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.

Scromting: the blend of two nightmares - screaming and vomiting. It sounds surreal, but it is as real as it could get. In an interview with the New York Post, Sydni Collins, 23, shared that she was "puking all morning." "I would let out yells or cries because nothing would come out. I was just dry heaving," she shares. This is how she ended up in the hospital with a feeding tube. What she was experiencing is called cannabis hyperemesis syndrome (CHS), a debilitating condition that triggers episodes of relentless nausea, abdominal pain, and severe vomiting in chronic weed users. She has been smoking weed daily as a teenager, since she was 16.

In the US, there are more than 2.5 million teens and 1 in 10 of them are casual cannabis users, with an additional of 600,000 teens considered to be addicted to it. Emergency rooms in the country have seen a steady rise in CHS cases over the last decade. In fact, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have also added CHS in its official diagnostic codes.

In Collins story, she became the trendsetter, because during her first hospital visit, she did not receive the diagnosis. However, her inability to eat a full meal afterward is what led to 7 ER visits in just one month. When she was finally admitted, she was only 87 pounds. She shared she would be in fetal position on the beds for hours, because that was the only way her stomach did not hurt. This is when she was finally diagnosed with 'superior mesenteric artery syndrome', which is a rare digestive disorder.

Misdiagnosis is common because there had been an absence of a diagnostic code for CHS.

What Are Experts Saying?

Dr David Streem, medical director of the Cleveland Clinic's Alcohol and Drug Recovery Center told USA TODAY that he has treated a range of patients with CHS over the years. He said that the condition is so severe that even the strongest anti-nausea medication that are given to chemotherapy patients, like Ondansetron, did not stop it.

However, there is a debate on CHS patients, and marijuana advocates like Paul Armentano, who is the deputy director of cannabis reform organization NORML, tells USA TODAY that CHS is actually "very rare" and that a lack of research on the syndrome has led to its misunderstanding. Armentano says, "The very fact that we're rebranding what was known for two decades as cannabinoid hyperemesis syndrome as scromiting. Scromiting is clearly sensational." It is made up, non-scientific, and sensational, says the cannabis advocate.

What is CHS or Cannabionoid Hyperemesis Syndrome, also known as the slang Scromting?

It is a side effect of prolonged use of marijuana. This results in nausea, vomiting, and abdominal pain.

As per Rome Foundation, a patients must meet the following criteria:

• Cyclical vomiting
• Presentation after prolonged marijuana use
• Relief of vomiting after the cessation of marijuana use

CHS was first reported in Australian medical literature in 2004. This is when a small study, published in BMJ analyzed 19 patients with cyclical vomiting after prolonged marijuana use.

While the research on what actually suddenly causes this syndrome is very limited, Armentano asks questions on if synthetic cannabis products, or a specific type of it leads to such a medical condition.

Stream said for treatment, IV drip of substance such as droperidol and haloperidol are often used in emergency rooms for CHS. Stream also said that Capsaicin, commonly referred to as hot pepper cream could also be rubbed on the abdomen for some temporary relief, along with hot showers or baths.

Julia Louis-Dreyfus, despite her private nature felt like she had to share her breast cancer diagnosis. She is now reflecting on why she did that.

She was diagnosed with stage II breast cancer in 2017 and on a Tuesday's episode of her podcast Good Hang, comedian Amy Poehler applauded her for sharing her diagnosis and treatment. Poehler told that "it was very helpful for a lot of people. It is not something you needed to share. You did."

On this, Julia said, “Well, I was kind of backed into a corner on that one because we had to shut our show down." The final season of her show Veep was halted during her breast cancer treatment. "It is funny how that worked out normally I would not have done that. I am very private. But because we had to shut Veep down for a year, I had to say it. 250 people were not going to be working," she said.

However, she did acknowledge that many people reached out to her, asking her about her experience and advice too and she was able to help. "There was something unbelievably comforting about being able to do that on the other side of this trauma. There is a lot to be said in self-soothing by soothing others. For real. I don’t mean to sound all Pollyannaish. I actually think it’s true," she said.

What Happened To Louis Dreyfus?

She was diagnosed with stage II breast cancer in 2017 and underwent chemotherapy, a double mastectomy, and breast reconstruction. It was in October 2018 when she had revealed that her cancer treatment was successful and that she was cancer-free.

During a conversation with journalist David Remnick at the New Yorker Festival in 2023, she opened up that her first reaction to her diagnosis was laughing. Well, because the night before, I had won an Emmy. And so, I came downstairs and … the Emmy was there. It was like on the dining room table. I'm coming down to get coffee. My cell phone rings, and it's my doctor saying, ‘Guess what, you have cancer,’” she said.

However, she revealed that despite such challenging times, she had the support of her family, including her husband Bill Hall, and her two sons, Henry and Charlie. “I have a very strong and supportive family, and for which I am eternally grateful. I was deeply terrified because who wouldn't be? I mean, all the tropes are true. You know, you get that call and it's like, ‘What, me? No, no, no.’ I mean, you can't imagine that something like that would happen to you," she said.

What Happens In Stage II Breast Cancer?

One of the most important part of a cancer diagnosis is to know what stage have you been detected at. Stage II breast cancer has cancer cells in a breast and/or in the lymph nodes near a breast. This could be further defined as stage IIA and Stage IIB, depending on other factors as followed:

Breast Cancer Stage IIA

Stage II A breast cancers are likely to have spread into the lymph nodes in the armpits. This is one of the first ways cancer starts to metastasize from its original location.

