A World Health Organization independent committee of experts says the spread of monkeypox in a number of countries around the world is worrisome but does not constitute what the WHO calls a Public Health Emergency of International Concern.

In early May, the World Health Organization was alerted to an outbreak of monkeypox in countries outside Africa, where this deadly disease has been circulating for decades. Since then, more than 3,200 confirmed cases and one death have been reported in more than 50 non-African countries. This has set alarm bells ringing as, until now, only sporadic cases of monkeypox have occurred outside Africa.

WHO Director-General, Tedros Adhanom Ghebreyesus calls the current outbreak an evolving health threat, noting the rapid spread of the disease into new countries and regions. He says the committee has agreed to reconvene another emergency meeting if appropriate.

WHO spokesman, Christian Lindmeier tells VOA the committee has drawn up a list of factors that could trigger a reassessment of the event.

“Evidence of an increase in the rate of growth of cases reported in the next 21 days, including significant spread to and within additional countries. Also, if we see an increase in endemic countries. So, evidence also of increased severity or a change in the viral genome associated with or leading to an end of transmissibility,” he said.

Monkeypox is a rare disease similar to smallpox. The virus causes rashes and flu-like symptoms. It is spread mainly through human contact with infected rodents but sometimes can be spread through skin-to-skin contact with an infected person.

The disease is mainly found in Central and West Africa. This year, WHO reports there have been nearly 1,500 suspected cases of monkeypox and around 70 deaths primarily in the Democratic Republic of the Congo, Central African Republic, and Cameroon.

Lindmeier says cases of Monkeypox have spread to the European region, to the Americas, as well as the Eastern Mediterranean and West Pacific regions.

“At this point, it is mainly in the newer countries affecting the community of the LGBTQ-Plus community of men having sex with men. But in the endemic countries, we have seen also children and women infected and deaths occurring in the weaker communities and weaker populations,” he said.

While questions regarding the monkeypox outbreak remain unresolved, WHO urges nations to remain vigilant and strengthen their ability to prevent transmission of the disease.

The WHO expert committee advises countries to step-up surveillance, improve diagnostics, and when appropriate to use therapeutics and vaccines. It also recommends affected communities to implement public health measures including contact tracing and isolation.
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A Texas group that helps women pay for abortions halted its efforts Saturday while evaluating its legal risk under a strict state ban. Mississippi’s only abortion clinic continued to see patients while awaiting a 10-day notice that will trigger a ban. Elected officials across the country vowed to take action to protect women’s access to reproductive health care, and abortion foes promised to take the fight to new arenas.

A day after the Supreme Court’s ruling overturning Roe v. Wade ended the constitutional right to abortion, emotional protests and prayer vigils turned to resolve as several states enacted bans and both supporters and opponents of abortion rights mapped out their next moves.

In Texas, Cathy Torres, organizing manager for Frontera Fund, a group that helps pay for abortions, said there is a lot of fear and confusion in the Rio Grande Valley near the U.S.-Mexico border, where many people are in the country illegally.

That includes how the state’s abortion law will be enforced. Under the law, people who help patients get abortions can be fined and doctors who perform them could face life in prison.

“We are a fund led by people of color, who will be criminalized first,” Torres said, adding that abortion funds like hers that have paused operations hope to find a way to safely restart. “We just really need to keep that in mind and understand the risk.”

Tyler Harden, Mississippi director for Planned Parenthood Southeast, said she spent Friday and Saturday making sure people with impending appointments at the state’s only abortion clinic — which featured in the Supreme Court case but is not affiliated with Planned Parenthood — know they don’t have to cancel them right away. Abortions can take place until 10 days after the state attorney general publishes a required administrative notice.

Mississippi will ban the procedure except for pregnancies that endanger the woman’s life or those caused by rape reported to law enforcement. The Republican speaker of the Mississippi House, Philip Gunn, said during a news conference Friday that he would oppose adding an exception for incest.

“I believe that life begins at conception,” Gunn said.

Harden said she has been providing information about funds that help people travel out of state to have abortions. Many in Mississippi were doing so even before the ruling, but that will become more difficult now that abortions have ended in neighboring states. Florida is the nearest “safe haven” state, but Harden said, “we know that that may not be the case for too much longer.”

