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.

Around 450 people in Gorakhpur district of Uttar Pradesh have received anti-rabies vaccinations after consuming charanamrit prepared with milk from a cow suspected of being rabid. The animal died after exhibiting unusual behaviour, which sparked concern among residents of two villages who may have consumed milk from the same cow.

The health department organised a vaccination camp in Dadi Khas village, in the Gola block of Gorakhpur, on October 21. Officials said around 50 people received the vaccine on Tuesday, followed by another 400 during the camp on Wednesday.

450 People In UP Consume Milk From A Suspected Rabid Cow

The incident came to light after the cow's condition deteriorated and the animal died on Tuesday evening. According to its owner, Navami Yadav, the cow had appeared unwell for one or two days before its condition worsened.

Private veterinarians suspected that a stray dog might have bitten the animal, although they did not confirm if the animal had rabies.

The cow's milk had reportedly been supplied to two shops and various households, extending concern beyond those who consumed charanamrit during Durga Puja.

Residents of Dadi Khas and neighbouring Govindpur village were among those affected by the concern over possible exposure.

A health department team led by pharmacist Siddharth Singh visited the village and administered the vaccines.

Amarendra Thakur, the in-charge of the community health centre, advised residents concerned about exposure to consult medical professionals and follow the recommended vaccination schedule. He also said arrangements would be made to ensure vaccines remained available at the health centre.

Can Rabies Spread Through Milk?

The incident has raised questions about whether consuming milk from a suspected rabid animal can transmit the infection.

Rabies is a viral disease that affects the central nervous system. It is mostly transmitted when the saliva of an infected animal enters the body through a bite or scratch, or comes into contact with broken skin or the mucous membranes of the eyes, nose or mouth.

Dogs account for most human rabies cases worldwide, but other infected mammals, like cattle, can also carry the virus.

However, there is no epidemiological evidence that rabies is transmitted through the consumption of milk.

The World Health Organization (WHO) states that post-exposure prophylaxis (PEP), which includes preventive treatment after a possible exposure, is not required solely because a person has consumed milk from a rabid animal. The WHO nevertheless advises against consuming milk from animals infected with rabies.

India's National Rabies Control Programme provides similar guidance, stating that there are no evidence-based reports of human rabies arising from consuming milk, including breast milk.

The cow in the UP incident was suspected of having rabies, but it had not been confirmed. But people who have consumed milk from a suspected infected animal should seek exposure advice from a healthcare professional.

According to the WHO, suspected rabies exposure requires prompt assessment because the disease is almost invariably fatal once clinical symptoms develop, but can be prevented when post-exposure prophylaxis is administered on time. Treatment may involve wound care, course of rabies vaccinations and, rabies immunoglobulin in some cases.

Pharmaceutical giants Moderna and Merck have been developing a personalised cancer vaccine that differs according to the patient's tumour characteristics.

According to results from a Phase 3 clinical trial, the vaccine has reportedly reduced the risk of melanoma returning or death by 42% and the risk of cancer spreading by 38% when combined with standard immunotherapy.

The findings, reported on October 22, build on evidence that messenger RNA (mRNA) technology could play a pathbreaking role in treating cancer.

The experimental vaccine, intismeran autogene, was tested alongside Keytruda, Merck’s immunotherapy drug, in patients whose melanoma had been surgically removed.

Latest Trial Results

The Phase 3 INTerpath-001 trial was based on 1,137 patients with high-risk stage IIB, IIC, III or IV melanoma who had undergone surgical removal of their cancer.

Participants received either intismeran autogene alongside Keytruda or Keytruda alone. The researchers compared how effectively the treatments helped prevent the cancer from returning or spreading.

After two years, 82.2% of patients who received the vaccine combination remained cancer-free, compared to 70% of those who received Keytruda alone, according to the trial results.

The combination also reduced the risk of recurrence or death by 42% and the risk of metastasis or death by 38%.

The study achieved its primary endpoint of recurrence-free survival and its key secondary endpoint of distant metastasis-free survival.

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What Is Intismeran Autogene And How Does It Work?

Unlike conventional vaccines that prevent infections, intismeran autogene is a personalised cancer vaccine. It is developed using a sample of the patient’s tumour to identify mutations that distinguish cancer cells from healthy cells.

