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.

Cancer, a rare occurrence? Unfortunately, not anymore. According to recent findings from an analysis published in The Lancet, cancer is one of the top 10 causes of death among Indian children. This is an alarming statistic, signalling an under-recognised public health problem. Data in the Global Burden of Disease Study 2023 noted that even as infectious diseases decline, noncommunicable diseases like cancer are emerging as a serious threat to child survival and well-being. In India, this epidemiological shift is particularly concerning in the context of childhood cancers. Despite being rare, they are highly treatable when detected in the early stages—yet most cases are diagnosed late.

As per the Indian Council of Medical Research’s National Centre for Disease Informatics and Research (ICMR-NCDIR), childhood cancers accounted for 3–5 per cent of cancer cases reported in India in 2022. The country sees an estimated 50,000 to 60,000 cases every year among children aged 0–14 years. This makes it one of the highest burdens globally. In 2023, 377,000 cases of childhood cancer were reported globally, along with 144,000 deaths, according to The Lancet research paper.

Read more: 3 Children In Every 4 Minutes Are Diagnosed With Cancer, That's What Makes Awareness Important Says Doctor

Hidden cancer burden in India

When it comes to childhood cancers in India, leukaemia, or blood cancers, are the most common, followed by lymphomas and tumours of the central nervous system. Collectively, these categories comprise most cases of childhood cancers in the country. The statistics vary across regions, with Delhi reporting the highest number of cases due to better diagnostic facilities. However, experts believe that the actual burden is likely to be much higher. Incomplete cancer registration and limited access to proper diagnostic facilities in underserved and rural areas are to blame for delayed diagnosis.

Why is childhood cancer detected late in India?

Experts say that cancer deaths in India can largely be attributed to delayed diagnosis. Early symptoms of cancer in children include fatigue, fever, unexplained weight loss, and swelling in certain body parts. These symptoms are often overlooked, leading to delays at multiple levels. According to the ICMR 2022 factsheet, a significant proportion of children reach hospitals only at advanced stages of the disease. By then, treatment becomes more complex, more expensive, and less likely to succeed.

Access to cancer care for children

Access to cancer care for children is uneven in India. Paediatric oncology services are largely limited to hospitals in tier-one cities, forcing families from rural areas and smaller towns to travel in order to access proper treatment. This imbalance results in delayed care, especially for economically vulnerable families. Financial limitations are another barrier in the process—even if treatment costs are subsidised, expenses such as travel, accommodation, and loss of income can be overwhelming.

Read more: 41 million children aged 5-19 living with high BMI in India: Study

Irregular survival patterns

Globally, survival rates for childhood cancers exceed 80 per cent in high-income countries. In India, outcomes are uneven. The ICMR 2022 factsheet noted that survival depends on the stage of diagnosis, type of cancer, and where the child is treated. Hospitals in India are reporting improving survival rates for certain forms of cancer, such as acute lymphoblastic leukaemia. The ICMR factsheet also highlights the need for a dedicated approach to paediatric cancer care, including better infrastructure, trained doctors, and stronger referral systems.

Indian weddings are a global sensation for all the taam-jhaam—the outfits, the music, the madness, and the unmatched vibe. In an ever-evolving culture, several new trends become a part of the wedding buzz in India. At a time when weight-loss drugs are the talk of the town, it is no surprise that they, too, have joined the list of new must-haves for Indian brides. For many soon-to-be brides and grooms, the pressure to look a class apart is always high. Amid the madness of wedding preparations, brides and grooms often miss the gym—weight-loss drugs come to their rescue.

India's Mounjaro brides

Clinics in metropolitan cities like Delhi and Mumbai are introducing weight-loss treatments into their traditional pre-bridal and bridal packages. Bridal packages initially focused on hair care, skincare, hair styling, and grooming—but they have now expanded to include shots of Mounjaro, a popular weight-loss drug. Some wellness centres in the city have advertised that they offer customised programmes combining workout routines, nutrition, and medication to help clients achieve desired results.

Doctors have noticed a clear rise in such inquiries. Several specialists report that a significant portion of their patients seeking obesity treatments are engaged couples working within a fixed timeline. While medical professionals acknowledge this demand, many emphasise that such treatments should only be prescribed when medically appropriate, rather than purely for cosmetic reasons.

