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.

US President Donald Trump this week underwent his third annual medical check-up during his second term and declared that it went “perfectly well”.

Trump, who turns 80 next month, visited the Walter Reed National Military Medical Center for a routine health examination on May 26. The medical check-up, conducted after about 13 months, reportedly lasted around 3.5 hours.

“Everything checked out PERFECTLY,” Trump wrote on social media.

However, neither Trump nor the White House has disclosed detailed medical findings, leading to renewed speculation about the health of the oldest American President.

The concerns come amid visible signs of deterioration observed during several public appearances. These include persistent bruising on his hands, micro naps during public meetings, slurred speech, and frequent factual mix-ups — all of which have raised questions about whether information regarding his health is being withheld.

The White House had earlier explained that the bruises on Trump’s hands were caused by “frequent handshaking” combined with aspirin use.

Trump Link His Conditions To Stroke

Doctors have also speculated that his slurred speech may indicate signs of a recent stroke.

Dr. Bruce Davidson, a professor at Washington State University’s Elson S. Floyd College of Medicine, discussed the issue during an appearance on The Daily Beast podcast. He said his interpretation was based on observing Trump’s physical behavior and speech patterns over time.

“Earlier in the year, there was video of him shuffling, and I thought that was weird,” he said on the podcast.

He suggested that such movement patterns can sometimes be seen in patients recovering from strokes.

Despite the speculation, Trump has continued to defend his mental sharpness and cognitive abilities.

“So I’ve taken (a cognitive test), and I’ve aced it all three times, I’ll tell you, because it is a positive thing,” Trump said. “It starts off with an easy question. And by the time you get to the middle, it gets tougher.”

Previous Medical Reports Declared Him Healthy

According to a White House summary of Trump’s previous annual medical examination in April last year, he was found to be in “excellent cognitive and physical health”.

“A comprehensive neurological examination revealed no abnormalities in his mental status, cranial nerves, motor and sensory functions, reflexes, gait, and balance. Cognitive function, assessed using the Montreal Cognitive Assessment (MoCA), was normal with a score of 30 out of 30,” White House physician Captain Sean Barbabella wrote.

There were also tests for depression and anxiety, and Trump recorded scores “within the normal range for both,” although exact numbers were not disclosed.

Scans conducted in October also reportedly showed that Trump was in “excellent overall health”.

In a landmark order, the Supreme Court of India has recognized the Right to Trauma Care as an integral part of the Right to Life under Article 21 of the Constitution.

The court issued comprehensive, time-bound directions covering the entire trauma chain of survival — comprising the inter-linked and coordinated chain of survival from the site of injury to definitive hospital care — aiming to strengthen emergency medical response and ensure timely access to trauma care across the country.

The directions, issued in SaveLIFE Foundation & Anr. v. Union of India & Ors., are binding on all 36 States and Union Territories. They cover the full spectrum of traumatic injuries, including:

• Road crashes

• Falls

• Burns

• Drowning

• Industrial accidents

• Fires

• Explosions

• Disaster-related trauma

In its the apex Court stated that “a uniform framework for trauma care, building public awareness, standardization of first aid skills, and proper Good Samaritan laws is required, since the right to trauma care of citizens is an integral part of the right to life enshrined under Article 21 of the Constitution of India.”

Why Is The Order Significant?

India records approximately 4.67 lakh accidental deaths every year from road crashes, falls, burns, drowning, industrial injuries, violence, and disasters.

Of these, road crashes alone account for approximately 1.77 lakh deaths annually. As per the 201st Report of the Law Commission of India, 50 per cent of those killed in road crashes could have been saved had they received timely emergency medical care.

The NITI Aayog-AIIMS Emergency and Injury Care Report (2021) found that at least 30% of all trauma-related deaths in India are attributable to delays in emergency care.

Despite the scale of preventable loss of life, India had no unified, enforceable national trauma care framework. Responses compiled from 34 States and Union Territories and placed before the Court revealed a deeply fragmented system, including inconsistent ambulance standards, unintegrated emergency helplines, absent trauma registries, ungraded hospital facilities, and patchy implementation of centrally mandated schemes.

The petition was filed by SaveLIFE Foundation in October 2024.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

What Has The Supreme Court Ordered?

The Supreme Court’s directions cover nine domains of the trauma chain of survival. All States and Union Territories are bound by these directions, with compliance to be reported before the Court-appointed monitoring authority.