At the National Right to Life convention in Atlanta, a leader within the anti-abortion group warned attendees Saturday that the Supreme Court’s decision ushers in “a time of great possibility and a time of great danger.”

Randall O’Bannon, the organization’s director of education and research, encouraged activists to celebrate their victories but stay focused and continue working on the issue. Specifically, he called out medication taken to induce abortion.

“With Roe headed for the dustbin of history, and states gaining the power to limit abortions, this is where the battle is going to be played out over the next several years,” O’Bannon said. “The new modern menace is a chemical or medical abortion with pills ordered online and mailed directly to a woman’s home.”

Protests broke out for a second day in cities across the country, from Los Angeles to Oklahoma City to Jackson, Mississippi.

In the LA demonstration, one of several in California, hundreds of people marched through downtown carrying signs with slogans like “my body, my choice” and “abort the court.”

Turnout was smaller in Oklahoma City, where about 15 protesters rallied outside the Capitol. Oklahoma is one of 11 states where there are no providers offering abortions, and it passed the nation’s strictest abortion law in May.

“I have gone through a wave of emotions in the last 24 hours. … It’s upsetting, it’s angry, it’s hard to put together everything I’m feeling right now,” said Marie Adams, 45, who has had two abortions for ectopic pregnancies, where a fertilized egg is unable to survive. She called the issue “very personal to me.”

“Half the population of the United States just lost a fundamental right,” Adams said. “We need to speak up and speak loud.”

Callie Pruett, who volunteered to escort patients into West Virginia’s only abortion clinic before it stopped offering the procedure after Friday’s ruling, said she plans to work in voter registration in the hope of electing officials who support abortion rights. The executive director of Appalachians for Appalachia added that her organization also will apply for grants to help patients get access to abortion care, including out of state.

“We have to create networks of people who are willing to drive people to Maryland or to D.C.,” Pruett said. “That kind of local action requires organization at a level that we have not seen in nearly 50 years.”

Fellow West Virginian Sarah MacKenzie, 25, said she’s motivated to fight for abortion access by the memory of her mother, Denise Clegg, a passionate reproductive health advocate who worked for years at the state’s clinic as a nurse practitioner and died unexpectedly in May. MacKenzie plans to attend protests in the capital, Charleston, and donate to a local abortion fund.

“She would be absolutely devastated. She was so afraid of this happening — she wanted to stop it,” Mackenzie said, adding, “I’ll do everything in my power to make sure that this gets reversed.”

The Supreme Court’s ruling is likely to lead to abortion bans in roughly half the states.

Since the decision, clinics have stopped performing abortions in Arizona, Alabama, Arkansas, Kentucky, Missouri, South Dakota, West Virginia and Wisconsin. Women considering abortions already had been dealing with the near-complete ban in Oklahoma and a prohibition after roughly six weeks in Texas.

In Ohio, a ban on most abortions from the first detectable fetal heartbeat became law when a federal judge dissolved an injunction that had kept the measure on hold for nearly three years.

Another law with narrow exceptions was triggered in Utah by Friday’s ruling. Planned Parenthood Association of Utah filed a lawsuit against it in state court and said it would request a temporary restraining order, arguing it violates the state constitution.

Gov. Tim Walz of Minnesota, where abortion remains legal, signed an executive order shielding people seeking or providing abortions in his state from facing legal consequences in other states. Walz also has vowed to reject requests to extradite anyone accused of committing acts related to reproductive health care that are not criminal offenses in Minnesota.

“My office has been and will continue to be a firewall against legislation that would reverse reproductive freedom,” he said.

In Fargo, North Dakota, the state’s sole abortion provider faces a 30-day window before it would have to shut down and plans to move across the river to Minnesota. Red River Women’s Clinic owner Tammi Kromenaker said Saturday that she has secured a location in Moorhead and an online fundraiser to support the move has brought in more than half a million dollars in less than three days.

Republicans sought to downplay their excitement about winning their decades-long fight to overturn Roe, aware that the ruling could energize the Democratic base, particularly suburban women. Carol Tobias, president of National Right to Life, said she expects abortion opponents to turn out in huge numbers this fall.