Read more: India To Strictly Inspect GLP-1 Drugs To Curb Misuse: Govt Flags Risks Amid Weight-loss Hype

The pressures of looking good at a wedding

Weddings in India are deeply rooted in tradition, elaborate, and often burdened by societal expectations around appearance. As a result, many resort to glycolic treatments, injections of Mounjaro, and sometimes even facial procedures for a bridal glow. However, weight-loss drugs serve a different purpose—they can boost a bride's confidence by helping her feel more comfortable in her own skin.

Others share similar experiences. Some individuals admitted that concerns about body image, often influenced by family expectations or societal standards, played a major role in their decision. In certain cases, weight became a factor in arranged marriage discussions, pushing individuals to seek faster solutions. However, most discontinued the injections shortly after their weddings.

Why are weight-loss drugs becoming so popular?

According to experts, the growing popularity of weight-loss drugs is linked to their increased availability. Globally, pharmaceutical companies have introduced their own versions of obesity treatments in India, and demand has risen drastically. At the same time, more affordable alternatives are being introduced by manufacturers to make these drugs accessible to a wider audience.

A word of caution

Despite the surge, experts warrant caution. Weight-loss drugs are intended to help clinically obese or significantly overweight individuals, as well as patients with type 2 diabetes and hypertension. These drugs are not meant to act as quick fixes for short-term aesthetic goals. Experts, therefore, stress the importance of using these drugs under expert guidance and supervision.

Misuse of weight-loss drugs

Doctors are also concerned about the misuse of weight-loss drugs—health authorities have started monitoring the sale and promotion of such medication, especially the cheaper versions on the market. Experts say that relying solely on these drugs instead of making essential lifestyle changes may not lead to sustainable results. For many, the appeal lies in convenience—maximum benefits with minimal effort. While these drugs may fit into a hectic routine, doctors continue to emphasise the need for a balanced approach to weight loss.

The UK National Health Service (NHS) is soon expected to roll out free weight-loss Wegovy jab to over a million people in England at risk of heart attacks and strokes.

The move is based on the recommendation of the National Institute for Health and Care Excellence (NICE), which said that overweight people with heart problems, or serious circulation problems in their legs, should have the weekly jab "as an extra layer of protection".

Developed by Danish drugmaker Novo Nordisk, Wegovy is primarily an antidiabetic medication used to treat Type 2 diabetes. People receiving the weight-loss drug Wegovy sustained weight loss for up to four years.

"We know that people who have already had a heart attack or stroke are living with real fear that it could happen again. The evidence from the clinical trial is compelling. It showed that people taking semaglutide alongside their existing heart medicines were significantly less likely to have another heart attack or stroke,” said Helen Knight, from NICE.

"Today's decision gives thousands of people in that situation an extra layer of protection, on top of the medicines they are already taking," she added.

Also read: Foundayo: US FDA Approves Eli Lilly’s GLP-1 Weight Loss Pill

Wegovy and Heart Risk

A November 2023 study, published in the New England Journal of Medicine, elicited a randomized clinical trial of tens of thousands of people, in which Wegovy - alongside existing heart medicines - was linked to a 20% reduced risk of heart attacks and strokes.

Importantly, benefits were seen early in the clinical trial, before significant weight loss occurred, suggesting the drug works directly on the heart and blood vessels, not just through weight loss, as per the NICE

The BBC reported that the UK faces a significant heart disease burden, and every year:

100,000 people get hospitalized due to heart attacks,

100,000 people experience a stroke

350,000 people live with peripheral arterial disease.

Sharon Hodgson, the health minister, said weight-loss drugs were a “gamechanger” and giving them to people at risk of heart attacks and strokes would be a “lifesaver”.

Also read: India To Strictly Inspect GLP-1 Drugs To Curb Misuse: Govt Flags Risks Amid Weight-loss Hype

Wegovy Is Top Weight-Loss Choice for US Teens

Only Wegovy has been approved by the US FDA for children aged 12 and older who are living with obesity. Since the approval in late 2022, the prescriptions have surged.

According to health data company Truveta, which reviewed medical records from 30 US health systems, prescriptions for Wegovy among teens jumped by 50 percent in 2024—rising from 9.9 per 100,000 adolescents in 2023 to 14.8 per 100,000 in 2024.

The first quarter of 2025 showed another increase, with the rate reaching 17.3 per 100,000.