Talk:Electronic cigarette

Possible side effect from some oil based flavourings

disclaimer: this is conjecture based on rapid development of various health issues within 2 years of trying a food additive flavoured ecig just couple times. I was 31 at the time of trying it with sedentary lifestyle. As I don't have exercise routine and am indoors as much as some hospitalized people, I breath very very casually so anything that would effect oxygen delivery in permanent way would be noticeable. I'd guesstimate there is 'good' odds that these issues would have developed anyway, I simply suspect the ecig lowered the oxygen intake ability during slow casual breathing just past a "tipping point" where as result there was acceleration in the onset of various health issues that may have been already on the way anyway due to lack of exercise etc and sitting on computer.

After trying ecig for only couple times, and not changing my daily routines in the following years I had a bunch of very subtle health issues develop that I have finally tracked down to the body regulating blood circulation to too low levels because of lack of oxygen. I would say that I was already "pre-compromised" due to sitting all day on computer so anything that would decrease the oxygen intake further was a tipping point. A bunch of mysterious issues developed with seemingly no connection because this lack of oxygen in circulation effects everything. Brittle nails, cold extremities, poor concentration - though because I also had some sort of stroke where I passed out about 1 year from trying the cig. — Preceding unsigned comment added by 91.155.31.86 (talk • contribs)

I'm sorry to hear that - but by wikipedia rules, that state that we can't use it as a discussion forum, we're not going to be able to discuss, or in other ways use your contribution in this article. May i suggest that you talk to a doctor about your concerns? --Kim D. Petersen 01:35, 31 January 2016 (UTC)

Semi-protected edit request on 16 January 2016

Laika19 (talk) 06:24, 16 January 2016 (UTC)

Recently, a meta-analysis was published showing that e-cigs might actually make it harder to quit smoking. The new analysis suggests that e-cigs make people 28 percent less likely to quit smoking. Source: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00521-4/abstract

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. --allthefoxes ^(Talk) 13:39, 16 January 2016 (UTC)

Interesting abstract, but "Odds of smoking cessation among smokers using e-cigarettes compared with smokers not using e-cigarettes were assessed " - this appears to be about dual-use. Johnbod (talk) 13:47, 16 January 2016 (UTC)

I also have concerns about one of the authors Stanton Glantz a known anti tobacco activist. More than just an abstract is needed and this is behind a paywall. It is also not pubmed indexed. AlbinoFerret 13:56, 16 January 2016 (UTC)

There's nothing much wrong with being "a known anti tobacco activist", though Glanze is also hardline anti-ecig, and a bit extreme I think. The article is free if you register (in the UK anyway), and just published online. No doubt it will be listed on PubMed in due course - The Lancet is certainly a top journal with an impact factor of 45 (and anti-ecig), though this is I think only a specialist sub-journal. Johnbod (talk) 14:23, 16 January 2016 (UTC)

Yes, and these biases will probably require accreditation if it comes in. Cant find the sub journals impact factor, might not be listed. AlbinoFerret 14:32, 16 January 2016 (UTC)

Having a position is not the same as bias: and this is an excellent journal and a top quality study. From what I can see it should definitely be added to our article and is very pertinent. The prior argument is a prime example of WP:BIAS — per the pertinent and recently debated section of WP:MEDRS:
        "Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, or conclusions."
Ping WhatamIdoing, who may have some insight as to the interpretation of that section. CFCF 💌 📧 15:50, 16 January 2016 (UTC)

Up until TMCk added the links below, my concerns were not to exclude the material but to add in text accreditation per WP:BIASED. AlbinoFerret 16:27, 16 January 2016 (UTC)

Reminds me of the formaldehyde scare or to a lesser degree the ambigoues propylene oxide claim (also Glantz) that remained in the article for far to long. Now we have this new review and (already) plenty of critical responses: "...not scientific."... , "...at best preliminary or at worst “grossly misleading...”, "...tentative and sometimes incorrect.”
So I'm wondering how much weight this flawed article deserves.--TMCk (talk) 15:54, 16 January 2016 (UTC)

You are aware that the Lancet and BMJ similarly criticized the PHE report? Or do we only find rebuttals when it suits us? Wired, The Guardian, BMJ.
To take it to the extreme, this article has a pretty decent title concerning criticism of the PHE report: E-cigarette ‘safety’ study was written by industry funded scientists, Lancet warns. CFCF 💌 📧 16:05, 16 January 2016 (UTC)

The PHE report wasnt written by a anti tobacco/anti ecig activist. Any use will have to be accredited to him. Though looking at the links above, its questionable what use it could have. AlbinoFerret 16:18, 16 January 2016 (UTC)

• I think it's pretty obvious that we need to include this source in the article. I propose that it belongs in the dual use section that we're discussing above, and the tricky issue will be how much weight to give it. Off the cuff, I would suggest that a controversial paper in The Lancet should get less weight than the Cochrane Collaboration and somewhat less than clinical practice guidelines from major Western democracies, but more than most other sources.—S Marshall T/C 17:18, 16 January 2016 (UTC)

It's not about dual use; it measures the effect of e-cigarette use on cessation of smoking. It does not break out users who were or were not dual users. So the Cessation section seems appropriate.

