has rarely been seen since the 1950s. But vaccine coverage has waned since the COVID pandemic, leading to a rising number of cases.

Diphtheria: Signs And Symptoms

Read More: UK Scientists Begin Drug Trial To Mend Broken Heart Syndrome

Within 2 to 5 days after exposure to the bacteria. The symptoms include

• a sore throat,
• fever,
• swollen neck glands,
• weakness.

Diphtheria: How the Disease Is Treated

It is usually treated with diphtheria antitoxin as well as antibiotics. Antitoxin neutralizes the circulating toxin in the blood. Antibiotics stop bacterial replication and thereby toxin production, speed up getting rid of the bacteria, and prevent transmission to others.

How To Prevent Diphtheria

Diphtheria can be prevented by vaccines and routine immunization. The vaccine is given most often combined with vaccines for diseases such as tetanus, pertussis, Hemophilus influenzae, hepatitis B, and inactivated polio.

Cholesterol is not all that bad as long as it is in the right proportion. It is of two types — good and bad cholesterol, the former being HDL and the latter LDL. It is a fatty substance in the blood that is made of essential proteins. While several tests are conducted to ascertain cholesterol levels in the body, there are some types of cholesterol that are not usually detected during routine check-ups. It turns out that this hidden form of cholesterol can quadruple the risk of stroke and heart attack, even if everything else is done right. This form of cholesterol is known as lipoprotein(a), or Lp(a) — it carries fats and proteins in your blood.

How does lipoprotein(a) affect heart patients?

Experts note that roughly 20 per cent of people have high Lp(a). It is similar to LDL, which is often known as bad cholesterol. However, there is a protein known as apolipoprotein(a) that makes Lp(a) twice as harmful. The extra protein leads to plaque build-up that eventually clogs arteries, thereby raising the risk of blood clots.

Both factors mean that someone is more likely to suffer from a stroke or heart disease. Recent research from the National Institutes of Health (NIH), which evaluated blood samples from 20,000 adults aged 40 and above, noted that those with the highest Lp(a) levels were about 30 per cent more prone to suffering a major heart event. These participants were also 50 per cent more likely to die from heart disease and 65 per cent more likely to suffer a stroke.

What are the consequences of high Lp(a) levels?

Researchers found that higher levels of Lp(a) were linked to a higher risk of a heart attack. However, these links were stronger in people who had already suffered from heart disease. Experts also found that one can quantify the specific levels of Lp(a) that can lead to a heightened risk of a major heart event, such as a stroke or heart failure. Researchers noted that, regardless of age, patients can opt for low-cost blood tests to determine their risk of genetic conditions. Lp(a) is not regularly checked in a standard cholesterol test. Instead, experts rely on a specific test to spot this condition.

Should you get Lp(a) levels checked?

According to the British Heart Foundation, it is important to get Lp(a) levels checked if someone in your family has high levels of it, or if there is a family history of coronary heart disease at an early age. The study’s findings also suggest that patients dealing with high Lp(a) levels need aggressive management of heart disease risk factors. If detected, you must work on a routine religiously to lower LDL and manage risk factors as much as possible. Lp(a) in the blood is determined by genes. However, according to researchers at the University of Queensland, other risk factors are:

1. Hypertension
2. High LDL
3. Diabetes
4. Not exercising enough
5. Unhealthy diet
6. Smoking

The good news, however, is that Lp(a) levels can be reduced with the help of drugs available on the market. In early clinical trials, drugs developed by Eli Lilly and Novartis lowered Lp(a) levels by 80–90 per cent. Combining this with a healthy diet and lifestyle can go a long way in the process.