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.

You can exercise regularly, eat reasonably well and have no obvious symptoms — yet still have plaque building up inside your arteries.

The process called atherosclerosis is often slow and silent, with symptoms appearing only after plaque significantly affects blood flow — sometimes with a heart attack or stroke.

A study published earlier this month in The New England Journal of Medicine (NEJM) found that plaque buildup can begin decades before symptoms appear. Researchers detected atherosclerosis in many apparently healthy young adults, including those in their 20s.

Atherosclerosis Can Start Decades Before Symptoms

The NEJM study showed that signs of hidden atherosclerosis could be detected in approximately one in 13 people aged 18–29. Among those aged 60–70, nine out of 10 showed signs of atherosclerosis.

Dr. Robert Grant, St. George’s University School of Medicine, Grenada, West Indies, told HealthandMe that the most important message is that atherosclerotic cardiovascular disease often begins decades before symptoms appear. Heart attacks and strokes are usually late manifestations of a process that develops gradually over many years.

“Atherosclerosis is not exclusively a disease of older adults. Clinical complications remain predominantly diseases of older adults. The pathological process often starts much earlier than the clinical disease becomes evident," he said.

The study therefore shifts our thinking from "atherosclerosis is an old-age disease" to "atherosclerosis is a lifelong disease that becomes clinically important with advancing age," he added.

Can Exercise And A Healthy Diet Protect?

Regular exercise, a healthy diet, avoiding smoking, maintaining a healthy weight, and good sleep remain important preventive measures, said Dr. Robert.

“These habits lower LDL cholesterol, improve blood pressure, reduce inflammation, improve insulin sensitivity, and substantially reduce cardiovascular event rates," he said. “They are foundational and should not be minimized.”

However, healthy lifestyles do not guarantee the absence of atherosclerosis. Other risk factors include:

• Genetic predisposition and family history
• Elevated lipoprotein(a) [Lp(a)]
• Insulin resistance or diabetes
• Previously elevated LDL levels during earlier life
• Hypertension that has gone undetected or untreated

Dr. Rajat Mohan, Senior Consultant Cardiologist at Sir Ganga Ram Hospital, also stressed that people who exercise and eat in moderation can still develop coronary disease because of other risk factors, including genetic tendencies.

He also emphasized the need to check cholesterol levels and avoid smoking.

Why Indians May Be More Vulnerable

Coronary artery disease has a high burden in the Indian population, with diabetes, family history, smoking and tobacco use among the factors contributing to risk, Dr. Rajat told HealthandMe.

"Diabetes is a precursor for developing coronary artery disease," he said.

Dr. Ramakanta Panda, renowned cardiac surgeon and Chairman, Asian Heart Institute, Mumbai, also pointed to studies suggesting greater vulnerability to early atherosclerosis among Indians.

Referring to the INTERHEART study, he said that Indians get their first heart attack 5-6 years earlier than people from other regions, and a UK study found double the risk compared with Europeans.

Can Normal Cholesterol And Blood Pressure Be Reassuring?

“Yes. The "normal" LDL range is not truly safe for arteries. In US adults without traditional risk factors, coronary atherosclerosis rose from 13.2% when LDL-C was below 70 mg/dL to 48.2% when it was 160 mg/dL or higher. Non-HDL cholesterol and apoB showed similar associations," Dr. Ramakanta told HealthandMe.

He added that beyond standard readings, doctors should consider:

• apoB and lipoprotein(a)
• HbA1c and insulin resistance
• Waist circumference and fatty liver
• hsCRP
• Premature family history
• Kidney disease and pregnancy complications
• Where appropriate, calcium scoring

Should Screening Be Universal?

Dr. Ramakanta said that mass screening has not been shown to reduce death rates significantly. However, targeted screening or testing can be helpful. For an apparently healthy person with no symptoms, a sensible approach is:

• Blood pressure
• Fasting glucose/HbA1c
• Lipid profile, particularly LDL
• Weight/BMI and waist circumference
• Smoking/tobacco, physical activity, diet and family history of premature heart disease
• Assess the person’s overall cardiovascular risk and treat modifiable risk factors accordingly

"The ESC specifically recommends systematic risk assessment in people without known cardiovascular disease. I would not recommend routine ECG, treadmill testing, echocardiography, or coronary CT for every asymptomatic individual unless they have risk factors.”

