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.

Doctors in Texas are seeing otherwise healthy young and middle-aged workers getting diagnosed with severe kidney disease and, in some cases, reaching kidney failure without the diabetes, high blood pressure or any other long-standing condition that commonly damage the kidneys.

The condition doctors suspect is chronic kidney disease of unknown etiology, or CKDu, a form of kidney disease that has been documented for decades among agricultural and manual workers in hot regions of Central America, Sri Lanka and India. Recent reports suggest similar cases may be going unrecognised in the US, particularly among vulnerable migrant workers.

What Is CKDu?

CKDu is a condition in which a person's kidney function progressively declines without the usual causes of chronic kidney disease.

Diabetes and high blood pressure are among the biggest causes of kidney disease globally. But CKDu presents differently as it been reported predominantly in relatively young workers who may have neither condition.

The disease can damage the kidney's filtering and tubular structures and gradually reduce its ability to remove waste and regulate fluids and electrolytes.

Currently, there are no specific tests or treatment options to tackle CKDu. Doctors generally investigate and rule out other causes of kidney damage while considering a person's occupation and environmental exposures.

Also read: Dialysis Demystified: When Is It Necessary, How Does It Work And Can It Be Avoided?

Young Workers Are At Risk

Geographical location is one of the strongest clues that helps doctors confirm CKDu diagnosis. In Central America, the disease has been particularly associated with people doing strenuous agricultural work in hot and humid conditions.

Similar concerns have emerged among outdoor workers in Texas, including people working in construction, roofing and other physically demanding jobs.

Repeated heat stress and dehydration are among the leading suspected contributors. When someone repeatedly loses large amounts of fluid through sweating and does not adequately replace it, the kidneys can come under considerable stress.

Researchers are also investigating whether pesticides, contaminated water, heavy metals, infections and frequent use of painkillers like NSAIDs could contribute. However, the definite cause of CKDu still remains unknown.

Also read: Cefepime: Antibiotic Used For Pneumonia, UTI Linked To Higher Death Risk In Adults

CKDu Remains Silent Until Significant Kidney Damage Has Occured

CKDu can be particularly dangerous because people may have few obvious symptoms during the early stages. Many affected workers discover the problem through blood or urine tests rather than because they feel seriously ill.

By the time symptoms like severe fatigue, weakness, nausea, sleep problems or breathlessness develop, kidney function may already be substantially reduced.

A US study based on patients receiving emergency dialysis at a Texas county hospital found that 17% had clinically diagnosed, suspected or possible CKDu-related kidney failure.

Climate Change Could Be Another Contributing Factor

Researchers are increasingly looking into the connection between extreme heat and kidney health. The National Institute of Environmental Health Sciences says CKDu has emerged mainly among agricultural workers in hot, humid regions and notes that rising global temperatures could increase exposure to severe occupational heat stress.

But scientists are still trying to determine exactly how heat, dehydration and other workplace exposures interact to result in last-stage kidney failure. That uncertainty is one reason why CKDu remains such a difficult disease to study.

A 2026 International Society of Nephrology report noted that proposed causes such as heat stress may contribute to kidney injury without necessarily explaining exactly how the disease begins.

US President Donald Trump wants his administration to gain greater control over how billions of dollars in biomedical research funding are distributed. He recently proposed new board that could have the power to veto individual grants of National Institutes of Health (NIH).

The proposal, drafted by Budget Director Russell Vought, emerged after a White House meeting was held on September 18, according to the latest reports. The proposed board would include Vought and NIH Director Jay Bhattacharya, whose unanimous agreement will reportedly be required for grants.

The plan is just a proposal and has not yet been formally issued, and details of its structure and authority could change.

Current Process Of Distributing NIH Grants

The NIH financially back research into cancer, heart disease, infectious diseases, neurological disorders and many other serious conditions. Its current grant process relies heavily on scientific peer review, in which experts evaluate applications for scientific merit before funding decisions are made.

NIH says its peer-review system is intended to provide “fair, independent, expert, and timely scientific reviews” and to prevent funding decisions being coloured from inappropriate influence.

At the second stage, advisory councils made up of scientists and public representatives review applications and provide recommendations.

The institute or centre director currently makes the final funding decision, taking those recommendations and other factors into account. The proposed system could introduce another layer of political oversight above that process that could significantly influence how funds are allocated to research.

Also read: Donald Trump Wants Childhood Vaccines Split Into 5 Shots To Prevent Autism: But Is There Evidence?

