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 Indian Ministry of Health & Family Welfare has identified 219 districts across the country as priority for intensified interventions for HIV/AIDS, as part of its strategy to control the epidemic by 2027.

The country aims to achieve HIV control by December 1, 2027. As part of its Mission AIDS Suraksha, the Ministry convened the regional workshops titled ‘Suraksha Sankalp Karyashala' in Delhi today.

The workshop laid a special focus on the states of Haryana and Delhi, to chart a targeted approach for program implementation and close monitoring of high-burden districts -- 11 in Haryana and 7 in Delhi.

In Delhi, the identified districts include North, New Delhi, Shahdara, Central, South East, South, and North West. In Haryana, the prioritized districts comprise Panipat, Rohtak, Sirsa, Jhajjar, Gurugram, Faridabad, Bhiwani, Hisar, Sonipat, Kaithal, and Fatehabad.

District program teams from these priority areas presented their progress, shared operational challenges, and collaboratively developed targeted, outcome-oriented action plans to further strengthen the HIV response at the grassroots level.

HIV Status In Delhi And Haryana

As per data from the Ministry, an estimated 59,079 people live with HIV in Delhi, with an adult HIV prevalence of 0.33 percent.

On the other hand, Haryana has an adult HIV prevalence of 0.24 percent, with an estimated 59,642 people living with HIV.

"Delhi continues to face critical gaps, with only around 70 percent of identified individuals currently linked to or receiving treatment, highlighting the urgent need to accelerate treatment coverage and retention,” said Dr. Rakesh Gupta, Additional Secretary & Director General, NACO.

"In contrast, Haryana has achieved a cascade of approximately 81:83:95, reflecting encouraging progress, while also signaling the need for intensified efforts to improve diagnosis and treatment linkage,” he added.

Focus Areas

HIV/AIDS A Public Health Challenge

By 2025, HIV targets were to ensure 95 percent people know their HIV status, 95 percent of them are on lifesaving antiretroviral therapy, and 95 percent of those on treatment are virally suppressed.

As per the National AIDS Control Organization’s report (Sankalak 2024), 81 percent of 25.44 lakh people living with HIV knew their status, 88 percent of them were receiving lifesaving antiretroviral therapy, and 97 percent of those on the treatment were virally suppressed till March 2024.

"HIV/AIDS continues to pose a significant public health challenge, necessitating sustained vigilance, innovation, and coordinated action across all tiers of governance,” said Dr. Gupta, in his keynote address.

Also read: Years After PrEP Rollout, The HIV Prevention Drug Still Remains A Privilege In India

Eliminating Vertical Transmission Of HIV

Dr. Gupta also emphazised the critical importance of eliminating mother-to-child transmission of HIV, which can occur during pregnancy, childbirth, and breastfeeding.

"Such transmission is entirely preventable through timely testing, counselling, and treatment, and called for strengthened antenatal screening and universal access to prevention services to ensure that no child is born with HIV," he added.

Also read: Reducing Mother-To-Child HIV Transmission To Zero Key To End AIDS In India: Experts

Stressing the need for a whole-of-system approach, Dr. Gupta called upon stakeholders across national, state, and district levels to work in close synergy, particularly at the field level, to bridge existing gaps in awareness, testing, treatment, and adherence.

The Suraksha Sankalp Karyashala serves as a vital platform for collaborative planning between national, State, and district stakeholders, reinforcing India’s coordinated, evidence-based, and data-driven approach to HIV prevention and testing services.

It aims to improve linkage and retention on treatment, enhance viral load suppression among people living with HIV, and expand targeted outreach among vulnerable and key populations.

Harish Rana, the 32-year-old resident from Ghaziabad who had been in vegetative condition for the last 13 years has now been removed from ventilators and other life support systems. He has been shifted to a normal bed. As per news reports, his water tube too was removed and a cap was placed on his feeding tube.

As per the hospital sources, Harish Rana's condition is now stable. Following the Supreme Court's order, the medical board will monitor his condition. While his feeding tube has been removed, doctors are still administering brain-soothing medicines.

Harish Rana's parents are also staying with him in AIIMS Delhi. His parents and brothers have been receiving daily counselling.

AIIMS Delhi Is Prepared For India's First Passive Euthanasia

Harish Rana's case marks India's first passive euthanasia. To conduct the passive euthanasia, AIIMS Delhi has set up a specialized team headed by professor and head of the department of anesthesia and palliative medicine, Dr Seema Mishra, has been constituted to implement the process. The team comprises doctors from departments of neurosurgery, onco-anesthesia, and palliative medicine, and psychiatry.

