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.

The US Food and Drug Administration (FDA) has announced nationwide recalls of two blood pressure medications over concerns about excess drug levels and manufacturing quality failures.

The recalls involve combination medications prescribed to manage hypertension. The FDA cited concerns that one medication may contain more of an active ingredient than specified, while the other failed quality tests that assess how quickly the drug dissolves in the body.

Which Blood Pressure Medications Have Been Recalled?

Also read: US FDA Recalls India-Made BP Drug For The Second Time In 3 Months: Here's Why

1. Viatris blood pressure medication: 21,620 bottles recalled

The FDA has announced a Class III recall of Viatris Inc.'s combination telmisartan and amlodipine tablets because they may contain more telmisartan than specified.

The Class III recall means the use of the affected product is not likely to cause adverse health consequences.

The FDA did not specify how much additional telmisartan the tablets may contain. However, the National Library of Medicine warns that an overdose of this medication could cause low blood pressure, dizziness or a rapid heart rate.

In total, 21,620 bottles of the medication have been recalled.

The recall covers 30-count bottles of telmisartan and amlodipine tablets (40 mg/5 mg) with the following lot codes:

• Lots 3228113, 3228114 and 3228115, with an expiration date of October 31.
• Lots 3228120 and 3228121, with an expiration date of November 30.

2. Macleods Pharmaceuticals blood pressure medication: 3,744 bottles recalled

The FDA has also recalled 3,744 bottles of another combination blood pressure medication manufactured by Macleods Pharmaceuticals.

The company first initiated the recall on October 7 over "failed dissolution specifications." This means the medication may not release its active ingredients at the required rate after being taken.

If a drug does not dissolve properly, its active ingredients may not be absorbed as intended, potentially affecting its effectiveness. In this case, the medication may not lower blood pressure as expected.

On October 26, the FDA classified the recall as Class II. This means using the affected product may cause temporary or medically reversible adverse health consequences, although serious health problems are unlikely.

The recall covers:

• Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide Tablets (40 mg/10 mg/12.5 mg), 30-count: 3,528 bottles; NDC 33342-246-07; lot number 12251163A; expiration date May 31, 2027.
• Olmesartan Medoxomil, Amlodipine and Hydrochlorothiazide Tablets (40 mg/10 mg/12.5 mg), 90-count: 216 bottles; NDC 33342-246-10; lot number 12251163B; expiration date May 31, 2027.

Read More: Mounjaro, Zepbound Ingredient Recalled In US Over Sterility Concerns

What Should You Do If You Have The Recalled Medication?

The FDA advises patients not to stop taking their medication without consulting their healthcare provider, as abruptly discontinuing blood pressure treatment may pose additional health risks.

If you have any of the affected products, contact your doctor or pharmacist for guidance on whether you should continue taking them or switch to an alternative.

For the Macleods Pharmaceuticals medication, the FDA did not issue a separate news release. Its enforcement report states that letters were sent to notify businesses and individuals who may have the affected products.

Patients should consult their healthcare provider before making any changes to their medication routine.

A child recently died in Lewis County amid an ongoing measles outbreak, marking New York state's first measles-related death in more than 30 years. The New York State Department of Health and Lewis County Public Health confirmed the death in a joint statement on November 2.

Officials did not release more information about the child or the circumstances surrounding the death to protect the family's privacy.

The death comes as measles cases continue to rise across the United States. New York had recorded 178 cases in 2026 as of October 24, including eight in New York City, according to health officials.

Last month, Governor Kathy Hochul declared a state disaster emergency. The order gave registered nurses the authority to order specimen collection and testing for measles cases.

US Reports More Than 4,800 Measles Cases In 2026

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

The outbreak in New York is part of a wider resurgence of measles across the country. The US Centers for Disease Control and Prevention (CDC) reported 4,852 confirmed cases as of October 29, 2026, the highest annual total since 1991.

In an exclusive interview with HealthandMe, Dr Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, said that the reported number of measles cases in the US could underestimate the actual scale of transmission. “You can assume that's off by a factor of at least five."

The CDC said 96% of confirmed cases this year were linked to outbreaks. It has also reported that at least 96% of cases have occurred among people who were unvaccinated.

Declining vaccination coverage has contributed to the growing measles transmission. During the 2025-2026 school year, 92.4% of US kindergarteners had received the measles, mumps and rubella (MMR) vaccine, below the 95% coverage level generally needed to maintain community protection.

When Can Measles Become Life-Threatening?

Also read: 'It’s The Best-Studied Vaccine In Human History': Former CDC Adviser Busts Common Myths About COVID Vaccines

Measles is a highly contagious viral infection that spreads through the air when an infected person coughs or sneezes. The virus can remain infectious in the air for up to two hours after an infected person has left a space.

