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.

Women with autoimmune diseases are more likely than men to get told that their symptoms were merely psychological, resulting in longer delays and timely treatment.

A new international study published in The Lancet’s eClinicalMedicine studied the diagnostic experiences of 6,607 people living with autoimmune diseases.

Researchers from the University of Cambridge and the University of East Anglia found that 43% of women reported that their symptoms had previously been attributed to psychiatric causes, compared to 33% of men.

Women were also more likely to report being told their physical symptoms were psychosomatic, meaning they were caused by psychological factors. This was reported by 34% of women, compared to 22% of men.

After accounting for factors like age, disease group, continent and household finances, women were nearly 50% more likely to report a psychiatric misdiagnosis and almost 75% more likely to report a psychosomatic misdiagnosis than men.

The findings highlight gender disparities patients with autoimmune conditions experience during the diagnostic process, especially when the condition is not immediately ascertainable through clinical tests.

Women Report Longer Delays In Diagnosis

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The study also found differences in how long patients waited between the onset of symptoms and receiving an autoimmune disease diagnosis.

Among women, the most frequently reported time to diagnosis was one to two years. For men, the most common interval was less than three months. Women also reported attending more healthcare consultations before receiving a diagnosis.

“Patients with autoimmune diseases can present with symptoms that can initially be difficult to explain medically, and sometimes it can take months or years before a diagnosis becomes clear,” said Dr Melanie Sloan, from the University of Cambridge and the University of East Anglia.

“Our findings highlight that psychological or mental health explanations can be given too soon. This is true for both sexes, but our study suggests that females may be particularly vulnerable to these types of misdiagnoses,” she added.

Autoimmune diseases develop when the immune system mistakenly attacks the body's own tissues. For example, conditions like lupus, rheumatoid arthritis and multiple sclerosis. Statistically, women are more likely to develop autoimmune diseases than men.

Diagnosis can be challenging because early symptoms may include fatigue, persistent pain, sleep disturbances and low mood. These symptoms are common in other conditions, may fluctuate over time and can affect multiple parts of the body.

Patient Accounts As Important As Medical Records

The researchers said that patient accounts are important because medical records may not capture the full diagnostic journey, including when symptoms first appeared or how patients experienced consultations.

Shaista Tayabali, a patient partner and co-author of the study, said, “The differences between the sexes in misdiagnoses for people with autoimmune diseases is stark. The fact that females reported higher rates of psychiatric and psychosomatic misdiagnoses than males, yet reported lower misdiagnoses for other physical diseases, suggests that historical gender biases remain a challenging aspect of the diagnostic journey.”

The researchers stressed that the findings do not mean psychological diagnoses are always incorrect. People can have both autoimmune and mental health conditions, and some autoimmune diseases, including lupus, can themselves affect the brain.

The team called for clinicians to remain alert to possible autoimmune conditions, acknowledge diagnostic uncertainty and reassess patients when symptoms persist.

A 46-year-old mother of six in Oregon, US, lost both legs and suffered multiple life-altering injuries after developing a severe infection following a hysterectomy.

According to a lawsuit alleging medical negligence, Trisha Stevens underwent the hysterectomy in October 2024. The lawsuit alleges that her infection was not diagnosed on time and treated promptly, which eventually led to peritonitis, septic shock and multiple organ failure.

Stevens and her husband are seeking $68.5 million in damages from several doctors and Legacy Health. The allegations have not been established in court yet.

Stevens lost both legs above the knees, her right hand and parts of her left hand. She also lost parts of her lips and tongue and suffered spinal cord damage that left her paralysed from the waist down.

“I came home having lost both of my legs and my right hand. My left hand was left unusable after the necrosis. I lost parts of my lips and tongue, and I live with paralysis in a body that no longer responds the way it once did,” Stevens told local news outlet KGW.

Her husband, Brian, now cares for her as she navigates the physical, mental and emotional consequences of the sepsis.

What Is Sepsis?

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Sepsis is a life-threatening medical emergency that occurs when the body's response to an infection gets dysregulated, damaging its own tissues and organs. It can develop from infections affecting the lungs, urinary tract, skin or gastrointestinal system, as well as infections after a surgery.

Without timely treatment, sepsis can progress to organ failure and death. In severe cases, it can cause septic shock, in which blood pressure falls dangerously low and organs receive insufficient blood flow.

Stevens' case involved peritonitis, an inflammation of the tissue lining the abdominal cavity, followed by septic shock, according to the lawsuit.

