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.

15-year-old Tanvi Pariyani’s death at AIIMS Delhi has raised questions about the treatment of a rare and complex congenital heart condition she had been living with since childhood.

Tanvi, from Kota, had been visiting AIIMS since she was two. Her medical records listed ventricular septal defect (VSD) with pulmonary atresia, a combination that can make treatment considerably more complicated than just a 'hole in the heart'.

Tanvi’s family has alleged that corrective surgery was repeatedly postponed. AIIMS, however, said its treating team concluded in 2017 that corrective surgery was not feasible because of the complexity of her cardiac anatomy and advised medical management.

The hospital has now constituted a committee to review her complete clinical records, investigations, treatment, expert opinions and the circumstances surrounding her death. An autopsy is also underway.

What Is Pulmonary Atresia With VSD?

A VSD is a hole in the wall separating the heart’s two lower chambers. The right side of the heart pumps oxygen-poor blood towards the lungs through the pulmonary artery.

In pulmonary atresia, the normal route through which blood leaves the right side of the heart and reaches the lungs is blocked or has not developed properly.

This can severely block blood flow to the lungs and reduce the amount of oxygen entering the bloodstream.

When pulmonary atresia occurs along with VSD, doctors have to deal with multiple abnormalities rather than simply closing the hole.

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Treatment Is Complicated

Some children may initially require procedures to ensure adequate blood reaches the lungs. Doctors may use medicines temporarily and later create an alternative pathway for blood flow through a shunt.

In some patients, the pulmonary arteries remain very small and the body develops additional blood vessels supplying the lungs.

These vessels, called major aortopulmonary collateral arteries (MAPCAs), may need to be brought together through a procedure called unifocalisation.

A conduit may then be used to connect the heart to the lungs, while the VSD may also need to be closed.

The anatomy can also change as a child grows. Small pulmonary arteries, abnormal blood vessels and rising pressure in the lungs can make later surgical repair more challenging.

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Events Leading Upto The Teen's Unfortunate Death

According to AIIMS, Tanvi was admitted on August 24 after her condition deteriorated and was being evaluated for a possible heart-lung transplant.

On September 1, she developed severe cyanosis, and her oxygen saturation fell to around 48%. AIIMS said she subsequently suffered a hypoxic spell followed by cardiac arrest. Despite oxygen support and resuscitation, she could not be revived and was declared dead at 5:06 am.

“The Director, AIIMS, New Delhi has constituted a committee to examine the matter in detail, review the sequence of events and establish the facts,” the institute said.

The committee’s findings and autopsy report will be important in establishing what happened and whether any intervention could have altered the outcome.

A new US CDC study has warned of a threefold rise in identifications of Trichophyton indotineae, a skin fungus that causes ringworm and is resistant to standard treatment.

Between 2022 and 2025, T. indotineae was identified in 29 countries, with resistance to terbinafine, a commonly used antifungal medication. The first US case was reported in 2023.

Most cases are treated with terbinafine, either as a cream or a pill.

“Our results reveal a marked global increase in T. indotineae isolation,” the authors wrote in their paper, published in the CDC’s monthly journal, Emerging Infectious Diseases.

What Did The Study Find?

During the study period, 566 users from 54 countries submitted 1,657,334 spectra that led to the identification of fungal agents.

• 123,025 (7.7%) were identified as Trichophyton spp. by 316 users across 44 countries.
• 3,399 (0.2%) were identified as T. indotineae by 183 users across 29 countries.
• Europe accounted for the largest share of users (63.8%), followed by Asia (16.8%), Latin America (15.7%), North America (1.6%), Oceania (1.6%), and Africa (0.5%).
• Most T. indotineae spectra were identified in Europe — 3,040 (89.4%).
• T. indotineae was also identified in countries where no cases had previously been reported, including Bulgaria, Croatia, Colombia, Luxembourg, and Uruguay.

However, the research cannot tell us how many people globally are contracting T. indotineae; it only shows that laboratories are detecting it more often.

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What Is Ringworm?

Ringworm has nothing to do with worms. The misleading name refers to an infection caused by dermatophytes, fungi that thrive in warmth and moisture.

It can affect people of all ages and is highly contagious. Careful attention and immediate treatment are required to control the infection effectively.

Ringworm, also called tinea corporis, is a skin infection caused by fungal spores invading the dead outer layers of the skin. It typically presents as circular, red, scaly patches accompanied by itching or discomfort.

Signs And Symptoms

Symptoms of ringworm depend on where the infection develops:

• Skin: It usually begins as a red, scaly patch or bump.
• Scalp: It may start as small, pimple-like lesions that progress into scaly, patchy areas.
• Nails: The nails may become thickened, discolored, brittle, or crumbly.

How Is Ringworm Transmitted?

Ringworm is highly infectious and can be transmitted through:

• Direct skin-to-skin contact: Touching an infected person can transmit fungal spores.
• Indirect contact: Sharing towels, bedding, or clothes with an infected person can spread the infection.
• Animals to humans: Ringworm can be carried by pets, including cats and dogs, without showing symptoms.

