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 World Health Organization (WHO) has reported significant global progress against neglected tropical diseases (NTDs), with fewer people requiring treatment. However, the rising burden of dengue remains a major concern.

The Global Report on Neglected Tropical Diseases 2026 found that 63 countries had eliminated at least one NTD by June 2026, up from 42 at the end of 2020.

“Elimination of neglected tropical diseases is one of the standout success stories of global health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

However, he warned that these gains could be lost without increased domestic financing, sustained external support and the integration of NTD services into primary healthcare.

Global Progress Against NTDs

Also read: World Chagas Disease Day: Women Key To Prevent, Eliminate The Fatal Neglected Tropical Disease

The number of people requiring interventions for NTDs fell to 1.41 billion in 2024, a 36% decline since 2010 and a 19% decline since 2020.

Cases of sleeping sickness have dropped by 98% since 1999, while Guinea worm disease recorded just 10 human cases in 2025, its lowest number yet.

Between 2021 and 2025, 31 countries eliminated at least one NTD. Of these, 16 received WHO recognition for the first time. Between January and June 2026, five more countries received recognition: Algeria, Australia, Libya and Tunisia for trachoma, and Chile for leprosy.

By June 2026, 42 countries had eliminated one disease each, 16 had eliminated two, four had eliminated three and one country, Togo, had eliminated four.

India has eliminated three NTDs: Guinea worm disease in 2000, yaws in 2016 and trachoma in 2024.

Why Dengue Remains A Concern

Read More: Dengue Is Spreading Beyond Monsoons And Into New Regions Across India, Says Expert

Despite progress against several NTDs, the report highlights uneven progress, with these diseases continuing to disproportionately affect the world's poorest and most vulnerable communities.

Dengue remains a major concern. Cases of the mosquito-borne disease reached a record 15.1 million in 2024, up from 2.74 million in 2020.

Locally acquired cases were reported across all six WHO regions. The organisation also classified dengue as a Grade 3 emergency, its highest emergency level, in 2024.

The Region of the Americas accounted for most reported cases, with Brazil contributing the largest share of the regional burden.

WHO said climate and environmental change, rapid and often unplanned urbanisation, population movement and the geographical expansion of Aedes mosquitoes are contributing to the spread of dengue.

WHO also warned that the geographical expansion of dengue into previously unaffected populations increases the risk of severe disease from secondary infections, making health system preparedness and the management of severe cases increasingly important.

In 2024, 12,554 deaths were reported across dengue, visceral leishmaniasis and chikungunya, against the 2030 target of 1,291 or fewer annual deaths.

Dengue accounted for 11,827 of these deaths, followed by visceral leishmaniasis (482) and chikungunya (245). Compared with the 2016 baseline of 5,163 deaths, reported deaths from these three diseases increased by 143.2%.

Other NTD Targets Remain Off Track

READ: Milestone In Kala-Azar Treatment: WHO Updates Treatment Guidelines, Recommends Shorter & Safer Regimens

The report also identified several challenges to achieving the 2030 targets. Deaths from vector-borne NTDs have increased, while progress towards yaws eradication remains off track. Only three disease-specific indicators achieved their 2025 milestones.

The WHO's 2021–2030 road map aims to:

• Reduce by 90% the number of people requiring NTD interventions

• Reduce NTD-related disability and premature deaths by 75%.

• Enable 100 countries to eliminate at least one NTD

• Eradicate Guinea worm disease and yaws

With five years remaining to meet these targets, WHO called for accelerated action, increased domestic financing and the integration of NTD interventions into universal health coverage to protect progress and address persistent gaps.

Utah has become the first US state to authorise an artificial intelligence (AI) system to issue prescriptions for certain medications, marking a significant development in the use of AI in healthcare.

The pilot programme allows Nolla Health, a healthcare technology startup, to use its AI-powered dermatology app, Nolla Derm, to examine adults with mild-to-moderate acne and recommend prescription treatments without requiring an doctor's and supervision.