Trump Administration Opposes Funding For 'Woke' Research

The administration has argued that federal research funding should better reflect its policy priorities and that some previous grants supported research it considers misaligned with those priorities.

At the White House meeting, Vought reportedly criticised the NIH for funding what he described as “woke” initiatives that conflicted with Trump's goals.

The administration has also argued that changes to research funding are needed to improve oversight and ensure taxpayer money supports what it considers scientifically sound and nationally relevant research.

Also read: Trump Nominates Dr Nicole Saphier As Third Surgeon General Pick

What Could The Proposed Board Change?

According to the reports, the board could review NIH grant awards and block funding that does not align with the administration's priorities. That would represent a significant change from a system in which scientific review is central to determining which research proposals are eligible for funding.

The NIH has already undergone changes to its grant process under the Trump administration. Separately, the White House has proposed more rules that would give political authorities greater power over federal grants across government agencies and sideline scientific peer review advisory.

NIH's Stance

The NIH has not confirmed the details of the proposed board. In a statement reported by The New York Times, NIH spokesperson Joshua Pradko said, “N.I.H. remains committed to its mission of funding biomedical research to benefit the health of the American people.”

Responding to reports that Vought wanted to rescind NIH funding, Pradko also said, “There will be no rescissions to N.I.H. grant monies. All N.I.H. grant monies will be spent.”

The NIH is currently dealing with a record number of applications. More than 40,000 grant applications have been received for the January 2027 council round, according to an NIH update issued September 18.

Commonly known as the ‘morning-after pill’, emergency contraceptive pills will soon be sold with prominent warnings on packs.

The Union Health Ministry has proposed bringing levonorgestrel 0.75 mg and 1.5 mg emergency contraceptive tablets under Schedule K of the Drugs Rules, 1945, with mandatory warnings on their packaging and package inserts. The draft notification was issued on September 3 and is currently open to public objections and suggestions.

The proposed warnings are intended to make it clear that the pills are meant only for emergency contraception and that they are not a regular contraceptive method.

They will also indicate that they are not abortion pills and do not protect against HIV or other sexually transmitted infections. They would also warn that frequent use can lead to side effects and advise women seeking regular contraception to consult a healthcare professional.

What Do Emergency Pills Actually Do?

Levonorgestrel is a synthetic version of the hormone progesterone. When taken as emergency contraception, it primarily works by delaying or preventing ovulation, meaning it can prevent an egg from being released when sperm are present.

It is intended to be taken after unprotected sex or contraceptive failure, such as a broken condom. The World Health Organization recommends levonorgestrel emergency contraception as a single 1.5 mg dose, or 0.75 mg in two doses 12 hours apart. It works best when taken as soon as possible and can be used within 120 hours of unprotected intercourse.

Crucially, it does not terminate an established pregnancy. That is why it should not be confused with medication used for medical abortion.

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

Emergency Pills Cannot Protect Against STIs

One of the proposed warnings is meant to addresses a common misconception about emergency contraceptive pills prevents pregnancy, not sexually transmitted infections.

It is important to under stand that levonorgestrel does not protect against HIV, syphilis, gonorrhoea, chlamydia or other STIs. Sexually transmitted infections can be prevented by barrier methods like condoms, when used correctly.

The proposed Indian warning specifically states that emergency contraceptive pills “do not offer any protection against HIV or any sexually transmitted infections.”

Also read: 5 Reasons To Get Regular STI Testing If You’re 'Sexually Active'

Reason Behind The Move

The move follows recommendations from the Drugs Technical Advisory Board (DTAB) after an expert review of contraceptive use in India.

Minutes of the 67th Drugs Consultative Committee meeting recorded recommendations for the package warnings stating that levonorgestrel emergency contraceptives should not be used more than twice a month, that they do not protect against HIV or STIs, and that alternative contraception should be considered with a registered medical practitioner.

The latest draft notification also states that frequent use “may lead to side effects” and encourages women to seek medical advice. However, this does not mean emergency contraception is considered inherently unsafe.

The WHO says side effects like nausea, vomiting, fatigue and temporary menstrual changes are generally mild and can be resolved without treatment. It also states that emergency contraceptive pills do not cause any harm to fertility.

The concern is instead about using an emergency method as a substitute for regular contraception. Repeated use can lead to menstrual irregularities and side effects.

The proposal would place levonorgestrel 0.75 mg and 1.5 mg tablets under Schedule K, while retaining their availability without a prescription. The draft is therefore not supposed to make morning-after pills prescription-only.