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.

New Delhi: Harish Rana, India's first person to receive legal approval for passive euthanasia, passed away at AIIMS, New Delhi, on Tuesday evening, PTI reported. This comes after the Supreme Court allowed the withdrawal of the life-support system, thereby putting an end to an emotional chapter for the family. He had been in a vegetative state for over 13 years, with almost no hope of recovery. Doctors, after the Supreme Court's approval, removed the life-support tubes, thereby allowing him to die naturally. Passive euthanasia refers to withholding or withdrawing life-support treatment for a patient with little or no hope of recovery, allowing him or her to die naturally.

Read more: 'Sabko Maaf Karte Hue...Tum Jao': Emotional Farewell to Harish Rana After Supreme Court Allows ‘Right to Die with Dignity’

The apex court had granted permission for this on March 11 this year, thereby allowing the withdrawal of medical intervention under Article 21 to keep him alive. The Article gives the right to live with dignity. After the verdict, Rana was moved to AIIMS Delhi, where doctors followed a legally approved procedure to discontinue artificial life support.

Who is Harish Rana?

Harish Rana was a BTech student at Panjab University. In 2013, he reportedly fell from the fourth floor of a paying guest accommodation and suffered a traumatic brain injury. This left him 100% disabled and in a vegetative state. He required round-the-clock medical attention for survival and was being fed through a PEG (percutaneous endoscopic gastrostomy) tube. Doctors had been treating him for the past few years while maintaining that there were almost no chances of recovery.

A decade of suffering

For Harish Rana, the suffering last over a decade - 13 years of suffering silently. Hailing from Ghaziabad, for him it all began after a catastrophic fall from the fourth floor. Since then, he was in a coma unable to communicate or move apart from involuntary gulps and raqre flickering of his eyes. His parents approached the judiciary to put an end to the endless cycle of pain that their son could not even express. On March 11, the Supreme Court granted Rana hte right to 'die with dignity', thereby marking a first-ever case of passive euthanasia. The verdict allows doctors to remove support tubes that keep a patient in a vegetative state. On March 16, at AIIMS, Rana received an emotional farewell and was removed from life support.

Harish Rana, the 32-year-old resident from Ghaziabad who had been in vegetative condition for the last 13 years is now waiting for his last few moments. A landmark judgment allowed for passive euthanasia in Rana's case. This means without any active intervention, he will be able to exercise his right to die with dignity. As a result he has been taken off ventilator and other life support systems and shifted to a normal bed. His water tube was removed along with a cap being placed on his feeding tube. Health and Me had previously reported on how AIIMS Delhi has prepared to conduct India's first passive euthanasia.

Also Read: Harish Rana, India’s First Passive Euthanasia Case, Dies at AIIMS

However, it has been over a week since Rana's food and water supply has been cut off. Reports note that he, along with his parents are facing anxiety after he has been denied food and water for over a week.

On March 23, it marks 10 days since Rana has been shifted to AIIMS. Doctors note that every minute Rana spends in AIIMS is crucial for him, and special care is being taken to ensure he does not suffer during this time. His condition is being monitored and doctors are still administering medications to soothe his brain.

A Landmark Judgment For India's Long Debate In Euthanasia

Manish Jain, who represented Rana in Supreme Court and played a key role in securing legal aid for him told NDTV that when the verdict was being announced the entire court was packed. "From the courtroom to the gallery, there was a crowd everywhere, everyone was eagerly waiting to see what the Supreme Court would decide. Both judges became emotional while delivering the verdict; the expression was clearly visible on their faces... I was very disappointed myself. But the family felt that if the verdict came in their favor, it would be a great relief for the patient."

He told the media outlet that when the verdict was being announced the entire court went silent for 10 to 15 minutes and everyone was emotional.

Before the verdict was delivered, both judges met with Harish's family and obtained information from the doctor about every aspect of the case.

Jain describes the verdict saying: "I lost even after winning". He said he had seen Harish himself a several times and knew that he was going through a lot of pain. "13 years is no small thing," he notes. "The way his parents and family cared for him is beyond words. But now the only solace is that the court also understood the situation and gave a verdict that will set an example in the history of the country's judiciary."