1. Integration of a single national emergency number — 112 — within three months.
2. Establishment of grievance redressal systems to protect Good Samaritans who provide emergency assistance to trauma victims.
3. Establishment of a National Medical Rescue Protocol for trauma cases.
4. Addition of all registered ambulances — public and private — under the National Ambulance Code (AIS-125, December 2014). The Court also mandated GPS or Vehicle Location Tracking Device (VLTD) fitment and real-time integration with helpline 112, along with periodic audits covering response times, quality of care, equipment, and outcomes.
5. All States and Union Territories have been directed to adopt and implement the standardized Emergency Medical Technician (EMT) curriculum notified by the National Commission for Allied and Healthcare Professions (NCAHP) within three months.
6. States and Union Territories must establish State Trauma Registries linked to a Coordinated Trauma Registry within four months of the issuance of these guidelines.
7. All States and Union Territories have been directed to grade and designate all public and private medical facilities according to trauma care capacity within three months.
8. Cashless treatment for trauma victims under the PM RAHAT scheme.
9. All States and Union Territories have been directed to undertake sustained, multilingual, district-level awareness campaigns covering all the above within one month.

Compliance Mechanism

The Court has also directed that copies of its order be sent to the Chief Secretaries of all States and Union Territories, who are required to submit Action Taken Reports to the Registry of the Supreme Court within the timelines prescribed for each direction.

The matter is expected to be listed after four months for issuance of further directions based on the compliance reports received.

Amid the rising number of Ebola cases and deaths in Africa, nearly 16 people in Gujarat and Maharashtra have been quarantined after travelling from affected countries such as the Democratic Republic of Congo and Uganda, with some showing suspected symptoms.

This comes after the Ebola alert in Bengaluru over a woman who returned from Uganda and later tested negative.

Ebola Alert In Gujarat

A businessman from Congo and three individuals who came into contact with him have been admitted to isolation wards at separate hospitals in Gujarat's Ahmedabad. All four samples have been sent for Ebola virus testing, said Gujarat Health Minister Praful Pansheriya.

The 37-year-old businessman arrived from Congo earlier this month in Mumbai and stayed there for five days before travelling to Silvassa and Daman over the next few days, eventually reaching Vadodara on May 22. After developing Ebola-like symptoms, including high fever and cold, he was hospitalized on May 26 in Vadodara.

After doctors in Vadodara learned about his travel history, he was referred to a government hospital in Ahmedabad, where he has been kept in an isolation ward.

The man has been kept under observation, and tests are being conducted, with reports still awaited. The admitted patient is currently stable and safe, and his temperature is under control, Pansheriya said, adding that the people associated with the patient are not showing any symptoms.

"Two other individuals who had accompanied him have also been admitted to isolated wards at SVP Hospital in Ahmedabad as a precautionary measure. Another person who came in contact with these individuals has also been isolated," the minister added.

“Till now, there is no Ebola case anywhere in Gujarat or India, so nobody needs to fear,” the minister said.

In addition, media reports cited a total of 11 people who arrived in Ahmedabad from Ebola-affected African countries being placed under home isolation at their residences.

According to the Ahmedabad Municipal Corporation Health Department, all these 11 passengers live in the western areas of Ahmedabad. None of them have shown any symptoms of Ebola or have been in contact with Ebola virus-infected patients in African countries.

However, as a precautionary measure, the authorities have made home isolation mandatory for anyone arriving from affected African countries.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

Ebola Alert In Maharashtra

In Maharashtra's Nagpur, health authorities issued a high alert at the airport after placing a 47-year-old man who returned from Uganda under 21-day home isolation.

The Nagpur Municipal Corporation (NMC) health department is closely monitoring the man's health round the clock. Officials said he has not shown any symptoms of Ebola so far.

The individual stated that he did not come into contact with any Ebola patient during his stay in Uganda. However, as per health protocols, a medical team will regularly check his condition during the isolation period.

If any symptoms develop, arrangements have been made to immediately shift him to a hospital.

Read More:Ebola Scare In Italy: Two suspected Cases Linked To Uganda Travel

Experts Question Continued Travel From Affected Countries

Ebola has been declared a Public Health Emergency of International Concern (PHEIC) globally by the WHO. To mitigate the risk, the Directorate General of Civil Aviation (DGCA) and the Ministry of Civil Aviation have imposed strict rules for all airlines and airports in India.

The government has also issued guidelines for passengers arriving from Ebola-affected countries. As part of the precautionary measures, travelers entering the country from such nations are required to undergo a 21-day quarantine period.

Epidemiologist Dr. Amitav Banerjee, professor at DY Patil Vidyapeeth, Pune, told HealthandMe that the National Institute of Virology (NiV) in Pune is equipped to test for the Bundibugyo strain.

"The RT-PCR done by NIV is very sensitive and not likely to miss Ebola infections. A proper history of movement and contacts with sick persons during a visit to Congo and Uganda will provide more important information," he said.

The expert added that these people should also be tested for malaria, as it is endemic in Uganda and more easily transmitted than Ebola. After a couple of weeks, they can be tested for IgM antibodies against Ebola.

However, Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, raised questions about why India is still allowing travelers from Ebola-affected countries.

"Our policy should be so strict that we do not allow anybody coming from those kinds of countries where there is already an outbreak of Ebola, because Ebola has neither a treatment nor a cure nor a preventive vaccine," Dr. Gilada told HealthandMe.