With the onset of winter, Delhi sees a sharp deterioration in air quality, exposing people across age groups to health risks including respiratory problems and eye irritation, among others.

Ahead of the season, the Delhi government has announced 10 interventions targeting major pollution sources, including vehicles, dust, waste and industrial emissions.

“Delhi Clean Air Action 2026 puts 10 focused interventions at the heart of the fight against pollution, targeting key sources from vehicles and dust to waste and industrial emissions. Cleaner air is a shared goal,” Delhi Chief Minister Rekha Gupta said in a post on X.

“We urge every Delhiite to join this effort through active Jan Bhagidari. Every responsible action counts towards a cleaner, healthier Delhi,” she added.

The measures were discussed during a review meeting with the Commission for Air Quality Management (CAQM) and the Delhi Pollution Control Committee (DPCC).

Also read: World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?

What Are The 10 Interventions?

The key measures undertaken include:

1. No PUCC, No Fuel

Enforcement at all 500 ANPR-enabled fuel stations, backed by a city-wide awareness campaign.

2. Public Transport First

Delhi Metro Sarthi App campaign from October 1–10; last-mile connectivity at all 228 Metro stations. Bus fleet: 6,840, including 5,088 e-buses.

3. Hotspot Action

42 of 50 pollution hotspots addressed, with traffic decongestion measures planned for the remaining areas.

4. Dust Control

1,193 km of roads redeveloped; remaining work targeted by November 15. Footpath paving and faster complaint resolution also planned.

5. No Open Waste Burning

Ward-level monitoring and stronger waste collection; 98 MRSMs, up from 76 last year. Dedicated monitoring teams by October 15.

6. Greening Drive

71 lakh plantations completed; 433 of 434 acres of identified brown areas greened.

7. Construction Waste Control

Malba App registration to be mandatory for building-plan approvals. Construction restrictions begin November 1, followed by a complete ban from December 10 to January 20.

8. Winter Protocol

Doubled parking charges, staggered office timings and 50% work-from-home. Restrictions on non-Delhi, below-BS-VI vehicles from November 1, except CNG and EVs.

9. EV Push

Higher incentives for scrapping old vehicles and registration drives under the Parivartan Scheme.

10. Industrial Pollution

Monitoring stations to rise from 47 to 60, with 334 enforcement teams and an AI-enabled Command and Control Centre.

Read More: Can Air Pollution Raise Suicide Risk? Study Finds A Possible Link

Why Does Delhi’s Air Quality Worsen In Winter?

Delhi-NCR’s air quality deteriorates during the colder months as emissions combine with unfavorable weather conditions.

According to CAQM, falling wind speeds, shallow atmospheric mixing, fog and low temperatures reduce the dispersion of pollutants, allowing particulate matter to accumulate near the ground.

How Does Air Pollution Affect Health?

Air pollution contains tiny particles such as PM2.5 and PM10, along with gases including nitrogen dioxide from vehicle exhaust, sulfur dioxide from industrial emissions and carbon monoxide.

PM2.5 is of particular concern because these extremely small particles can penetrate deep into the lungs and, after entering the bloodstream, trigger inflammation and affect other organs.

The health effects of air pollution go beyond respiratory symptoms such as coughing, wheezing and breathing difficulties. Long-term exposure has been linked to a higher risk of heart disease, stroke, lung cancer, diabetes and chronic respiratory diseases. Exposure during childhood can also affect lung development and respiratory health.

Reducing exposure to polluted air remains important, particularly during periods of poor air quality. A balanced diet and adequate nutrition can also support overall health, although nutrition cannot replace measures to reduce exposure to air pollution.

Red Bull got relief after Delhi High Court overturned a Food Safety and Standards Authority of India (FSSAI) order that instructed the Austrian beverage giant to drop its ‘energy drink’ label. In a recent ruling, the court made its decision after it found that the Indian food regulator did not give sufficient time to the company to present its case.