What Happened To Harish Rana?

It was in 2013 when he suffered severe head injuries after he fell from the fourth floor from his PG accommodation while he was studying at Panjab University. He had been bedridden ever since, and survived on feeding tube. His father filed a petition seeking passive euthanasia under the guidelines Supreme Court had laid down in 2018 under Common Cause judgment. This is the second time the parents have approached the apex court.

In 2024, the court also suggested that Rana could receive home-based care with support from the Uttar Pradesh government. The home-based care includes periodic visits by doctors and physiotherapists. The court suggested that in case home care was not feasible, he could be moved to Noida's district hospital. However, his parents have noted that his condition continued to worsen. Family advocate Rashmi Nandakumar also informed the bench that "nothing seems to be working out".

"He is falling ill quite often and is repeatedly admitted to hospital," she said. The advocate further added that the family only sought passive euthanasia, which is withdrawal of treatment, and not any active intervention.

Justice Pardiwala also read medical reports and observed, "Just look at the condition of the boy. It's pathetic."

Recent court ruling on this case involves a bench comprising Justice JB Pardiwala and Justice KV Viswanathan that allowed the withdrawal of life support for Harish Rana, a resident of Ghaziabad, who has been in a coma and kept alive on tubes for breathing and nutrition after sustaining severe head injuries following a fall from a building in 2013 in Chandigarh.

Perez Hilton thanked doctors and nurses after his care at the Southern Hills Hospital in Las Vegas. He was hospitalized for 21 days after he experienced complications with the medicines he was taking for flu. In a video, he said, "My stupidity landed me in the hospital;". The celebrity blogger explained that he was taking medications on an empty stomach that led to serious health complications.

Also Read: Harish Rana Taken Off Food And Water Support For Over 10 Days; Waiting For Passive Euthanasia

What Happened To Perez Hilton?

He posted a video on March 23 on his YouTube channel and said, "It was the worst and best thing that's ever happened to me". The 48-year-old, whose real name is Mario Armando Lavandeira Jr, and goes by Perez Hilton said that he had flu for "about a week" and started to take his medications to get better.

However, the biggest mistake he did was taking those medications on an empty stomach. Though, he shares that he has never had food before any of his medications.

Turns out, the medications were hard on his stomach and intestines. After a week of taking the medications on an empty stomach, he developed an ulcer, a perforation and sepsis that led him to be admitted in a hospital with intense stomach pains.

“The first few days were a lot of pain and constant tests,” Perez recalled. “Because they couldn't find where the perforation was.” He added: “Eventually, after five days, I ended up having laparoscopic surgery. Surgery where they don’t cut you up, but they miraculously make these incisions.”

He aid that surgeons used cameras to "literally flip around all of my organs, trying to find the perforation first. Then after flipping around all of my organs, washing me our 'cause I had so much infection in there. So much infection". He also said that his lungs had to be drained out and that his body "kept falling apart". He was also put on heart medication because his "heart got out of control".

Also Read: World Tuberculosis Day 2026: Theme, Origin, And Significance

Due to his long hospital stay, he developed another infection and for two weeks he could not eat normal food. “It was such a slow process,” Perez shared. “Two weeks of just sickness and then another week of getting better before I was released. The last week was hell, because I had already been in the hospital two weeks by then.”

How Is Perez Hilton Now?

Perez is now at home and would continue to receive his medication intravenously through a PICC line in his arm for 10 days. He said it is more effective than oral medications. “When I saw my kiddos—who had visited me—but when we got home we had the biggest, most cathartic group hug. And tears and tears and tears. They were so worried for their dad," he said.

He also said that he learned from his experience of being hospitalized and hopes that his video works as a "cautionary tale" to those who are watching. He said, "I hope this video can be a cautionary tale to some of you. Take medication with food. That's very important. Take medication with food. Don't have it on an empty stomach. Don't end up like me in the hospital for 21 days.”