Severe infection and septic shock can disrupt blood circulation and reduce oxygen delivery to tissues. When blood flow becomes critically inadequate, tissue can die, which is known as necrosis. In some cases, surgeons may need to amputate affected limbs to remove dead or severely damaged tissue and prevent further complications.

However, limb loss is not an inevitable outcome of sepsis. It represents a severe complication that can occur in some critically ill patients.

Warning Signs

The US Centers for Disease Control and Prevention identifies several possible signs of sepsis:

• Fever, shivering or feeling unusually cold
• Confusion or disorientation
• Rapid heart rate or a weak pulse
• Shortness of breath
• Clammy or sweaty skin
• Extreme pain or discomfort

After surgery, worsening abdominal pain, fever, unusual bleeding, wound discharge or a sudden deterioration in general health warrants urgent medical assessment. Symptoms should not be dismissed simply because a patient has recently undergone a procedure.

Sepsis requires immediate evaluation and treatment. Management may include antibiotics, intravenous fluids, support for organ function and, where necessary, surgery to control the source of infection.

Spain is seeing a rise in COVID-19 cases as the XFG variant, also known as American COVID, becomes the dominant circulating strain. Acute respiratory infections have reached epidemic levels, with COVID-19 and bronchiolitis contributing to the increase.

The Carlos III Institute’s Acute Respiratory Infection Surveillance System (SiVIRA) recorded 493.8 cases per 100,000 people between September 28 and October 4, up 3.3% from 478.2 the previous week.

According to Redacción Médica, infection intensity remains low despite the upward trend. COVID-19 incidence alone approached 120 cases per 100,000 people.

XFG Dominates COVID-19 Cases In Spain

The European Centre for Disease Prevention and Control (ECDC) estimated that XFG accounted for 54% of sequences reported by countries with sufficient data during weeks 34 and 35.

In Spain, the variant represented around 69% of those identified in primary care and 65% of hospital samples. However, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) cautioned that the rise cannot be attributed to XFG alone.

Spain is also witnessing a rise in respiratory viruses, which reached 478.2 cases per 100,000 inhabitants between 21 and 27 September, well above the 373 the previous week and also above the 400 mark, which marks the start of an epidemic.

Estimates put the total incidence of Covid-19 at 119.2 cases, compared with 92.6 in the previous week. The rate of positive test results stands at 4.1 per cent for flu, 27.2 per cent for SARS-CoV-2 and 0.2 per cent for respiratory syncytial virus (RSV), which causes bronchiolitis.

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What Is The XFG Variant?

XFG is a recombinant Omicron lineage formed when two Omicron sublineages combined. The World Health Organization (WHO) classified it as a variant under monitoring in 2025 because of its growth advantage. It is not a variant of concern yet.

Although XFG has mutations in its spike protein, studies suggest its ability to evade immunity differs only slightly from that of other JN.1 descendants.

There is no evidence that XFG causes more severe illness than other circulating Omicron variants. However, increased transmission can still lead to more hospital admissions by raising the total number of infections.

XFG Symptoms

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XFG has no distinctive symptoms that reliably separate it from other COVID-19 variants. Common symptoms include:

• Sore throat
• Runny or blocked nose
• Cough
• Fever or chills
• Headache and muscle aches
• Fatigue

Loss of smell or taste is less common than during the early pandemic. Symptoms alone cannot identify the variant causing an infection.

Why Are Cases Rising?

The Institute reported that possible contributors to rising infections include:

• Greater transmissibility of XFG
• Waning immunity from vaccination and previous infections
• Increased social contact after summer
• Seasonal patterns of recurring COVID-19 waves
• Multiple sublineages circulating simultaneously

The relative contribution of each factor remains uncertain.

COVID-19 Cases Rise In The UK And France

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United Kingdom: The UK Health and Security Agency recorded a staggering 230% jump in cases from August to September, rising from 1,374 to 4,589. Hospital admissions soared even more dramatically from 950 to 4,939 in the same period.

The National Health Service (NHS) advises calling 999 for medical emergencies, including severe breathing difficulties, coughing up blood, collapse, loss of consciousness or a first seizure. The agency has also advised Brits testing positive to isolate for at least five days, with under-18s needing just three days. Anyone with the virus should avoid contact with immunocompromised people for 10 days.

France: COVID-19 cases among people consulting general practitioners for acute respiratory infections in France reached 13 per 100,000 during September 21–27, up from nine the previous week, The Connexion reported.

This represented approximately 8,806 cases, compared with around 6,000 a week earlier.

Overall, acute respiratory infections reported by general practitioners rose from 103 to 151 cases per 100,000 people. Rhinoviruses accounted for 40% of samples, compared with 10% for COVID-19.