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.

India’s first approved dengue vaccine, QDENGA, could be available in the private market by the first half of 2027, Dr Reddy’s Laboratories said. The company is partnering with Japan’s Takeda to promote and distribute the vaccine in India.

“Subject to the completion of applicable processes with local authorities, the vaccine is anticipated to become available in the first half of 2027,” the companies said.

QDENGA Vaccine: Why The Launch Matters

Also read: Delhi Dengue Cases Rise In September: Is Weather Fueling The Surge?

India’s dengue burden has risen 11-fold over the past two decades. Rapid urbanization, climate change and mosquito breeding have contributed to the growing public health challenge.

A nationwide ICMR dengue surveillance study found that all four dengue virus serotypes — DENV-1 to DENV-4 — are circulating across multiple regions. About one in 14 patients had concurrent infections with multiple serotypes.

QDENGA Approved In India: Who Can Take It?

QDENGA received market authorization from the Drug Controller General of India (DCGI) in July to prevent dengue in people aged 4 to 60 years.

According to Takeda, it can be given regardless of previous dengue infection and does not require pre-vaccination testing.

Since 2022, QDENGA has been approved in 43 countries across Asia, Latin America and Europe. It is also part of Brazil’s National Immunization Program and public immunization programs in Argentina, Colombia and Indonesia.

How Effective Is QDENGA?

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

QDENGA is designed to protect against all four dengue virus serotypes, regardless of previous dengue exposure.

The DCGI approval is supported by Takeda’s clinical program, which included 19 Phase 1, 2 and 3 trials involving more than 28,000 participants.

The pivotal Phase III TIDES trial included more than 20,000 participants across eight countries. Key findings included:

• 80.2% efficacy against virologically confirmed dengue one year after the second dose.
• 90.4% efficacy against dengue-related hospitalization at 18 months.
• 84.1% protection against dengue-related hospitalization after 4.5 years.
• Data showed protection across all four serotypes for up to seven years.

An Indian Phase III trial involving people aged 4 to 60 years also found the vaccine safe, well tolerated and immunogenic.

What Is QDENGA?

QDENGA (TAK-003) is a live-attenuated tetravalent dengue vaccine targeting all four dengue virus serotypes.

It is given as two 0.5 mL subcutaneous doses, three months apart. The vaccine uses a DENV-2 backbone with structural proteins from DENV-1, DENV-3 and DENV-4.

The WHO recommends QDENGA for use in dengue-endemic settings without pre-vaccination screening. It is also WHO-prequalified for procurement through agencies including UNICEF and PAHO.

QDENGA Manufacturing In India

Dr Reddy’s will handle promotion and distribution in the private market, while Takeda will retain rights to promote and distribute QDENGA in India’s public market.

In February 2024, Takeda partnered with Hyderabad-based vaccine maker Biological E to expand QDENGA production.

Biological E plans to manufacture 50 million doses annually, supporting Takeda’s goal of producing 100 million doses globally each year by the end of the decade.

The company’s production will focus heavily on multi-dose vials for public health sectors and National Immunization Programs in dengue-endemic countries globally.

Nearly one in four doctors globally is aged 55 or older and could reach retirement age within the next decade, according to a new World Health Organization (WHO) report, highlighting growing pressure on health systems.

The WHO has published its National Health Workforce Accounts: Health Workforce Levels and Trends 2026, the first in an annual series providing a global picture of health workforce levels and trends.

The report flagged that ageing among health workers is intensifying workforce shortages in some countries, while an ageing population is simultaneously increasing demand for healthcare services.

The global health worker shortage fell from 20 million in 2013 to 15 million in 2020 and was earlier projected to reach 10 million by 2030. However, newer analysis has revised the 2030 shortage estimate upward to 11.1 million.

“Ageing is the hidden health workforce crisis that requires urgent attention. It is creating a double pressure on health systems, primarily in high-income countries,” said Dr Khassoum Diallo, Acting Unit Head of Health Workforce Policies and Data, WHO Academy.

“We know that better data drives better policy, and these findings reinforce the importance of future-focused action to strengthen health workforce planning, education, employment and retention,” Dr Diallo added.

Also read: Japan Has 107,677 Centenarians; 88% Are Women: Challenges Of An Aging Population

Key Findings From The WHO Report

Based on the latest available data from 122 countries, nearly 25% of doctors are aged 55 or older and could reach retirement age within the next decade. In high-income countries, this rises to nearly one in three.

There are currently more than 70 million health and care workers worldwide. Global health workforce density increased by 52%, from 44.8 per 10,000 people in 2006 to 67.9 in 2025.