But Wisconsin Gov. Tony Evers, a Democrat, said Saturday he believes the issue will energize independents and he hopes to translate anger over Roe’s demise into votes.

“Any time you take half the people in Wisconsin and make them second-class citizens,” Evers said, “I have to believe there’s going to be a reaction to that.” 
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The World Health Organization’s chief said Saturday that the monkeypox outbreak was a deeply concerning evolving threat but did not currently constitute a global health emergency.

WHO Director-General Tedros Adhanom Ghebreyesus convened a committee of experts Thursday to advise him whether to sound the U.N. health agency’s strongest alarm over the outbreak.

A surge of monkeypox cases has been detected since early May outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in Western Europe.

More than 3,200 confirmed cases and one death have now been reported to the WHO from more than 50 countries this year.

“The emergency committee shared serious concerns about the scale and speed of the current outbreak,” noting many unknowns about the spread and gaps in the data, Tedros said. 

“They advised me that at this moment the event does not constitute a Public Health Emergency of International Concern (PHEIC), which is the highest level of alert WHO can issue but recognized that the convening of the committee itself reflects the increasing concern about the international spread of monkeypox.”

Tedros said the outbreak was “clearly an evolving health threat” that needed immediate action to stop further spread, using surveillance, contact-tracing, isolation and care of patients, and ensuring vaccines and treatments are available to at-risk populations.

‘Intense response’ needed

“The vast majority of cases is observed among men who have sex with men, of young age,” chiefly appearing in urban areas, in “clustered social and sexual networks,” according to the WHO report of the meeting.

While a few members expressed differing views, the committee resolved by consensus to advise Tedros that at this stage, the outbreak was not a PHEIC.

“However, the committee unanimously acknowledged the emergency nature of the event and that controlling the further spread of outbreak requires intense response efforts.”

They are on standby to reconvene in the coming days and weeks depending on how the outbreak evolves.

The committee recommended that countries improve diagnostics and risk communication.

It noted that many aspects of the outbreak were unusual, while some members suggested there was a risk of sustained transmission due to the low level of population immunity against the pox virus infection.

Knowledge gaps

The committee that considered the matter is made up of 16 scientists and public health experts and is chaired by Jean-Marie Okwo-Bele, a former director of the WHO’s Vaccines and Immunization Department.

Thursday’s five-hour private meeting was held in person at the WHO’s Geneva headquarters and via video conference.

The committee discussed current observations of plateauing or potential downward trends in case numbers in some countries; difficulties in contact tracing due to anonymous contacts, and “potential links to international gatherings and LGBTQ+ Pride events conducive for increased opportunities for exposure through intimate sexual encounters.”

They were also concerned that the potential stigmatization of affected groups could impede response efforts.

There are knowledge gaps on transmission modes, the infectious period, as well as over access to vaccines and antivirals and their efficacy, they said.

Blistery rash

The normal initial symptoms of monkeypox include a high fever, swollen lymph nodes and a blistery chickenpox-like rash.

Initial outbreak cases had no epidemiological links to areas that have historically reported monkeypox, suggesting that undetected transmission might have been going on for some time.

Few people have been hospitalized to date, while 10 cases have been reported among health care workers.

The WHO’s current plan to contain the spread focuses on raising awareness among affected population groups and encouraging safe behaviors and protective measures.

There have been six PHEIC declarations since 2009, the last being for COVID-19 in 2020 — though the sluggish global response to the alarm bell still rankles at the WHO HQ.

A PHEIC was declared after a third emergency committee meeting Jan. 30. But it was only after March 11, when Tedros described the rapidly worsening situation as a pandemic, that many countries seemed to wake up to the danger.
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The U.S. Supreme Court’s decision to overturn Roe v. Wade, which has guaranteed a woman’s constitutional right to an abortion for almost 50 years, is set to activate anti-abortion laws in at least 13 states.

While some of the so-called “trigger laws” have been in place for years, others have been enacted more recently. Some states could activate their anti-abortion laws immediately, with others following shortly thereafter.

