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.
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.
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.
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.
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.
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Regaining weight is one of common effects of stopping GLP-1 treatment for obesity. But apart from this, users have reported unusual side effects like hair fall, vision loss and even psychiatric symptoms.
According to two case reports published in the Primary Care Companion for CNS Disorders, stopping GLP-1 weight-loss drugs may ensue serious psychiatric symptoms in some patients like hallucinations, paranoia, mania and severe depression.
The reports describe two men who developed acute psychiatric symptoms after abruptly discontinuing tirzepatide, sold under the brand names Mounjaro and Zepbound. Both patients needed hospitalisation and psychiatric treatment.
The latest findings raise questions about the possible psychiatric effects of stopping GLP-1 medicines on the brain.
What Happened To The Two Patients?
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The first case involved a 61-year-old man with a history of depression who stopped taking tirzepatide in August 2025 because of nausea.
Around two months later, he was hospitalised with worsening confusion and erratic behaviour. He experienced paranoia, auditory and visual hallucinations, and Cotard's delusion, a rare condition in which a person believes they are dead or no longer exist.
Medical investigations, including brain imaging, an electroencephalogram and tests of cerebrospinal fluid, did not identify a clear explanation for his symptoms. He received antipsychotic medication along with his existing antidepressant treatment.
Although his psychotic symptoms initially improved, he was readmitted weeks later with severe depression and catatonic features, a condition involving symptoms like reduced movement, unresponsiveness and difficulty communicating. He subsequently required electroconvulsive therapy.
The second case involved a 52-year-old man with a history of anxiety who abruptly stopped tirzepatide in September 2025 after losing approximately 100 pounds (45 kg) over six months.
About a month later, he developed significant mood and behavioural changes, including irritability, impulsivity, grandiosity and rapid, disorganised speech. Doctors diagnosed a manic episode. He was treated with an antipsychotic and transferred for psychiatric care.
Can Stopping GLP-1 Drugs Affect Mental Health?
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GLP-1 receptors are found not only in the digestive system but also in the brain, including regions involved in appetite, reward processing and mood regulation.
GLP-1 medicines influence these regions, which may partly explain why researchers are investigating their effects on mental health.
The authors of the case reports suggest that abruptly stopping the medication could contribute to sudden changes in mood or behaviour in certain vulnerable individuals. They also point towards dopamine signalling and neuroinflammatory processes.
However, researchers could not establish that withdrawal from tirzepatide was responsible for the psychiatric symptoms.
Both patients had pre-existing mental health conditions, which may have contributed to their symptoms. The second patient also had low vitamin B12 levels and increased marijuana use before developing symptoms.
The authors described the psychiatric symptoms after discontinuation of medication as “an underrecognized clinical phenomenon” and called for further research.
GLP-1 Drugs & Psychiatric Symptoms
The case reports do not mean that GLP-1 medicines cause psychosis, mania or other psychiatric disorders when stopped.
In January 2026, the US Food and Drug Administration (FDA) said its review of 91 clinical trials involving more than 107,000 participants found no increased risk of suicidal thoughts or behaviour with GLP-1 medicines.
It also found no increased risk of other psychiatric adverse events, including anxiety, depression, irritability and psychosis, compared to placebo.
However, that assessment primarily examined risks associated with taking the medicines. It does not settle the question of whether abrupt discontinuation could be linked with psychiatric symptoms in a small, vulnerable group.
The findings, however, indicate that patients should not stop GLP-1 treatment without discussing it with their healthcare provider. People may discontinue these medicines because of side effects, cost, access problems or other reasons, but a clinician can help change treatment plans.
Anyone experiencing new symptoms like confusion, hallucinations, extreme mood changes, paranoia or unusual behaviour after stopping a GLP-1 medication should seek urgent medical intervention.
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A new blood test may help identify microscopic precancerous changes linked to ovarian cancer before a tumour develops, according to a study published in Nature Medicine. Researchers found that the test could detect a molecular signal associated with an early precursor of high-grade serous ovarian cancer, one of the most common and aggressive forms of the disease.
The study, led by researchers at the Hoag Family Cancer Institute in California, identified elevated levels of an RNA molecule called Tu-Stroma in blood samples from women with a condition known as serous tubal intraepithelial carcinoma (STIC).
The findings could eventually help identify women at increased risk of developing ovarian cancer, especially those with inherited genetic mutations.
What Is STIC And How Is It Linked To Ovarian Cancer?
High-grade serous ovarian cancer mostly originates in the fallopian tubes rather than directly in the ovaries. It may begin with microscopic changes in the cells lining the fallopian tubes, known as serous tubal intraepithelial carcinoma or STIC.
These lesions are precancerous, which means they are not invasive cancer but can lead to the development of high-grade serous ovarian cancer.
STIC is difficult to detect because the abnormal cells are microscopic and cannot be identified through routine imaging. They are often discovered incidentally when women undergo surgery to remove their fallopian tubes or ovaries.
