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 dengue virus is rapidly shifting serotypes, especially in young adults. The phenomenon is not unique to India and has been observed in several dengue-endemic countries across Asia, Latin America, and parts of the Pacific.

Dengue is caused by four closely related virus serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. The dominant serotype in circulation can change over time, leading to new outbreaks when population immunity is low against the emerging strain.

A 2026 genomic study, published in the international journal Acta Tropica, found that DENV-2 and DENV-3 were the most common serotypes between 2019 and 2024 in South India, with dominance shifting every 2–3 years. The authors, including those from the Indian Institute of Science, Bengaluru, highlighted the importance of monitoring these shifts because they can alter outbreak severity and vaccine effectiveness.

A 2025 study led by researchers from AIIMS Bhopal reported the emergence of a new DENV-2 lineage that displaced the previously dominant DENV-1 strain between 2019 and 2023. The findings, published in the journal Viruses, demonstrated how one serotype can replace another in a population.

“India is witnessing active serotype shifts, and they directly explain rising severity, especially in young adults. Initial infection with one of the four dengue serotypes results in lifelong immunity to that specific serotype. Whereas, a secondary infection with a different serotype can trigger Antibody-Dependent Enhancement (ADE),” Dr. Shikha Taneja Malik, Senior Scientific Affairs Manager, Drugs for Neglected Diseases initiative (DNDi), South Asia, told HealthandMe.

“Young adults who were exposed to one serotype in childhood are now encountering a new dominant serotype, making them especially vulnerable to severe secondary infections,” she added.

The four serotypes of dengue virus makes it a difficult virus; and protection against one does not always mean balanced protection against all.

"In young adults, this becomes even more important because many may have already been exposed to one dengue serotype earlier in life, while later infections may involve a different or shifting virus serotype. This can make the immune response more complex and, in some cases, may increase the risk of severe disease through antibody-dependent enhancement," Dr. Rohit Sharma, Consultant, Apollo Spectra Hospital, Jaipur, told HealthandMe.

Shifting Serotypes: A Global Trend Beyond India

Researchers have also documented a gradual shift in disease burden from children toward adolescents and young adults in some regions. This occurs because:

• Previous exposure patterns change over time.
• Urbanization increases transmission among older age groups.
• Childhood immunity profiles evolve as dominant serotypes change.
• Secondary infections with a different serotype can increase the risk of severe disease.

India's Indigenous Dengue Vaccine: DengiAll

DengiAll is India's first indigenous tetravalent dengue vaccine. Developed by the Indian pharmaceutical company Panacea Biotec, it is designed to protect against all four serotypes of the dengue virus and requires only a single dose.

The indigenously developed dengue vaccine is expected to play a crucial role in protecting the 10–20 age group, who are most susceptible to severe dengue cases, Dr. N. K. Arora, Member of the National Technical Advisory Group on Immunisation in India (NTAGI), told HealthandMe.

"Most dengue infections are mild, and treatment protocols have improved significantly over the years. However, the disease can become severe, particularly among adolescents and young adults aged 10–20 years. This is why the indigenous dengue vaccine is being eagerly awaited, as it has the potential to provide an important layer of protection for this vulnerable age group," he said.

The vaccine expert noted that the indigenous dengue vaccine is currently undergoing trials.

“The trials will take at least two and a half years, which means by the end of 2028, we will have the results,” Dr. Arora said.

Brazil's Vaccine Setback Raises Questions for India

Also read: Dengue Is Spreading Beyond Monsoons And Into New Regions Across India, Says Expert

Meanwhile, Brazil has suspended its Butantan-DV dengue vaccine after the death of two people who received the shot, which was proven to be over 80 percent effective in preventing the risk of severe disease for up to five years

This suspension, announced on June 8, is a crucial wake-up call for India, said experts, as the Butantan-DV is pretty similar, if not identical, to DengiAll. Both are also based on the same core viral strains developed by the US National Institutes of Health (NIH),

"Brazil’s recent experience with its dengue vaccination campaign should be viewed as an important safety signal for India, especially as India prepares for the possible rollout of DengiAll," Dr. Rohit said.

"Before any large-scale rollout, India must carefully study whether the vaccine produces strong type-specific protection against all four serotypes and whether there is any risk of imbalance in immunity," he added.

A dengue vaccine can be a major public health tool, but it must be supported by transparent data, long-term safety monitoring, and region-wise surveillance of circulating dengue serotypes, the experts said.

The Ebola outbreak in the Democratic Republic of the Congo is accelerating rapidly, with health authorities reporting 72 new confirmed cases in the last 24 hours, one of the largest single-day increases since the current epidemic began.

The latest government data shows that the total number of confirmed Ebola infections has reached 782, while 29 additional deaths were recorded over the same period, bringing the overall death toll to 181.

The outbreak's case fatality rate (CFR) has also increased to 23.1 per cent, up from approximately 21 per cent previously, indicating that the disease continues to pose a serious public health threat.

According to the Centers for Disease Control and Prevention, Uganda has reported 19 confirmed Ebola cases and two deaths as of June 14.

The outbreak involves the rare Bundibugyo strain of Ebola, for which there is no approved treatment or vaccine.

Outbreak Reaches New Areas

Health officials confirmed that the virus has spread to two additional health zones:

• Nia-Nia Health Zone in Ituri Province
• Mabalako Health Zone in North Kivu Province

• Ituri Province – cases reported in 20 health zones
• North Kivu Province – cases reported in 34 health zones
• South Kivu Province – cases reported in one health zone

Recoveries Offer Hope

Despite the rising numbers, Congolese health authorities reported that 40 patients have recovered from Ebola since the outbreak began.