The 13 states that have laws that would ban or halt abortions with the Supreme Court’s overturn Friday of Roe are Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah and Wyoming.
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The U.S. Supreme Court has struck down the decades-old Roe v. Wade decision, which said women have a constitutional right to have an abortion. States will now decide whether to permit the procedure; it’s expected that roughly half could do so. VOA’s Laurel Bowman reports.
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NASA’s next moon mission scores a win despite another setback. Plus, South Korea launches one of its own rockets to space, and the UK readies what it hopes will be its first domestically launched satellites. VOA’s Arash Arabasadi brings us The Week in Space
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Federal health officials on Thursday ordered Juul to pull its electronic cigarettes from the U.S. market, the latest blow to the embattled company widely blamed for sparking a national surge in teen vaping. 

The action is part of a sweeping effort by the Food and Drug Administration to bring scientific scrutiny to the multibillion-dollar vaping industry after years of regulatory delays. 

The FDA said Juul must stop selling its vaping device and its tobacco- and menthol-flavored cartridges. Those already on the market must be removed. Consumers aren’t restricted from having or using Juul’s products, the agency said. 

To stay on the market, companies must show that their e-cigarettes benefit public health. In practice, that means proving that adult smokers who use them are likely to quit or reduce their smoking, while teens are unlikely to get hooked on them. 

The FDA noted that some of the biggest sellers like Juul may have played a “disproportionate” role in the rise in teen vaping. The agency said Thursday that Juul’s application didn’t have enough evidence to show that marketing its products “would be appropriate for the protection of the public health.” 

Juul said it disagrees with the FDA’s findings and will seek to put the ban on hold while the company considers its options, including a possible appeal and talking with regulators. 

In a statement, the FDA said Juul’s application left regulators with significant questions and didn’t include enough information to evaluate any potential risks. The agency said the company’s research included “insufficient and conflicting data” about things like potentially harmful chemicals leaching from Juul’s cartridges. 

“Without the data needed to determine relevant health risks, the FDA is issuing these marketing denial orders,” Michele Mital, acting director of the FDA’s tobacco center, said in the statement. 

The agency has granted some e-cigarette applications. Since last fall, the agency has given its OK to tobacco-flavored e-cigarettes from R.J. Reynolds, Logic and other companies. 

But industry players and anti-tobacco advocates have complained that those products account for just a tiny percentage of the $6 billion vaping market in the United States. 

Regulators repeatedly delayed making decisions on devices from market leaders, including Juul, which remains the best-selling vaping brand although sales have dipped. 

Last year, the agency rejected applications for more than a million other e-cigarettes and related products, mainly due to their potential appeal to underage teens. 

The American Lung Association called Thursday’s decision “long overdue and most welcome,” and cited Juul for stoking youth vaping. 

E-cigarettes first appeared in the U.S. more than a decade ago with the promise of providing smokers a less harmful alternative. The devices heat a nicotine solution into a vapor that’s inhaled, bypassing many of the toxic chemicals produced by burning tobacco. 

But studies have reached conflicting results about whether they truly help smokers quit. And efforts by the FDA to rule on vaping products and their claims were repeatedly slowed by industry lobbying and competing political interests. 

The vaping market grew to include hundreds of companies selling an array of devices and nicotine solutions in various flavors and strengths. 

The vaping issue took on new urgency in 2018 when Juul’s high-nicotine, fruity-flavored cartridges quickly became a nationwide craze among middle and high school students. The company faces a slew of federal and state investigations into its early marketing practices, which included distributing free Juul products at concerts and parties hosted by young influencers. 

In 2019, the company was pressured into halting all advertising and eliminating its fruit and dessert flavors. The next year, the FDA limited flavors in small vaping devices to just tobacco and menthol. Separately, Congress raised the purchase age for all tobacco and vaping products to 21. 

But the question of whether e-cigarettes should remain on the market at all remained. 

The FDA has been working under a court order to render its decisions; anti-tobacco groups successfully sued the agency to speed up its review. 

FDA regulators warned companies for years they would have to submit rigorous, long-term data showing a clear benefit for smokers who switch to vaping. But all but the largest e-cigarette manufacturers have resisted conducting that kind of expensive, time-consuming research. 