How Does The New Blood Test Work?
The researchers found that women with STIC had elevated levels of Tu-Stroma, an RNA molecule related to interactions between abnormal cells and surrounding healthy tissue.
The molecule is linked to a process in which cancer cells weaken neighbouring healthy cells, creating an environment that allows abnormal cells to thrive.
By measuring Tu-Stroma in blood samples, researchers investigated whether this molecular signal could identify STIC before invasive cancer develops.
In a separate validation group, the test detected STIC in 92.3% of women who had the precancerous condition and correctly identified 98.2% of healthy women.
Researchers also modelled how the test might perform in a population of women with inherited risk factors for ovarian cancer. They estimated that approximately 72% of positive results would be accurate, while a negative result would be correct nearly 100% of the time.
Also read: Why Lobular Breast Cancer Can Be Difficult To Detect On A Mammogram?
Could The Test Help Women With BRCA1 And BRCA2 Mutations?
The findings may be relevant to women carrying inherited mutations in the BRCA1 and BRCA2 genes, which increase the risk of ovarian and breast cancers significantly.
Women with these mutations may be advised to consider surgery to remove of their fallopian tubes and ovaries. While this can reduce ovarian cancer risk, it also has consequences like including the loss of fertility and the possibility of early menopause.
Dr Esha Madan, co-author of the study and a researcher at Hoag Family Cancer Institute, said, “For women at high risk, this could transform how we approach prevention.”
She added, “Today, decisions about preventive surgery are largely guided by inherited risk, without knowing whether precancerous lesions are actually present. Our discovery could eventually provide that missing biological information.”
Can This Blood Test Be Used For Ovarian Cancer Screening?
The study analysed previously collected blood samples from women whose diagnoses were already known. It did not test the blood marker prospectively in a large population of women undergoing routine screening.
The test performed well in samples from people with confirmed conditions and may not achieve the same accuracy in the general population.
Researchers are now planning prospective studies involving women with and without inherited risk factors. These studies will assess whether Tu-Stroma can identify precancerous changes before they progress and whether the results can shape clinical decisions.
Dr Rajan Gogna, who led the research, said, “We asked a fundamentally different question: What if we could identify the earliest molecular warning signs before invasive cancer even develops?”
The discovery offers a new direction for ovarian cancer detection, shifting the focus from finding an existing tumour to identifying biological changes that may precede it.
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Long known to be a key risk factor for lungs and heart, a new study now shows that long-term exposure to air pollution and fine particulate matter (PM2.5) may increase the risk of developing type 2 diabetes by 16%.
A rise of 10 micrograms per cubic metre in PM2.5 concentration was associated with a 10% to 16% increase in diabetes risk.
The findings come amid rising pollution levels in Delhi, highlighting the potential metabolic health consequences of prolonged exposure to poor air quality.
Published in the Journal of Vascular Diseases, the analysis found that air pollution is not just a cardiopulmonary concern but also a potential contributor to metabolic health problems.
The researchers analysed 13 major previous reviews, covering more than 200 million participant observations worldwide.
Reviews examining new diabetes cases consistently found an association between air pollution exposure and a higher risk of developing the disease.
The studies also reported higher diabetes prevalence, elevated blood sugar levels and an increased burden of related health complications.
The association was observed even among populations living in areas classified as having clean air. Since nearly everyone is exposed to outdoor air pollution, even relatively small increases in individual risk could translate into millions of additional diabetes cases worldwide.
South and East Asia are among the regions likely to face a particularly high burden.
Dr. Anoop Misra, Padma Shri, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-Doc Hospital for Diabetes and Allied Sciences, said air pollution should be recognised as a potential contributor to metabolic disorders, including diabetes, rather than viewed only as a respiratory and environmental concern.
“Air quality management must become a core part of diabetes prevention,” he said.
He also highlighted the growing public health burden in heavily polluted South Asian cities and stressed the need to integrate air quality management into diabetes prevention.
Yashendra Sethi, first author of the study, said India must focus on improving environmental conditions to protect metabolic health.
“If India wants to tackle both diabetes and pollution, we must improve metabolic health and clean up our environment. We cannot fight diabetes while ignoring the air we breathe,” Sethi said.
The researchers emphasised that diabetes prevention should be considered alongside heart and lung health when framing clean-air guidelines.
They recommended strengthening continuous air quality monitoring, tightening emissions standards and incorporating environmental factors into national healthcare policies.
Delhi's air quality slipped into the 'very poor' category on November 11, with the 24-hour average Air Quality Index (AQI) settling at 313. This came a day after stronger winds brought some relief, pushing the AQI into the 'poor' category.
According to the Air Quality Early Warning System (EWS) for Delhi, PM2.5 and PM10 concentrations are also expected to rise over the next two days.
Of the 58 monitoring stations that recorded data on Wednesday, one reported 'severe' air quality, 34 were in the 'very poor' category, 22 in the 'poor' category and one in the 'moderate' category.
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