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 United States is now providing doses of an experimental Ebola treatment developed by Mapp Biopharmaceutical for clinical trials in the Democratic Republic of Congo, where a growing outbreak of the Bundibugyo strain has infected more than 1,000 people and claimed over 250 lives. The decision marks a significant shift from the U.S. government's earlier stance, which limited access to the drug to Americans considered at high risk of exposure.

Health officials are racing to find effective ways to contain the outbreak, as there are currently no approved vaccines or treatments specifically designed for the Bundibugyo strain of Ebola. A small number of cases and deaths have also been reported in neighboring Uganda, raising concerns about the disease spreading further across the region.

The experimental therapy, known as MBP134, was developed by San Diego-based Mapp Biopharmaceutical. While the U.S. had previously kept its stockpile for potential use in exposed American citizens, it is now making doses available to support clinical research in Congo. This is the first time Washington has publicly committed stockpiled supplies of the treatment for a broader international trial.

According to the World Health Organization, researchers will test MBP134 both on its own and alongside the antiviral drug remdesivir, marketed as Veklury. Remdesivir became widely known during the COVID-19 pandemic and is being evaluated to see whether it can improve outcomes when combined with the antibody treatment.

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Ebola Situation In Western Africa

The confirmed cases in the Ebola outbreak in the Democratic Republic of Congo (DRC) have reached the highest total ever recorded during the first month of an outbreak in Africa, according to the World Health Organization (WHO).

As of June 22, confirmed Ebola cases in Congo had risen to 1,094 and deaths to 277, according to the DRC Ministry of Health. The WHO raised concerns about the rapid spread of the deadly virus and the challenges facing containment efforts.

“This is the largest number of confirmed cases in the first month of an Ebola disease outbreak in Africa,” said Dr Abdirahman Mahamud, Director, Health Emergency Alert and Response Operations at WHO, during a press briefing in Geneva.

"What is important is we need to scale up and this outbreak is moving faster than us," he told reporters after returning from Bunia last week.

Mahamud also noted signs of hope, highlighting a quick increase in the number of Ebola beds to over 500 in the past fortnight and signs that community resistance and violent resistance to Ebola responders was beginning to abate.

As of June 24, Uganda had recorded 20 confirmed Ebola cases, including two fatalities. The latest infection was identified on June 21, with no additional cases reported afterward. Of the confirmed infections, 15 were linked to travel from the Democratic Republic of the Congo (DRC), while five resulted from local transmission. Among the nine cases with available location data, eight were detected in Kampala and one in the neighboring Wakiso District.

Chemotherapy is often considered the most challenging aspect of cancer treatment due to its wide range of side effects. However, new advances in targeted therapies may soon reduce the need for conventional chemotherapy for some breast cancer patients.

Two drugs developed by pharmaceutical giants AstraZeneca and Gilead Sciences have shown encouraging results in treating triple-negative breast cancer (TNBC), one of the most aggressive and difficult-to-treat forms of the disease.

Triple-negative breast cancer lacks three key receptors commonly targeted by standard breast cancer therapies, making many conventional treatments ineffective.

In recent weeks, the US Food and Drug Administration (FDA) approved two targeted therapies—Datroway, developed by AstraZeneca in partnership with Daiichi Sankyo, and Trodelvy from Gilead Sciences—as first-line treatment options for certain patients with advanced triple-negative breast cancer.

Why These Drugs Are Better Than Chemo?

Both Datroway and Trodelvy belong to a class of medicines known as antibody-drug conjugates (ADCs). These therapies use antibodies to identify proteins present on most triple-negative breast cancer cells and deliver a potent dose of chemotherapy directly to the tumor.

The approach is designed to minimize damage to healthy tissues compared with traditional chemotherapy, which affects rapidly dividing cells throughout the body. Clinical trials showed that both drugs reduced the risk of disease progression by about 40% compared with standard chemotherapy, Washington Post reported.

“For seven out of 10 patients with metastatic triple-negative breast cancer who are not candidates for immunotherapy, chemotherapy has remained the only treatment option," said Arlene Brothers, Executive Director, Triple Negative Breast Cancer Foundation, in a statement.

The new drugs for the first time, will pave the way "for these patients will have a new standard of care beyond traditional chemotherapy at the outset of their treatment.”

Efficacy of Trodelvy And Datroway

Gilead's approval is based on two clinical trials that evaluated how effectively Trodelvy delayed tumor growth. When used alone, Trodelvy reduced the risk of tumor progression or death by 38% compared with chemotherapy in patients who were not eligible for immunotherapy.

Among patients eligible for immunotherapy—approximately 30% of all triple-negative breast cancer cases—a combination of Trodelvy and Merck's Keytruda reduced the risk of tumor progression or death by 35%.

“For more than twenty years, patients with mTNBC have had limited choices in first-line treatment. Building on its impact in second-line mTNBC, Trodelvy now offers patients a powerful new backbone therapy option in the first-line setting,” said Dietmar Berger, Chief Medical Officer, Gilead Sciences, in a statement.

