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 Central Drugs Standard Control Organisation (CDSCO) has now launched a nationwide crackdown on unapproved Fixed Dose Combination (FDCs) after 90 combination medicines that were being sold without mandatory central approval were busted last week.

CDSCO, India's apex drug regulatory body in the country, made the shocking discovery after scrutinizing drug samples uploaded on the SUGAM portal, the government’s online system for drug testing data.

Several of these samples were found to fall under the ‘new drug’ category but lacked approval from the central authority. As a result, the CDSCO wrote a letter to all states and union territory drug controllers, asking them to investigate manufacturers and marketers of these FDCs.

The letter reads: "The SUGAM lab testing data for the year 2025, a large number of drug samples (FDCs) are detected as unapproved and fall under the category of 'New Drug'. No new drug shall be manufactured for sale unless it is approved by the Licensing Authority 'as defined in Rule 3 of New Drugs and Clinical Trial Rules, 2019, Further, as per Rule 80 of New Drugs & Clinical Trial Rules 2019, a person who intends to manufacture new drug in the form of API or Pharmaceuticals formulation, as the case may be, for sale or distribution, shall make an application for grant of permission to the Central Licensing Authority in Form CT-21 along with a fee as specified in Sixth Schedule."

"The presence of unapproved drugs in the supply chain is a matter of serious concern, posing potential risks to public health and safety. It also indicates non- compliance with the provisions of the Drugs and Cosmetics Act, 1940, and rules made thereunder.

"Accordingly, please initiate appropriate investigation and regulatory action against the concerned manufacturers, marketers, and other stakeholders, as deemed fit. Kindly ensure strict monitoring and enforcement to prevent manufacture, sale, and distribution of such unapproved drugs," the letter states, on appropriate action against the sale and distribution of unapproved drugs.

FDCs are drugs that contain two or more active ingredients in a single formulation. The CDSCO has asked states to investigate and submit reports on the action taken at the earliest.

What Made It To The Unapproved List Of FDCs?

Cough And Cold Medicines

Cough and cold combination medicines have formed the single largest group. At least 14 to 16 entries show combination of ingredients found in everyday pharmacy shelves: dextromethorphan, ambroxol, guaiphenesin, chlorpheniramine, phenylephrine, terbutaline, and menthol in various permutations.

Several of these are sold as flavoured syrups for children. Budesonide-levosalbutamol inhalation suspension that is used for asthma and chronic obstructive pulmonary disease, too features in the list.

Nutritional Supplements

The next group is of the vitamins, minerals and other nutritional supplement which has roughly 18 to 20 entries. They include:

• Multivitamin capsules
• Iron-folic acid syrups
• Calcium-vitamin D3-K2 combinations
• Abapentin-methylcobalamin preparation

This group has accounted for at least 10 entries, which include antifungal creams that could lead to potential misuse and skin damage when sold without prescriptions.

Anti-Diabetic Medicines

This has accounted for six entries, and the combination includes:

• Glimepiride paired with metformin or pioglitazone

What Is India's Rule For FDCs?

Under India's New Drugs and Clinical Trial Rules of 2019, any FDC is treated as a new drug and must have the central government's approval before it could be manufactured and sold. The regulator's letter noted that there were presence of unapproved drugs in the supply chain that could pose risks to public health. This also amounts to a violation of the Drugs and Cosmetics Act, 1940.

“The presence of unapproved drugs in the supply chain is a matter of serious concern, posing potential risks to public health and safety. It also indicates non- compliance with the provisions of the Drugs and Cosmetics Act, 1940, and Rules made thereunder," it said.

DCGI urged states and UTs "to examine the unapproved FDCs in generic name as mentioned in the attached annexure". This is done to check whether any approval has been granted by the local office. "Accordingly, please initiate appropriate investigation and regulatory action against the concerned manufacturers, marketers, and other stakeholders, as deemed fit. Kindly ensure strict monitoring and enforcement to prevent the manufacture, sale, and distribution of such unapproved drugs," the letter noted.

Breakbone Fever, also known as dengue, is a mosquito-borne disease that is once again on the rise, with the U.S. Centers for Disease Control and Prevention issuing a travel alert across 17 Countries.

The federal agency flagged 'Level 1' risk for breakbone fever, calling for practicing usual precautions. It stated a higher-than-expected number of cases and urged people planning to travel to countries with an uptick in cases to be aware of the risk.

The CDC alert issued on March 23 identified 17 countries reporting an increased number of cases of dengue. These include: Afghanistan, Bangladesh, Bolivia, Colombia, Cook Islands, Cuba, Guyana, Maldives, Mali, Mauritania, New Caledonia, Pakistan, Samoa, Sudan, Timor-Leste, Vietnam, and the United States territories of American Samoa, Puerto Rico, and the US Virgin Islands, where local transmission is already common.

In 2026, the US reported a total of 496 dengue cases to date, and the vast majority of these cases were reported among people who contracted the illness while traveling abroad.