Five new recoveries were announced from the health zones of Rwampara, Mongbwalu, and Mambasa.

The Ministry of Health emphasized that early medical care can improve survival chances, urging anyone experiencing symptoms to seek treatment immediately.

Also read: Ebola Survivors May Face COVID-Like Memory Loss and Brain Issues For Over 7 Years: NIH Study

Ebola Spreads In Orphanage

The outbreak has spread in an orphanage after two orphaned infants died from Ebola. Six more babies were identified as suspected Ebola cases at the orphanage of 69 children in Bunia, a city in Ituri province, at the epicentre of the outbreak in Congo.

Now, all children and staff are being monitored for symptoms, while four nuns who cared for the infants have reportedly fallen ill, the Guardian reported.

The situation highlights ongoing challenges facing response teams, including community mistrust, delayed reporting of symptoms, and difficulties tracing contacts in affected regions.

'Blind Spots' in Ebola Outbreak

The World Health Organization (WHO) last week warned that there are still many "blind spots" in the Ebola outbreak in the Democratic Republic of the Congo, suggesting the spread of the deadly disease may be much wider than official estimates.

"There are still many blind spots in some areas that are high risk," said Olivier le Polain, a WHO epidemiologist in Beni, eastern Congo, according to Reuters.

"Surveillance really needs to be strengthened in those areas."

Another major challenge is a shortage of beds that medics can use to isolate patients, he said. There were only 250 available across the three affected provinces.

"I'm really worried," WHO chief Tedros Adhanom Ghebreyesus said in an exclusive interview with STAT News.

He noted that due to political instability and mistrust among communities, contact tracing rates are currently around 50 per cent. "It should reach 95 per cent. The virus is ahead of us."

Lamenting that "the community is not collaborating," he said some people are being hidden from health authorities, while high levels of displacement make it difficult to locate and monitor contacts.

What Is Ebola?

Ebola is a highly lethal viral hemorrhagic fever first identified in 1976. Over the past five decades, it has caused over 30 outbreaks, primarily in Central and West Africa.

Symptoms include fever, headache, weakness, vomiting, diarrhea, muscle pain, sore throat, and unexplained bleeding. This eventually leads to severe complications like bleeding, organ failure, and death.

The Ebola outbreak in the Democratic Republic of the Congo (DRC) continues to intensify, with confirmed infections rising to 710 and the death toll reaching 149, according to the country's Ministry of Health.

The figure represents the total number of confirmed cases as of Friday, according to the latest situation report, which documented 21 new cases in the previous 24 hours.

The ministry also reported a case fatality rate of 21 per cent, while cautioning that the true toll could be higher as several suspected Ebola-related deaths remain under investigation.

According to the US Centers for Disease Control and Prevention (CDC), Uganda has reported 19 confirmed cases and two confirmed deaths as of June 12.

'Blind Spots' in Ebola Outbreak

The World Health Organization (WHO) last week warned that there are still many "blind spots" in the Ebola outbreak in the Democratic Republic of the Congo, suggesting the spread of the deadly disease may be much wider than official estimates.

"There are still many blind spots in some areas that are high risk," said Olivier le Polain, a WHO epidemiologist in Beni, eastern Congo, according to Reuters.

"Surveillance really needs to be strengthened in those areas."

Another major challenge is a shortage of beds that medics can use to isolate patients, he said. There were only 250 available across the three affected provinces.

The outbreak involves the rare Bundibugyo strain of Ebola, for which there is no approved treatment or vaccine. The disease went undetected for weeks, and first responders say they are now playing catch-up.

The WHO does not yet have projections for the size of the epidemic, Le Polain said, after the US CDC warned that it could reach a scale similar to the 2014–2016 West Africa outbreak, which caused more than 11,000 deaths.

'The Virus Is Ahead of Us'

"I'm really worried," WHO chief Tedros Adhanom Ghebreyesus said in an exclusive interview with STAT News.

He noted that due to political instability and mistrust among communities, contact tracing rates are currently around 50 per cent. "It should reach 95 per cent. The virus is ahead of us."

Lamenting that "the community is not collaborating," he said some people are being hidden from health authorities, while high levels of displacement make it difficult to locate and monitor contacts.

Ebola Spreads to 3 New Health Zones

Also read: Congo Ebola Cases Rise to 676; FIFA World Cup Team Arrives in US After Quarantine

Earlier, the virus spread to three new health zones in North Kivu and Ituri provinces, Health Minister Dr. Samuel-Roger Kamba said in a post on the social media platform X.

Kamba said the virus has now reached:

• Masereka (North Kivu)
• Vuhovi (North Kivu)
• Kambala (Ituri)

"Three new health zones affected: Masereka and Vuhovi in North Kivu, Kambala in Ituri. Our teams are adapting, and surveillance is intensifying. The response follows every signal, in every zone," he said.

What Is Ebola?

Symptoms include fever, headache, weakness, vomiting, diarrhea, muscle pain, sore throat, and unexplained bleeding. This eventually leads to severe complications like bleeding, organ failure, and death.

Ebola is a highly lethal viral hemorrhagic fever first identified in 1976. Over the past five decades, it has caused over 30 outbreaks, primarily in Central and West Africa.

Three strains of the virus — Ebola virus, Sudan virus, and Bundibugyo virus — have caused the largest outbreaks in Africa.