The programme is currently limited to adults aged 18 and above in Utah and covers a small list of topical acne medications. However, the initiative is significant as AI systems can eventually issue prescriptions without a doctors reviewing every case beforehand.

The development has also raised questions about whether AI can make decisions that are normally made by licensed medical professionals, especially when a prescription depends on assessing a patient's symptoms, medical history and treatment risks.

How Does Utah's AI Prescription Work?

Patients using Nolla Derm are required to verify their identity, provide informed consent and complete a medical questionnaire. They then submit photographs of their face through the app.

The AI system analyses the images to check acne severity and combines this information with the patient's medical history to determine whether treatment is appropriate.

It can then select from a limited list of topical acne treatments approved by physicians and generate a prescription.

The programme is being introduced in three stages, with different levels of medical supervision.

• First 100 patients: Two Utah-licensed physicians independently review and approve every AI-generated prescription before it is sent to a pharmacy.
• Next 400 patients: The AI can issue prescriptions directly and physicians will review cases retrospectively.
• Subsequent patients: Physicians review at least 10% of prescriptions each month, along with cases involving complications or side effects.

Advancing in stages requires the company to meet safety targets, including at least 95% agreement with physician assessments and no serious adverse events, as well as written approval from the state. Patients can also contact a licensed physician through the app.

Also read: Woman With Epilepsy Dies After Following ChatGPT’s Advice To Stop Medication: Why AI Cannot Replace A Doctor

Patient Safety Concerns

While AI can analyse information quickly, prescribing medication involves more than identifying a condition and selecting a drug. Doctors consider a patient's medical history, allergies, existing medications, and other health conditions. There are several concerns surrounding the use of AI for these decisions.

1. Incorrect diagnosis

An AI system assessing acne through photographs may not always be able to distinguish it from other skin conditions. Some skin disorders require different treatments or deeper medical investigation.

If the system incorrectly classifies a condition as acne, a patient could receive inappropriate medication, which could delay correct diagnosis.

Also read: New AI Tool Uses Facial Photos To Predict Cancer Patients’ Survival Risk

2. Missing important medical details

A prescription may be unsuitable because of a patient's allergies, medical history, pregnancy status or other medications.

Although Nolla Derm collects medical information through a questionnaire, questions remain about whether an automated system can consistently identify important details.

Also read: AI-Created Virus Injected Into A Human For The First Time To Fight Antibiotic Resistance

3. Delayed treatment

Not every skin problem is acne. Some lesions or changes in the skin may require an examination to rule out other conditions, including skin cancer.

If patients rely on an automated assessment instead of seeking medical attention, there is a risk that a condition could be overlooked and its diagnosis could be delayed.

4. Limited ability to detect complications

Patients may experience side effects after starting treatment. An AI system may not be able to assess these developments as comprehensively as a clinician who can examine the patient, order investigations or modify treatment.

5. Accountability when something goes wrong

Another concern is determining who is responsible if an AI-generated prescription causes harm. The Utah pilot includes oversight and malpractice insurance requirements, but the bigger question of accountability remains an important issue.

Doctors Question Whether AI Should Prescribe Without Human Oversight

Also read: AI May Suggest 3 Times More Expensive Medical Tests And Drugs Than Doctors, New Study Finds

The initiative has prompted concerns among medical professionals about how much responsibility AI systems should be given in healthcare. John Whyte, chief executive of the American Medical Association (AMA), has questioned whether AI should independently make medical decisions.

"These tools can play a very effective role, but they shouldn't autonomously be trying to practice medicine, and if they are, then they need to be held to very high standards, just as humans are," he told the Los Angeles Times. "And I don't think they can meet that burden," he added.

Earlier in 2026, Utah authorised another AI pilot involving prescription refills through the healthcare startup Doctronic. The programme attracted criticism from the state's Medical Licensing Board, which raised concerns about allowing AI to handle medication decisions without medical professionals.