The treatment uses mRNA to encode up to 34 tumour targets, known as neoantigens. Once administered, these targets help the immune system recognise those targets and generate an immune response against cancer cells.

The vaccine is designed to be used with Keytruda. The vaccine and immunotherapy therefore have complementary roles in the treatment strategy.

Also read: Could A Daily Pill Help Prevent Breast Cancer Recurrence? Roche's Promising Experimental Drug Awaits FDA Approval

What Did Researchers Say?

Professor Georgina Long, the trial’s principal investigator and medical director of Melanoma Institute Australia, said the results are a significant development for treatment after surgery.

“'This is a coalescence of an mRNA platform, personalised, and the use of algorithms and data in a way that we've never seen before. These results show that patients with earlier-stage melanoma can be treated after surgery in a fundamentally new way,” Professor Long said.

The combination’s safety profile was consistent with previous studies, and the companies said no new safety signals were observed in the Phase 3 trial. Detailed findings are being presented at the European Society for Medical Oncology meeting in Madrid.

She added, “Intismeran in combination with pembrolizumab has the potential to establish a new treatment paradigm in the adjuvant melanoma setting, helping patients remain cancer-free for longer,” Long said in the companies’ August announcement of the trial’s positive topline results.

Moderna and Merck have said they will engage with regulators about submitting the treatment for approval. Further FD review will be needed before it can become a treatment option.

An experimental daily pill developed by Swiss healthcare company F Hoffmann-La Roche AG has sparked hope for a new treatment option for people with early-stage breast cancer. The drug, giredestrant, reduced the risk of invasive disease recurrence or death by at least 30% compared to standard hormone therapy, according to findings from its Phase 3 trial.

The US Food and Drug Administration (FDA) is expected to share its drug approval verdict by November 30, 2026.

Giredestrant is an experimental once-daily pill designed to block and degrade oestrogen receptors, which can contribute to breast cancer risk.

It is being studied in oestrogen receptor (ER)-positive, HER2-negative breast cancer, a subtype that accounts for the majority of breast cancer diagnoses.

Breast Cancer Drug Giredestrant’s Trial

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The Phase 3 lidERA trial, involving 4,100 people with early-stage ER-positive, HER2-negative breast cancer, compared giredestrant to standard endocrine therapy.

The results showed that giredestrant reduced the risk of disease recurrence or death by 30% relative to standard endocrine therapy.

At three years, 92.4% of participants receiving giredestrant were alive and free of invasive disease, compared to 89.6% of those receiving standard treatment.

Even though the trial met its primary goal, overall survival data was still immature at the time of analysis. Hence, the findings depict an improvement in invasive disease-free survival, not proof that the drug helps people live longer.

Giredestrant was generally well tolerated in the trial. Treatment was discontinued because of adverse events in 5.3% of participants receiving the drug, compared to 8.2% receiving standard endocrine therapy.

Latest Developments In October 2026

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On October 19, Roche announced that it would present new giredestrant data at the 2026 ESMO Annual Meeting, scheduled for October 23 to 27 in Madrid.

The presentation includes outcomes reported by patients from the lidERA trial. According to Roche, these findings suggest that the promising results in reducing disease recurrence seen with giredestrant was achieved without compromising tolerability or quality of life of the patients.

The company will also present biomarker findings from the evERA trial, which was based on giredestrant combined with everolimus in advanced breast cancer. These are separate settings from using giredestrant alone after surgery for early-stage disease.

Earlier in October, detailed results from the Phase 3 evERA trial were published in The New England Journal of Medicine.

In people with advanced ER-positive, HER2-negative breast cancer, giredestrant combined with everolimus reduced the risk of disease progression or death by 44%.

With 62%, the combination showed even results among participants whose tumours had an ESR1 mutation, compared to standard endocrine therapy combined with everolimus. The FDA has set December 18, 2026, to announce its decision for this combination in certain patients with advanced breast cancer.

The FDA accepted Roche's application for giredestrant as an adjuvant treatment for adults with stage I to III ER-positive, HER2-negative breast cancer under priority review. The decision will be made on November 30, 2026.

If approved, giredestrant’s use will depend on the overall clinical guidance and patient's individual circumstances. According to Bloomberg, the drug is expected to generate up to $15 billion in revenue.