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In a separate clinical trial, AstraZeneca's Datroway reduced the risk of tumor progression or death by 43% compared with chemotherapy. The drug also extended median progression-free survival by five months.

“Datopotamab deruxtecan (brand name Datroway) is the first and only medicine to significantly prolong overall survival in the 1st-line setting compared to chemotherapy in patients with metastatic triple-negative breast cancer who are not candidates for immunotherapy. This approval will bring a much-needed treatment option for these patients,” said Tiffany A. Traina, Triple-Negative Breast Cancer Clinical Research Program, Memorial Sloan Kettering Cancer Centre, part of the study.

Burden Of Triple-negative Breast Cancer

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Triple-negative breast cancer (TNBC) represents about 10–15% of global breast cancer cases but accounts for a disproportionately high share of mortality. In 2025, more than 48,000 Americans were diagnosed with triple-negative breast cancer.

The disease is known for its aggressive nature. On average, triple-negative breast cancer recurs or spreads within about 2½ years, compared with around five years for other forms of breast cancer. Additionally, nearly half of patients never receive a second line of treatment.

Both AstraZeneca and Gilead are now investigating their therapies in earlier stages of breast cancer.

The Ebola outbreak in the Democratic Republic of the Congo (DRC), driven by the Bundibugyo virus, continues to grow rapidly.

According to the latest government data, the number of confirmed cases in the DRC has risen to 1,118, including 291 deaths.

As of June 24, Uganda had reported 20 confirmed cases, including two deaths. The most recent case was reported on June 21, and no new cases have been recorded since.

Among the confirmed cases in Uganda, 15 had travel links to the DRC and five were linked to local transmission.

Outside Africa, France has reported a confirmed Ebola case in a doctor who returned from a humanitarian mission in Ituri province, the hardest-hit region in the DRC, with 997 confirmed cases and nearly 280 deaths.

What Makes Bundibugyo Virus Unique?

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Bundibugyo is one of the rarest Ebola virus strains. There have been only two previous outbreaks: one in Uganda in 2007 and another in the DRC in 2012, with case fatality rates of 32% and 55%, respectively.

A key difference is that there is currently no approved vaccine for the Bundibugyo strain. Vaccines are available for the Sudan and Zaire Ebola strains, but treatment for the Bundibugyo virus remains limited to supportive care.

The Unusual Symptoms Seen in Bundibugyo Patients

In a Correspondence published in The New England Journal of Medicine (NEJM), researchers from the Institut National de Santé Publique in Kinshasa analyzed the clinical characteristics of Bundibugyo virus disease (BVD).

Researchers recorded symptoms in 405 patients with confirmed BVD and 516 people who tested negative.

Among confirmed BVD patients, the most common symptoms were:

• Fever (74.3%)
• Diarrhea (67.4%)
• Vomiting (66.7%)
• Headache (42.2%)
• Loss of appetite (39.5%)
• Abdominal pain (37.3%)
• Difficulty breathing (34.1%)
• Difficulty swallowing (32.8%)
• Muscle pain (23.5%)
• Joint pain (22.7%)

Notably, bleeding-related symptoms, often associated with Ebola, were relatively uncommon and were reported in only 10.4% of patients at presentation.

Bundibugyo: Symptoms That Differed Between Men and Women

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The symptom profile was largely similar across age groups and between men and women. However, fever was slightly less common among men, while headaches became less frequent with increasing age. Men were also somewhat more likely to report cough and chest pain, the researchers said.

Bundibugyo: Symptoms That Distinguished Confirmed Cases

Compared with people who tested negative, patients with confirmed BVD were much more likely to experience gastrointestinal and systemic symptoms.

• Vomiting: 66.7% vs. 50.8%
• Diarrhea: 67.4% vs. 49.6%
• Loss of appetite: 39.5% vs. 17.2%
• Abdominal pain: 37.3% vs. 16.3%
• Difficulty breathing: 34.1% vs. 10.9%
• Difficulty swallowing: 32.8% vs. 10.7%
• Fever: 74.3% vs. 64.9%

How Was The Study Conducted

The researchers reviewed 2,351 recorded cases in the individual-level database for BVD between May 3 and June 8, 2026.

Of these, 505 patients (21.5%) had laboratory-confirmed BVD based on PCR testing, while 635 patients (27.0%) who were suspected of having the disease tested negative.

Researchers noted that patients with confirmed BVD were demographically similar to those who tested negative. In both groups, most patients were adults aged 20 to 39 years, and women slightly outnumbered men.

Higher Viral Load Linked to Death

Among 253 patients with laboratory-confirmed infection tested using the RADIONE PCR assay in Bunia, Ituri Province, researchers found that patients who died generally had lower cycle-threshold (Ct) values, indicating a higher viral load, than those who survived.

Among 129 patients with available symptom-onset and sample-collection dates, the mean delay between symptom onset and testing was 7.4 days, with a median delay of 4.8 days.

Earlier diagnosis and treatment could improve survival rates and help reduce virus transmission within communities, the researchers said.