While Juul remains a top seller, a recent federal survey shows that teens have been shifting away from the company. Last year’s survey showed Juul was the fourth-most popular e-cigarette among high schoolers who regularly vape. The most popular brand was a disposable e-cigarette called Puff Bar that comes in flavors including pink lemonade, strawberry and mango. That company’s disposable e-cigarettes had been able to skirt regulation because they use synthetic nicotine, which until recently was outside the FDA’s jurisdiction. Congress recently closed that loophole. 

Overall, the survey showed a drop of nearly 40% in the teen vaping rate as many kids were forced to learn from home during the pandemic. Still, federal officials cautioned about interpreting the results given they were collected online for the first time, instead of in classrooms. 

The brainchild of two Stanford University students, Juul launched in 2015 and within two years rocketed to the top of the vaping market. Juul, which is partially owned by tobacco giant Altria, still accounts for nearly 50% of the U.S. e-cigarette market. It once controlled more than 75%. 

On Tuesday, the FDA also laid out plans to establish a maximum nicotine level for certain tobacco products to reduce their addictiveness. In that announcement, the agency also noted that it has invested in a multimedia public education campaign aimed at warning young people about the potential risks of e-cigarette use. 

 
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An advisory panel for the U.S. Centers for Disease Control and Prevention recommended Wednesday that people ages 65 years and older choose higher-dose flu shots or ones that include an ingredient to boost immune response.

The CDC commonly adopts the recommendations of the Advisory Committee on Immunization Practices, but in the past it has not advised older adults to get a particular flu shot.

The CDC says older people are both at a higher risk for more serious illness from the flu and tend to have a lower protective immune response.

The advisory committee said that while its preference is for the higher-dose shots or adjuvanted flu vaccines, if one of those options is not available, people age 65 and older should still be vaccinated with a standard flu vaccine.

Some information for this report came from The Associated Press. 
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The United States is expanding its capacity to test for monkeypox by shipping tests to five commercial labs.

The Department of Health and Human Services said Wednesday the effort will “dramatically expand testing capacity nationwide and make testing more convenient and accessible for patients and health care providers.”

Health care providers will be able to start using the labs to test for monkeypox by early July, the agency said.

As of Tuesday, the Centers for Disease Control and Prevention said there have been 142 reported monkeypox infections in the United States since the first in mid-May.

More than 30 countries where monkeypox is not endemic have reported cases.

Some information for this report came from The Associated Press and Reuters 
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Nearly 1 in 5 American adults who reported having COVID-19 in the past are still having symptoms of long COVID, according to survey data collected in the first two weeks of June, U.S. health officials said Wednesday. 

Overall, 1 in 13 adults in the United States have long COVID symptoms that have lasted for three months or more after first contracting the disease and that they did not have before the infection, the data showed. 

The data was collected June 1-13 by the U.S. Census Bureau and analyzed by the U.S. Centers for Disease Control and Prevention. 

Long COVID symptoms include fatigue, rapid heartbeat, shortness of breath, cognitive difficulties, chronic pain, sensory abnormalities and muscle weakness. They can be debilitating and last for weeks or months after recovery from the initial infection. 

The CDC analysis also found that younger adults were more likely to have persistent symptoms than older adults. 

Women were also more likely to have long COVID than men, according to the study, with 9.4% of U.S. adult women reporting long COVID symptoms compared with 5.5% of men. 

The survey found nearly 9% of Hispanic adults have long COVID, higher than non-Hispanic white and Black adults, and more than twice the percentage of non-Hispanic Asian adults. 

There were also differences based on U.S. states, with Kentucky and Alabama reporting the highest percentage of adults with long COVID symptoms, while Hawaii, Maryland and Virginia reported the lowest, according to the survey. 
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The Black Death, a plague that killed up to 60% of people in western Eurasia from roughly 1346 to 1353, likely originated in the Tian Shan mountains of central Asia, new research shows.

Scientists recovered two genomes of an ancient strain of Yersinia pestis, the bacterium that causes plague, from human remains buried in two 14th-century cemeteries in Kyrgyzstan. The strain is the ancestor of the microbes that caused the Black Death.

“The origin of the Black Death has been one of the most widely debated topics not only in medieval history, but I perhaps will not exaggerate if I say that it has been one of the most debated topics in history, period,” said historian and study co-author Philip Slavin of the University of Stirling.

There are many competing theories, he said, “but without ancient DNA, you wouldn’t be able actually to confirm one of those theories.”