How To Prevent Ringworm

Preventing ringworm is largely about maintaining good hygiene and avoiding contact with infected people or animals.

• Shower regularly, dry thoroughly, and change clothes daily.
• Do not share towels, combs, or bedding.
• Wear flip-flops or sandals in community showers, tanning rooms, locker rooms, and pool areas.
• Consult a veterinarian if your animal displays signs of ringworm.
• Prevent fungal growth by keeping moist areas such as the groin and feet dry.

When To Seek Medical Attention?

Left untreated, ringworm can spread across the body or penetrate further, potentially leading to complications such as secondary bacterial infections.

See a doctor if:

• Symptoms do not go away with treatment.
• The infection affects the scalp or nails.
• You feel very uncomfortable or the affected area is severely inflamed.

Bhutan has achieved a major public health milestone that several countries, including India, are still attempting to.

The World Health Organization (WHO) has validated Bhutan’s elimination of dog-transmitted rabies as a public health problem, making it the first country in the WHO South-East Asia Region to achieve this milestone.

Bhutan's achievement comes after it recorded zero human deaths from dog-induced rabies since June 2023. It also demonstrated that it has the systems needed to prevent the disease from returning.

In India, rabies continues to remain a major public health concern. Bhutan’s public health achievement, therefore, offers an important lesson for India and other countries. Eliminating rabies means tackling the disease at its source, rather than relying only on treatment after a dog bite.

How Did Bhutan Eradicate Rabies?

Bhutan’s progress towards rabies eradication was built over more than a decade through a One Health approach, bringing together human health, veterinary services, local governments and communities.

The country’s Nationwide Accelerated Dog Population Management and Rabies Control Programme focused on mass dog vaccination, population management, surveillance and community awareness.

“Bhutan has shown that eliminating dog-mediated human rabies is possible when strong national leadership, a mature One Health approach and communities come together around a shared goal,” said Dr Nilesh Buddha, Officer-in-Charge, WHO South-East Asia Region.

Bhutan also became the first country to sterilise its entire dog population that roamed freely on the streets through a nationwide programme.

WHO said Bhutan maintained universal, free access to post-exposure prophylaxis (PEP) across all 20 districts, while continuing mass dog vaccination and integrated human-animal surveillance. Cross-border coordination with Indian states is also being strengthened to protect the achievement.

“Bhutan's success shows that the health of humans, animals and the environment we share is inextricably linked,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said.

He added that the fight against rabies is won by bringing health workers, veterinarians and communities together rather than working in silos.

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What Can India Learn From Bhutan?

In terms of rabies eradication, India has made progress, but the burden remains substantial.

WHO estimates that 5,726 people die from rabies in India every year, based on an ICMR-National Institute of Epidemiology study. Around 9.1 million animal bites occur annually, with more than three-quarters caused by dogs.

The Indian government’s National Rabies Control Programme also states that around 96% of rabies mortality and morbidity is associated with dog bites.

India already has systems in place that could help with elimination of rabies. The Animal Birth Control Rules, 2023 provide for sterilisation and vaccination of stray dogs, while the National Rabies Control Programme focuses on ensuring access to PEP for people exposed to animal bites.

Bhutan’s experience shows that rabies elimination cannot depend only on giving vaccines to people after bites occur. Vaccinating dogs, controlling dog populations, strengthening surveillance, ensuring rapid access to PEP and improving community awareness have to work together.

Dr Soneet Yadav, ER Consultant, Ruby Hall Clinic, Pune, told HealthandMe, "Rabies keeps claiming lives mainly because people wait long for post‑exposure treatment and because we do not control Rabies in stray and free‑roaming dogs well. To get rid of rabies, India must use a coordinated "One Health" plan that brings together health workers, city officials, vets and animal‑care groups.”

He added, “The important goal is to make sure many dogs get vaccinated all the time while we also run birth‑control programmes and keep a tighter watch on animal‑bite incidents. In hospitals in rural and underserved areas, anti‑rabies shots and Rabies Immunoglobulin (RIG) should always be available. I think people need to hear that every suspected Rabies exposure means they must go to a doctor fast.”

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What You Should Do Immediately After A Bite?

Once the virus reaches your nervous system, modern medicine will not be able to help you as there is no cure. But rabies is 100 per cent preventable if treated in time.

The moment you realise you have been licked, scratched, or bitten by an animal, especially one that is unvaccinated or unknown, Dr Yadav recommends the following things:

1. Wash the wound thoroughly with soap and running water for at least 15 minutes.
2. Apply antiseptic like iodine or alcohol.
3. Avoid putting chilli, turmeric, oil or other ingredients on the wound
4. Rush to a doctor; do not wait for swelling, itching or any other sign. You will need a post-exposure prophylaxis (PEP) shot, which includes a course of anti-rabies vaccines and sometimes immunoglobulin injections.
5. Keep a record of the animal if possible. If it is someone’s pet, you will want to confirm their vaccination history.