However, in this stage, no tumor in the breast is found yet, though the cancer has spread to the lymph nodes in the armpits. In case there is a tumor, it is in the breast for about 2 centimeters or smaller and the cancer has spread to the lymph nodes. In case the tumor is 2cm to 5cm, and the cancer has not spread to the lymph nodes, it would still be considered breast cancer stage IIA.

Breast Cancer Stage IIB

This happens when the tumor is larger or the cancer cells have spread further into the lymph nodes than with stage IIA.

If the breast tumor measures 2cm to 5cm and the cancer cells are also found in the armpit lymph nodes, or if the tumor is more than 5cm and it has not spread to the lymph nodes, then it would be diagnosed as breast cancer stage IIB.

What Are The Common Symptoms Of Breast Cancer Stage II?

• A lump in the breast or the armpit
• Nipple discharge
• Dimpled skin on the breast
• Swelling or redness
• An inverted or flattened nipple
• Changes to the skin or a breast rash
• Changes to the size or shape of the breast
• Pain

While Delhi again woke up to a thick layer of haze on Tuesday, December 9, with the AQI remaining in "poor" and "very poor" categories as per the Air Quality Early Warning System for Delhi. A new Centre for Research on Energy and Clean Air (CREA) report released on December 6 noted that it is not Delhi, but Ghaziabad, which is the most polluted city in India, as of November 2025.

What Makes Ghaziabad The Most Polluted City In India?

Ghaziabad remained most polluted city in India, with a monthly average of PM2.5 or particulate matter 2.5 at the concentration of 224 µg/m³. This means Ghaziabad violated the National Ambient Air Quality Standards (NAAQS) on every day of the month as per the CREA's Monthly Air Quality Snapshot.

Of the entire month, the city experienced 19 "very poor" days, with 10 "severe" days and 1 "poor" day. In the list of top 10, Noida, Bahadurgarh, Delhi, Hapur, Greater Noida, Baghpat, Sonipat, Meerut and Rohtak also joined the list.

Of the 10 cities, six of them were from Uttar Pradesh, followed by 3 cities from Haryana and then Delhi. All cities except Delhi recorded PM2.5 levels higher than the previous year.

What About The Pollution Levels In Delhi?

The national capital ranked as the fourth most polluted city, recording a monthly average PM2.5 concentration of 215 µg/m³ in November, about twice its October level of 107 µg/m³. The city experienced 23 ʻVery Poorʼ days, six ʻSevereʼ days, and one ʻPoorʼ day throughout November.

Despite widespread pollution, the contribution of stubble burning was comparatively lower this year, an average of seven per cent in November, down from 20 per cent last year. Peak contributions of stubble burning reached 22 per cent, significantly lower than 38 per cent recorded in the previous year.

The analysis drew on real-time continuous ambient air quality monitoring stations (CAAQMS) PM2.5 data.

“Despite a significant reduction in stubble-burning influence, 20 out of 29 NCR cities recorded higher pollution levels than the previous year, and many still did not register a single day within NAAQS limits. This clearly indicates that the dominant drivers are year-round sources such as transport, industry, power plants, and other combustion sources. Without sector-specific emission cuts, cities will continue to breach standards,” said Manoj Kumar, analyst at CREA.

CREA's previous report has highlighted that Delhi’s air pollution almost doubled in November, with average PM2.5 levels touching 215 micrograms per cubic meter. The city recorded 23 days of very poor air, six severe days, and only one poor day. Although stubble burning played a smaller role this year, contributing an average of 7 percent, the pollution remained dangerously high.

Across India, pollution trends were equally worrying. Nine of the ten most polluted cities saw higher pollution levels than last year. Ghaziabad was the worst affected, with PM2.5 levels at 224 micrograms per cubic meter.

According to CREA analyst Manoj Kumar, declining stubble burning shows some progress, but major year round sources such as transport, industry, power plants, and other combustion activities continue to drive the crisis. Without strong emission cuts in these sectors, pollution levels will keep breaching national standards.

Doctors Warn of a Deepening Health Emergency

In an interview with ANI, doctors from AIIMS described Delhi’s air quality as a medical emergency. Prof Dr Anant Mohan and Dr Saurabh Mittal from the Department of Pulmonary, Critical Care, and Sleep Medicine said the current situation is now putting vulnerable groups at serious risk, including pregnant women, unborn babies, newborns, and adults with heart or neurological conditions.

Dr Mohan warned that the impacts may be felt for generations. Since the particles are extremely small, they can pass from a pregnant woman to the fetus and interfere with growth. Babies exposed to such conditions in the womb are more likely to be underweight and may have weaker lungs as they grow. Some complications might show up only later in life.

Dr Mittal added that the effects of toxic air go far beyond respiratory illness. Prolonged exposure is increasing cases of breathlessness, lung inflammation, asthma attacks, and chronic conditions like COPD. Fine particulate matter is also entering the bloodstream, raising the risk of heart attacks and strokes.

The growing health concerns underline the need for immediate and coordinated action, making the work of the newly formed expert group even more urgent.

How To Read Delhi's AQI?

• 0-50: 'good'
• 51-100: 'satisfactory'
• 101-200: 'moderate'
• 201-300: 'poor'
• 301-400: 'very poor'
• 401-500: 'severe'