The CDC advised travelers to risk areas to prevent mosquito bites by

• using an EPA-registered insect repellent,
• wearing long-sleeved shirts
• long pants when outdoors,
• sleeping in an air-conditioned room or a room with window screens.

What Is Dengue? Why Is It Called Breakbone Fever

Dengue is a disease caused by a virus spread through mosquito bites. It is transmitted through infected mosquitoes, primarily the species Aedes aegypti.

The breakbone fever is caused by an infection with any of four different dengue viruses. These include:

• Dengue virus type 1 (DENV-1 or DEN-1)
• Dengue virus type 2 (DENV-2 or DEN-2)
• Dengue virus type 3 (DENV-3 or DEN-3)
• Dengue virus type 4 (DENV-4 or DEN-4)

Common Symptoms of the dengue are:

• Sudden onset of high-grade fever.
• Intense headache
• Severe muscle, joint, or bone pain.
• Skin Rash that often appears 2–5 days after the fever starts
• Nausea and Vomiting
• Minor bleeding
• Fatigue.

The disease can take up to 2 weeks to develop, with illness generally lasting less than a week.

However, it can quickly become severe within a few hours, usually requiring hospitalization.

In severe cases, health effects can include hemorrhage (uncontrolled bleeding), shock (seriously low blood pressure), organ failure, and death.

Breakbone Fever: Global Burden

According to the World Health Organization (WHO), about half of the world's population is now at risk of dengue.

It estimates that:

• About 390 million dengue infections occur annually worldwide
• Nearly 100 million people develop symptoms each year

The two main authorized vaccines in the world against dengue are Dengvaxia and Qdenga.

These vaccines are designed to protect against all four serotypes of the virus, with a focus on reducing severe disease and hospitalizations.

In addition, the Butantan-DV vaccine developed by the Butantan Institute in São Paulo has shown potential to be over 80 percent effective in preventing the risk of severe disease for up to five years. It also offers broader protection against all four dengue serotypes.

Sonia Gandhi, Congress Parliamentary Party chairperson, is under treatment for systemic infection, said the doctors treating her at the private hospital in Delhi, today.

The Rajya Sabha MP was admitted to the Sir Ganga Ram Hospital on March 24, 2026. As per initial reports, she was feeling unwell due to the change in weather and has been put under observation.

"Sonia Gandhi has been admitted to Sir Ganga Ram Hospital on 24th March night for fever. As per Dr. Ajay Swaroop, Chairman of SGRH, she is undergoing treatment with antibiotics for systemic infection,” the hospital said in a statement.

She "is showing response to treatment", it added.

Earlier, the hospital noted that the doctors are conducting further investigations to check for possible infection in the stomach and urinary tract.

What Is A Systemic Infection?

Systemic infection occurs in the bloodstream and affects the entire body, rather than a single organ or body part.

It occurs when pathogens like bacteria, viruses, or fungi enter the bloodstream and travel to multiple organs and tissues.

These infections can be life-threatening and common symptoms include:

• high fever,
• fatigue,
• rapid heart rate,
• confusion.

Earlier this year, in January, Sonia Gandhi was admitted to Sir Ganga Ram Hospital after she suffered respiratory discomfort.

Also Read: COVID Variant BA.3.2 Spreads To 23 Countries: Is The Variant Under Monitoring A Cause Of Worry?

Did Delhi Pollution Make Sonia Gandhi Sick?

Due to an increase in population during the peak winter season in Delhi, the 79-year-old Parliamentarian had been regular with hospital visits and check-ups. Hospital source, while speaking to the news agency PTI, said that "it is a routine admission".

According to reports, she had complained of some respiratory discomfort. Once her medical examination was done, it was found that "her bronchial asthma had been mildly exacerbated", confirmed Dr. Swaroop.

A hospital source told PTI that this is due to the combined effects of cold weather and pollution.

As a precautionary measure, she was admitted to the hospital for further observation and treatment. The physicians who were treating her made a decision on her discharge based on her clinical progress.

Sonia Gandhi's Health History

On June 7, 2025, she was admitted to the Indira Gandhi Medical College and Hospital (IGMC) in Shimla for a routine medical check-up. She was also later discharged after her medical examination.

As per Naresh Chauhan, Principal Advisor (Media) to the Himachal Pradesh Chief Minister, she was brought in due to minor health concerns. However, he said that after being put under observation by doctors to assess her condition, she was stable.

Dr. Aman Chauhan, Deputy Medical Superintendent at IGMC, said, "Her blood pressure was slightly on the higher side, but there is nothing serious. No additional tests were conducted; only routine investigations were carried out. She was not given any special medical advice because everything was perfectly fine."

In the same month, on June 15, she was admitted to Sir Ganga Ram Hospital again under the Department of Surgical Gastroenterology for a stomach-related issue. Before that, she was again in the Delhi hospital on June 9 for a medical check-up.