The WHO estimates that:

• 67 countries will not have enough health workers to maintain population health needs by 2030.
• The global health workforce shortage is projected to reach 11.1 million by 2030.
• An additional 832,000 health workers are needed just to maintain current age-standardized workforce density, primarily in high-income countries.

Major Gaps Between Rich And Poor Countries

Read More: Unusually High Cancer-Fighting Immune Cells Could Explain Why Some People Live Beyond 100: Study

The report also found major disparities in health worker availability between regions and income groups.

The density of medical doctors is 13 times higher, while the density of nurses and midwifery personnel is six times higher, in the WHO European Region than in the WHO African Region.

Health worker density also remains strongly linked to national income, with high-income countries having substantially greater workforce density than low-income countries.

“Despite gains in workforce production and data reporting, uneven and severe shortages of health and care workers remain, and health worker density remains strongly correlated with national income,” explained Dr Diallo. “Addressing these inequities is essential to achieving Health for All.”

Ageing Population Could Further Increase Demand

The workforce challenge is also unfolding as the global population ages. About one in 10 people worldwide was aged 65 or older in 2024. In high-income countries, the share was nearly one in five. Globally, the proportion is projected to reach about one in eight by 2030.

The WHO noted that population ageing will increase healthcare needs, meaning countries cannot simply aim to maintain their current health workforce density.

“Investing in the health and care workforce is essential to strengthening health systems, safeguarding health security and advancing sustainable development,” said Dr Diallo.

Lung cancer in people who have never smoked is an increasingly recognized global health concern. A new study found that a rare inherited EGFR mutation may increase lung cancer risk by over 60 times in never-smokers.

Lung cancer in never-smokers is the seventh leading cause of cancer death worldwide. Approximately 60% to 80% of lung cancer cases in never-smokers globally occur in females.

The study, published in Science, found that a rare inherited EGFR T790M mutation can increase lung cancer risk by over 60 times in never-smokers and 25 times in smokers.

Smoking itself increases the risk of developing lung cancer fourfold in the general population.

What Did The Study Find?

To look for the rare mutation, researchers evaluated genotyping data from 3.37 million people and found that it occurs in about 1 in 15,850 people.

Among the 17 cancers and non-pulmonary conditions screened, the mutation showed a strong association only with lung cancer. Researchers also traced its origin to southern Appalachian populations in the US.

“Recognition of individuals more likely to carry EGFR T790M, including those with family history of lung cancer, multifocal lung cancer, or lung nodules or Southeastern US ancestry, may help to inform future screening and prevention strategies for those at highest risk,” said the researchers.

“Smoking is bad for lung cancer. This mutation is bad for lung cancer. When you do both, your risk is the sum of those two risks,” said Alexander Gusev, a quantitative geneticist at Dana-Farber. “So, you definitely don't want to smoke.”

The mutation was not linked to any of the 17 other common cancers studied, suggesting that its effects may be largely limited to lung cancer.

Could Genetic Testing Change Lung Cancer Screening?

“Today, lung cancer screening is driven almost entirely by smoking history,” said Jaclyn LoPiccolo, attending physician and lung cancer researcher at Dana-Farber Cancer Institute, who co-led the study.

LoPiccolo added that the findings raise the possibility that, in the future, screening could also be dictated by inherited genetic risk.

“If further studies confirm the benefit, people with EGFR T790M could be identified through genetic testing and offered personalized CT screening to identify lung cancers when they are at their most curable stage,” she said.

How Does The Mutation Increase Risk?

Although most lung cancers are associated with tobacco use or exposure, the proportion diagnosed in people who have never smoked has been rising. Yet the genetic factors underlying these cancers, particularly the role of inherited risk, are not well understood.

In 2005, researchers identified the rare inherited EGFR T790M mutation in a European family with multiple cases of lung cancer. Since then, the mutation has been reported in other families with unusually high rates of the disease.

In the study, LoPiccolo noted that the mutation occurs in about 1 in 15,000 people in the US population, but in certain areas of the Southeastern US, it can be as frequent as 1 in 2,000 people.

Other Lung Cancer Risk Factors

Lung cancer occurs when abnormal cells grow uncontrollably in the lungs. It remains the leading cause of cancer deaths worldwide, with an estimated 2.5 million new cases and 1.8 million deaths in 2022.

Beyond inherited genetic risk, lung cancer can also develop following exposure to second-hand smoke, air pollution, and workplace chemicals and carcinogens.

These include asbestos, silica dust, diesel exhaust, arsenic and other industrial chemicals.

Radon gas is another lesser-known risk factor. It is invisible and odorless, and prolonged exposure to high levels of radon can increase the risk of lung cancer.