Read: AIIMS Delhi Sets Up Team To Process India's First Ever Passive Euthanasia For Harish Rana

“The process generally involves withholding or withdrawing the nutritional support gradually while ensuring adequate pain relief. The patient is given palliative sedation so that he or she is not in distress. Life support measures such as artificial nutrition, oxygen and medications are slowly withdrawn. The aim is not to prolong nor hasten death,” Dr Sushma Bhatnagar, former head of the department of onco-anaesthesia, pain and palliative care, AIIMS-Delhi.

What Happened To Harish Rana?

It was in 2013 when he suffered severe head injuries after he fell from the fourth floor from his PG accommodation while he was studying at Panjab University. He had been bedridden ever since, and survived on feeding tube. His father filed a petition seeking passive euthanasia under the guidelines Supreme Court had laid down in 2018 under Common Cause judgment. This is the second time the parents have approached the apex court.

In 2024, the court also suggested that Rana could receive home-based care with support from the Uttar Pradesh government. The home-based care includes periodic visits by doctors and physiotherapists. The court suggested that in case home care was not feasible, he could be moved to Noida's district hospital. However, his parents have noted that his condition continued to worsen. Family advocate Rashmi Nandakumar also informed the bench that "nothing seems to be working out".

"He is falling ill quite often and is repeatedly admitted to hospital," she said. The advocate further added that the family only sought passive euthanasia, which is withdrawal of treatment, and not any active intervention.

Justice Pardiwala also read medical reports and observed, "Just look at the condition of the boy. It's pathetic."

Recent court ruling on this case involves a bench comprising Justice JB Pardiwala and Justice KV Viswanathan that allowed the withdrawal of life support for Harish Rana, a resident of Ghaziabad, who has been in a coma and kept alive on tubes for breathing and nutrition after sustaining severe head injuries following a fall from a building in 2013 in Chandigarh.

Meningitis outbreak in Kent University that infected a dozen of people have now further infected more people. The total number as of now is 27, as experts say that incubation period of the bacteria may lead to an increase in number of those who are sick. However, health officials, as per The Guardian report, believe that they have contained the fatal outbreak, with "no cases emerging that are not linked to the original cluster of 20".

Read: UK Meningitis Outbreak: 9-month-old Baby Battles For Life In Intensive Care

The bug that causes the infection has been identified as the known strain of meningitis B and MenB vaccines will be offered to 5,000 students living in the University of Kent halls of residence in Cantebury. While several reports claim that parents are rushing to pharmacies to get their children vaccinated, due to which there is a shortage of the MenB vaccines, health secretary, Wes Streeting has denied any such claims. "There is actually plenty of stock of vaccine supply in the country," he said.

Read: Meningitis Outbreak From Kent University Is Now A National Incident, Parents Fighting For Jabs Amid Low Stock

As per the UK Health Security Agency (UKHSA) official, people infected in Kent were the ones who visited a nightclub on 5,6 or 7 March. The officials, including NHS members and county council public health staff who have been tackling the outbreak believe that it has not been passed on to anyone outside the area. "All cases to date are linked to the current outbreak in Kent," said a UKHSA spokesperson, as reported by The Guardian.

Another official involved in the multi-agency response said, "We may have contained it. There are no cases popping up elsewhere that we know of – no cases that we know of outside the cluster – or not yet anyway. We are rolling out a vaccine and antibiotics and tracing contacts. So there’s nothing we’re not doing.”

Quickest-growing Meningitis Outbreak Ever

UKHSA chief executive Susan Hopkins said the outbreak "looks like a super-spreader" event with "ongoing spread" through universities' halls of residence. She added: "There will have been some parties particularly around this, so there will have been lots of social mixing. I can't yet say where the initial infection came from, how it's got into this cohort, and why it's created such an explosive amount of infections."

She further said that in her 35 years working in medicine, healthcare, and hospitals, "This is the most cases I've ever seen in a single weekend with this type of infection". She added: "It is the explosive nature that is unprecedented here - the number of cases in such a short space of time." She also remarked that this was the "quickest-growing outbreak" she has ever seen in her career.

What Is Meningitis?

Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered as one of the classic symptoms of meningitis. It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.

Meningitis is an infectious illness that brings about inflammation in the meninges. The most common cause of such inflammation is bacterial or viral infections, though other causes are also possible including fungal, parasitic, or non-infectious causes (autoimmune disease, head injury, or brain surgery). Meningitis may be caused by bacterial meningitis, which the Centers for Disease Control and Prevention (CDC) indicates can be so severe and bring about conditions like hearing loss, vision problems, and death if not received on time.