As to weight, it uses the same methods as Cochrane but includes more and newer studies than were available to Cochrane. Cloudjpk (talk) 22:55, 16 January 2016 (UTC)

• I think Johnbod's right and it's at least partly about dual use; the fact that it doesn't break out dual users from quitters is a design flaw. Simply put, the Cochrane Collaboration is the most reliable source in medicine, and the idea that a brand new just-published study proves Cochrane wrong is the sort of thing that we might normally see coming from an IP address on Talk:Homeopathy.—S Marshall T/C 09:56, 17 January 2016 (UTC)

While I think that may be putting it very harshly, I essentially agree. The new study seems to be very high quality and follows proper methodology, but the Cochrane report weighs heavier. A few years down the line, or when/if the Cochrane report is pointed out as being significantly outdated we might need to revise that opinion, but for now it holds. CFCF 💌 📧 14:43, 17 January 2016 (UTC) 

I agree with you. The scientific writer in me wants to dismiss this paper for all the flaws in it. However by policy it must be included and I agree that it meets the criteria for inclusion and reasonable weight. I would also assess it for the same weighting as S Marshall. SPACKlick (talk) 20:24, 16 January 2016 (UTC)

S Marshall, TracyMcClark, and SPACKlick what is your opinion on in text accreditation per WP:BIASED? AlbinoFerret 20:48, 16 January 2016 (UTC)

I don't think it's necessary, this may be one of those times where it's best just to put it in knowing the data will become clearer as more studies and response appear. SPACKlick (talk) 11:02, 17 January 2016 (UTC)

I agree that by policy it should be included, flawed or not. It will be interesting though, to see the responses in the peer-reviewed press - since i find the criticism by Pf. Ann McNeill to be particularly damaging "This review is not scientific. The information included about two studies that I co-authored is either inaccurate or misleading. ..."[1].

I think this is one of the studies that we are going to have to keep an eye on, particular with regards to replies/commentaries if we are to take Pf McNeill's commentary seriously. --Kim D. Petersen 00:17, 17 January 2016 (UTC)

It took me a moment to figure out that AlbinoFerret meant WP:INTEXT attribution, when he (or his spilling chucker  ;-) typed "accreditation". I don't think this is necessary; you're never going to see "News flash: Professors of Medicine oppose tobacco!" in the headlines.

On the question of the MEDRS line above, it helps to read it in context. Don't replace a meta-analysis with primary sources because you personally believe that the author is "extreme" (or whatever your objection to him is). Of course, if you've got dozens of meta-analyses, then you should pick from among the best; you can't cite them all. And no matter what, you should accurately describe the actual results, e.g., "People who use both are no more likely to quit that people who use only one" rather than "Science proves that ecig users are incapable of quitting". WhatamIdoing (talk) 05:11, 17 January 2016 (UTC)

Thank you for the canvassed opinion, this isnt a personal opinion, WP has a whole section on Stanton Glantz's activism with plenty of references. It took me about 2 minutes to find a good source, Forbes[2] which includes "Speakers at the meeting included Stanton Glantz, an anti-tobacco activist,". AlbinoFerret 13:46, 17 January 2016 (UTC)

I pinged WhatamIdoing as the primary author of the relevant section of MEDRS seeking input to improve quality of the discussion — something which WP:Canvas explicitly refers to as "not canvasing".
The CDC is known to be anti-tobacco, having a science-based opinion is not the same as bias and does not disqualify the CDC from expressing views concerning tobacco use. Being an anti-tobacco activist does not call into question the scientific veracity of the research — nothing in the linked section suggests that Glantz's research would be of inferior quality or that his opinion is not based upon scientific results. CFCF 💌 📧 14:28, 17 January 2016 (UTC)

You called in an expert on MEDRS to discuss WP:BIASED which isnt on MEDRS? Thats mixing apples and oranges. The CDC is a organization, which to my knowledge doesn’t have highly respectable RS like Forbes calling them anti tobacco activists. AlbinoFerret 18:35, 17 January 2016 (UTC)

MEDRS definitely has sections that relate to bias, for example the one I cited.
The CDC runs "anti-tobacco campaigns" [3], but that might not be enough. CFCF 💌 📧 19:16, 17 January 2016 (UTC)