Can AI Prescribing Improve Access To Healthcare?

Supporters argue that AI could help address gaps in access to medical care, especially for conditions that are commonly straightforward.

Zach Boyd, director of Utah's Office of Artificial Intelligence Policy, said the programme was designed to encourage healthcare innovation while maintaining safeguards.

"The Nolla Health pilot program represents a significant step forward in leveraging AI to improve healthcare access for Utahns, while maintaining rigorous oversight and safety," he said. "Our office facilitates innovative AI solutions while ensuring that public health and patient safety remain paramount."

Nolla's chief medical adviser, Dr Zaid Fadul, also highlighted the importance of independent oversight.

"The real test for AI in healthcare isn't how smart it is. It's whether someone other than the company can shut it off," he said.

"In Utah, the state can, and physicians can. That's the standard every AI in medicine should meet."

Healthcare affordability was one of the major influencers of US midterm election outcomes. A recent poll revealed that more than half of US voters believe their healthcare costs have worsened under President Donald Trump's administration.

The analysis by health policy research organisation KFF was published a day after the 2026 midterm elections' results were announced. It found that 54% of midterm voters said the administration's policies had made their personal healthcare costs worse. Only 10% said their costs had improved.

Voters who said their healthcare costs had increased were more likely to support Democratic candidates. Among this group, 82% voted for Democratic candidates, compared to 16% who voted Republican.

The findings come as Democrats made significant gains in the November 3 midterms, winning control of both the House of Representatives as well as the Senate.

Democrats Have An Advantage On Healthcare

Also read: 2026 US Election Results: What Democrats’ Wins Mean For RFK Jr’s MAHA Movement And Vaccine Policy

KFF's analysis of the 2026 Voter Poll found that Democrats had a 19-percentage-point advantage over Republicans on healthcare.

When asked which party was better equipped to handle healthcare, 49% of voters chose Democrats, compared to 30% who chose GOP.

This shows a bigger jump from the 2024 presidential election, when Democratic presidential candidate Kamala Harris had a seven-point lead over Donald Trump on the same issue.

Democrats also held a narrow advantage on the economy as 43% of voters said that they trusted the party to handle it better, compared to 37% who chose Republicans. This marked a sharp reversal from 2024, when Trump had a 10-point advantage over Harris on the economy.

The healthcare advantage was also visible among independent voters. Among independents who said Trump's policies had made their healthcare costs worse, 69% voted for Democratic candidates for Congress.

Healthcare Affordability: A Major Election Concern

Also read: US Midterms: Where Did Voters Support Abortion Rights And Where Did They Reject Them?

Healthcare costs had emerged as a significant concern even before voters went to the polls. A separate KFF Health Tracking Poll conducted between September 16 and 21 found that six in 10 voters were worried about affording healthcare. This included 25% who were very worried and 35% who were somewhat worried.

The poll also found that 47% of voters considered healthcare costs an extremely significant issue for candidates to discuss during the midterm campaign.

Democratic candidates repeatedly highlighted healthcare affordability, criticising Republicans over the expiration of enhanced Affordable Care Act (ACA) premium tax credits and reductions in Medicaid spending included in the 2025 reconciliation law.

The enhanced ACA tax credits had helped lower insurance premiums for people purchasing coverage through the marketplaces. Their expiration raised concerns about higher insurance costs for many enrollees.

Medicaid spending reductions also became a key point of debate because of their implications for people relying on the government-funded health insurance programme.

Democrats' victory gives the party control of both chambers of Congress, creating opportunities to analyse Trump administration's healthcare policies and push for changes in insurance affordability and Medicaid. It also gives them room to bring reforms in reproductive healthcare, vaccine policies, and gender-affirming care.

However, implementing major policy changes may be difficult while Trump remains president, especially if legislation faces a presidential veto.