While the legal fight between the food regulator and the billion-dollar beverage giant boils down to just two words on a can, the health question is much bigger: What does drinking an energy drink like Red Bull actually do to the body?

FSSAI Vs Red Bull

FSSAI had said India does not have a notified food standard specifically defining an “energy drink”, objecting to brands like Red Bull making claims like boosting energy or enhancing focus.

The regulator's concerns also included linked to what these beverages actually contain, particularly excessive caffeine, sugar, and other controversial ingredients like taurine.

The biggest concern that the lawsuit is built upon is what causes the sudden surge of ‘energy’ after someone consumes this drink. Is it giving your body useful energy?

Also read: High Sugar, Salt Or Fat? India May Mandate Red Hexagon Labels On Food Packs

Red Bull’s Ingredients And What It Does To Your Body

Caffeine

One of the main ingredients responsible for the immediate feeling of energy alertness is caffeine. Caffeine stimulates the central nervous system, making you feel more awake and less tired. But that boost does not mean the drink is providing the body with sustained energy in the nutritional sense.

Depending on the product, energy drinks can also contain substantial amounts of added sugar, which adds calories but does not make the drink healthier.

The caffeine content of energy drinks varies considerably. The US FDA notes that energy drinks can contain roughly 41 to 246 mg of caffeine per 12 fluid ounces, depending on the product.

The energy boost claim may comes from the caffeine content, which is what consumers should be mindful about. Too much caffeine can lead to faster heartbeat, palpitations, increased blood pressure, anxiety, jitters, headaches, nausea and sleep disruption. For most healthy adults, the FDA cites 400 mg of caffeine a day.

Also read: Every Extra 100g Ultra-Processed Food Linked To 14% Higher Heart Risk, 11% Higher BP Risk

Energy drinks can also temporarily increase blood pressure and cardiovascular load. A 2024 review and meta-analysis of randomised trials found that energy drinks acutely increased systolic and diastolic blood pressure in healthy adults.

Excess caffeine in young people can cause palpitations, increased heart rate and blood pressure, anxiety, sleep problems and digestive symptoms. Therefore, the FDA and medical experts advise against energy drinks for children and teenagers.

This is also why energy drinks have attracted regulatory restrictions worldwide. England, for example, plans to prohibit their sale to under-16s from April next year.

Sugar

The sugar content is another reason to be careful about how often you drink energy drinks. Regular and frequent consumption of high amounts of added sugar, through liquid calories like energy drinks, can increase overall calorie intake and contribute to weight gain and obesity.

Over time, excess sugar intake is also linked with a higher risk of metabolic problems like type 2 diabetes and fatty liver disease. For people who regularly consume these energy drinks, the concern is therefore not just the caffeine, but also how much added sugar they are consuming with each can.

Taurine

HealthAndMe previously reported that taurine may help fuel the growth of certain leukaemia cells. The research raised questions about taurine's role in blood cancer. The research was about the behaviour of cancer cells and does not establish that taurine-laced energy drinks cause blood cancer in humans.

Taurine occurs naturally in protein-rich foods like meat and fish and is also produced in the human body. Known for its function of maintaining fluid balance, cardiovascular support, and electrolyte regulation, taurine has been touted for years as a "health-enhancing" supplement. Taurine is also added to energy drinks for its claimed brain-boosting and anti-inflammatory effects and is marketed as a means to enhance mental concentration and physical output.

A study by University of Rochester's Wilmot Cancer Institute revealed how leukemia cancer cells hijack taurine as an energy source. Specifically, the cancer cells take in taurine to fuel glycolysis—a biological process that allows them to produce energy and proliferate at a fast rate.

The bottomline is that the Delhi High Court's ruling does not mean that Red Bull has been declared healthy. It addresses whether FSSAI followed the correct procedure when restricting the “energy drink” label. So even though Red Bull can be marketed and sold as an “energy drink”, it cannot be automatically considered healthy.