Early symptoms include high fever, cough, runny nose and red, watery eyes. Small white spots called Koplik spots may appear inside the mouth, followed by a rash that begins on the face and spreads down the body.

While many people recover, measles can cause serious complications, including pneumonia and encephalitis, or inflammation of the brain. These complications can lead to hospitalisation and, in some cases, death. Young children, pregnant women and people with weakened immune systems are vulnerable to the illness.

MMR Vaccine Is The Best Protection Against Measles

The CDC recommends two doses of the MMR vaccine. The first is given between 12 and 15 months of age, while the second is recommended between four and six years.

One dose is approximately 93% effective against measles infection, while two doses are about 97% effective, according to the CDC.

Infants aged six to 11 months who live in or are travelling to areas with a high risk of measles exposure may be advised to receive an early dose. However, this dose does not replace the two routine doses recommended after the child's first birthday..

The US Food and Drug Administration (FDA) has granted tentative approval to Dr. Reddy's Laboratories for the first generic version of lenacapavir, a long-acting injectable for HIV prevention. The development raises hopes of making HIV prevention more affordable in 120 low- and middle-income countries, including India.

The approval is considered “tentative”, the FDA’s standard designation for generics while the originator remains under patent.

The development comes just 16 months after Gilead Sciences received approval for its original product, marking one of the fastest timelines for a major HIV innovation.

Lenacapavir is the first twice-yearly injectable pre-exposure prophylaxis (PrEP) option for HIV prevention. Dr. Reddy's generic injection is expected to cost US$40 per person annually across the 120 eligible countries, with initial supplies expected by the end of 2026.

Calling it “a moment of immense pride”, Deepak Sapra, Chief Executive Officer, API and Services, at Dr. Reddy's, said the FDA approval validates the company's efforts to expand access to twice-yearly HIV prevention across low- and middle-income countries.

Also read: South Africa Receives 1st Batch Of HIV Prevention Medicine Lenacapavir

Dr Reddy's First Of 6 Generic Drugmakers To Get FDA Nod

In October 2024, Gilead Sciences signed voluntary licensing agreements with six generic manufacturers to produce and supply low-cost versions of lenacapavir in 120 low- and middle-income countries.

The six manufacturers are:

• Dr. Reddy's Laboratories (India)
• Emcure Pharmaceuticals (India)
• Hetero Labs (India)
• Eva Pharma (Egypt)
• Ferozsons Laboratories (Pakistan)
• Mylan (a subsidiary of Viatris)

Dr. Reddy's is the first among the six licensees to receive tentative US FDA approval. The other five companies are at various stages of product development, bioequivalence testing and regulatory filing.

What Will Cheaper Lenacapavir Mean For India?

At its August 11, 2026, meeting, the Indian drug regulator's Subject Expert Committee recommended waiving local Phase III clinical trials and bioequivalence studies for generic injectable lenacapavir applications submitted by Dr. Reddy's and Emcure Pharmaceuticals for PrEP.

The proposed price of approximately US$40 per person annually could make twice-yearly HIV prevention more accessible.

However, this is an indicative price for generic supplies, not a confirmed retail price in India. The eventual Indian price will depend on regulatory approval, manufacturing costs, supply capacity, competition and distribution.

Read More: Exclusive With Leading HIV Expert: What's Driving Rising HIV Cases Among India's Youth And How To Prevent It

What Does The Approval Mean For HIV Prevention?

Generic lenacapavir could offer people at risk of HIV an alternative to daily oral PrEP pills. Its twice-yearly dosing may help those who struggle with daily medication adherence or face stigma and barriers to healthcare access.

“For someone at risk of HIV, taking a pill every day to prevent a disease they do not have is a hard thing to ask. Two injections a year of a product that is almost 100% effective at preventing HIV changes that entirely.”

“Generic lenacapavir has the potential to transform HIV prevention, and this is a significant milestone, but an affordable drug alone is not enough,” said Professor Saiqa Mullick, Director of Implementation Science at Wits RHI, University of the Witwatersrand, which partnered with Dr. Reddy's.

Lenacapavir: How Does It Work?

Lenacapavir is a long-acting antiretroviral drug developed by Gilead. For HIV prevention, it is administered as two injections in the abdomen, providing protection for six months.

People must test negative for HIV before receiving it. The drug does not treat existing HIV infections or prevent other sexually transmitted infections.

Two major clinical trials demonstrated its high efficacy. In one study involving adolescent girls and young women in South Africa and Uganda, there were zero new HIV infections among participants who received lenacapavir. A second trial involving gay men and gender-diverse individuals also demonstrated high efficacy with twice-yearly injections.