Researchers reconstructed an ancient Y. pestis genome for the first time in 2011 using samples from a burial ground in London. Since then, a handful of additional Black Death genomes from western Eurasia and many more from modern Y. pestis strains carried by rodents and their parasites — the natural reservoirs of plague — also were sequenced.

But even with the new data, “it was still quite clear to us that this kind of research was not really telling us much about where it all started and when it all started,” said Maria Spyrou, a biologist at the Eberhard Karls University of Tübingen and first author of the new study.

Spike in deaths

The wellspring of the Black Death wouldn’t be found in a European grave. But Slavin thought that two cemeteries near Lake Issyk-Kul in Kyrgyzstan looked promising. Based on tombstone inscriptions, the area saw a spike in deaths between 1338 and 1339. Some of those deaths were blamed on an unknown “pestilence.”

The researchers extracted and sequenced genetic material from seven teeth from seven individuals buried at the cemeteries. Human teeth are crisscrossed by a dense network of blood vessels, making them one of the best places in which to look for the centuries-old DNA of blood-borne pathogens like Y. pestis. Three of the seven individuals had plague DNA in their teeth, allowing researchers to reconstruct the genome of the strain that killed them.

In a genetic family tree of the plague, the new strain sits right at base of what Spyrou called an “explosion of genetic diversity” — a dramatic radiation of new strains including the ones that caused the Black Death. The origin strain’s closest modern cousins are carried by marmots in the surrounding Tian Shan area, so it seems to have developed locally.

“It started most likely in this Tian Shan region of central Asia,” said Spyrou. “But I don’t want to claim that we have found, I don’t know, a patient zero or outbreak zero, because this is almost impossible using the archaeological record.”

Sharon DeWitte, an archaeologist at the University of South Carolina, was excited by the results, but she noted that there’s still a small chance the Black Death reached central Asia from elsewhere.

“Yersinia pestis can travel pretty far without accumulating any genetic variation,” she said. “But that being said, there’s strong evidence that that general area was the origin.”

Why, how did it spread?

Finding where the Black Death began is a major step toward understanding why and how it spilled over from animals to humans and spread so catastrophically in the 14th century. Slavin suspects trade was an important factor.

“This community was situated right at the heart of long-distance trade routes known as the Silk Road,” he said. They were “extremely cosmopolitan, very multinational, very multiethnic, and [had] lots of geographic mobility.”

Graves contained pearls from the Pacific and Indian oceans, silks from China or Uzbekistan and shells from the Mediterranean, said Slavin.

Climate could also have been involved, said Spyrou and DeWitte. Future studies of historical climate events in central Asia could help explain the pandemic’s timing and spread. More ancient plague genomes from Asia also would help, but Slavin noted that finding similar archaeological sites or collections isn’t as straightforward as it sounds.

Plague still kills people every year. Because it evolves fast and jumps from animals to humans, it’s important to understand the conditions that make it dangerous and monitor it closely, according to DeWitte. And studying past pandemics can offer lessons for the present, too.

“The Black Death is basically a natural experiment where we are gathering a huge amount of data about the human populations affected, the animals that might have been involved, the bacterium that was involved, and climate conditions,” said DeWitte. “And I think all that’s really important in terms of building resilience for populations moving forward so that we don’t actually suffer from the worst possible outcomes of pandemic disease.”
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Risk of infection from the disease, which causes paralysis in children in under 1% of cases, was low because of high vaccination rates
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The U.S. Food and Drug Administration is proposing a limit on the amount of nicotine allowed in cigarettes with an aim to make it easier for people to quit using them and to prevent young people who experiment with cigarettes from becoming addicted. 

The proposed limit appeared Tuesday among a number of actions the Biden administration is considering. 

The FDA said more than half of adults who smoke cigarettes make a serious attempt at quitting each year, but that most fail because of the addictiveness of cigarettes. 

“The goal of the potential rule would be to reduce youth use, addiction and death,” the agency said. 

“Nicotine is powerfully addictive,” FDA Commissioner Robert Califf said in a statement. “Making cigarettes and other combusted tobacco products minimally addictive or non-addictive would help save lives.” 

Some information for this report came from Agence France-Presse and Reuters
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