Not really considering Forbes isnt alone

• Reuters [4] "But some researchers say activists like Glantz may have been prejudiced against e-cigarettes by their past battles with the tobacco industry."
• CNN [5] "Stanton Glantz, senior researcher on the study, a professor at University of California-San Francisco and tobacco control activist" [6] "Stanton Glantz, a longtime anti-tobacco advocate"
• NY Times [7] "Stanton A. Glantz, a doctor and anti-tobacco crusader"
• The Telegraph [8] "Glantz is known for his anti-smoking activism, and is one of the founders of the lobbying group Americans for Nonsmokers' Rights."
• SFGate [9] "Stanton Glantz, a longtime antismoking activist"

Stanton Glantz is shown by these very reliable sources to be a activist, that more than one exists speaks volumes. There are probably a dozen more reliable sources that dont have the stature of the ones listed here. The Reuters source even links his activism to e-cigs. The sources show him to be a biased source and as such should have in text attribution, perhaps "...by anti tobacco activist Stanton Glantz said..." AlbinoFerret 19:53, 17 January 2016 (UTC)

Beyond several high quality sources (World Lung Foundation etc.) — the CDC themselves call their campaigns anti-tobacco [10],[11].
Repeating that while ignoring the multitude of sources pointing out flaws in the PHE-methodology seems pretty disingenuous — unless we should attribute the PHE report similarly as per Wall Street Journal – U.K. Government Agency’s E-Cigarettes Report Based on ‘Flimsy’ Evidence. CFCF 💌 📧 20:11, 17 January 2016 (UTC) 

Now you are going off topic and pointing out other stuff exists. I am not suggesting we allow non MEDRS sources to rebut findings of a source. But for indicating the bias of an author of a review. Do you have any source that points out the bias of a specific author of any review? That any of them are activists? AlbinoFerret 21:34, 17 January 2016 (UTC)

That is both a false dichotomy, and neither does one need to look very far — seeing as link just above yours from the Wall Street Journal states (concerning the central tennet of the paper — the 95% risk-reduction):

The Lancet also criticized Public Health England for failing to acknowledge the “potential conflicts of interest” of the study authors. The 2014 paper disclosed that one of the authors, Riccardo Polosa, had served as a consultant to Arbi Group SRL, an e-cigarette distributor.

CFCF 💌 📧 22:02, 17 January 2016 (UTC)

The PHE 95% paper was in 2015, not 2014 thats a different one, so you are confusing papers. A consultant also is not the same as an activist. AlbinoFerret 00:27, 18 January 2016 (UTC)

The PHE report (2015) just, as they say, took the 95% figure from an earlier paper, by Nutt and a long list of others, not doubt including Polosa, who is a name in the field. There are links in earlier sections on this page to it. I think Nutt said in a radio interview there were 19 people (for 2 days) involved in coming up with the figure, using modern risk analysis techniques. Johnbod (talk) 14:22, 18 January 2016 (UTC)

Having industry ties is a far more serious allegation than being an anti-tobacco activist; something which one could deem each medical doctor to be — seeing as they are actively paid to promote smoking cessation. These things are not really on the same level, and the criticism of the PHE report is far more scathing:

The Lancet said these caveats meant “the opinions of a small group of individuals with no pre-specified expertise in tobacco control were based on an almost total absence of evidence of harm.” It branded the study “extraordinarily flimsy” and said that in using it, Public Health England had “fallen short of its mission” to rely on the highest-quality evidence.

CFCF 💌 📧 16:00, 18 January 2016 (UTC) 

A consultant is not "seeing as they are actively paid to promote smoking cessation". You had better have a RS for that accusation. But we are getting off topic. The topic of this section is a review whoes author is Glantz. He is proven to be an activist by multiple highly regarded RS. AlbinoFerret 16:05, 18 January 2016 (UTC)

I have to provide an RS to tell you that medical doctors have as part of their job description to get their patients off cigarettes? No, the topic of this section is the conclusions of the review. You are trying to paint a perfectly fitting study in the light of coming from a biased source because it does not agree with your view. CFCF 💌 📧 16:33, 18 January 2016 (UTC)

Thats incorrect, what I want to see is that readers know the source of the information and its bias. I advise you to WP:FOC and not on what reasons you may think other editors want to include things. You on the other hand are posting non sourced claims of others like they are being paid to promote things when hired as a consultant, you do know the meaning of a consultant is one who consults or advises right? Polosa has also been a consultant for Pfizer and Global Health Alliance for treatment of tobacco dependence[12] looks like he has advised people on both sides of the issue. AlbinoFerret 16:42, 18 January 2016 (UTC)

It looks like you've misunderstood some essential points here. Cessation is the same as quitting, and I haven't stated a single thing about either individuals — I have only cited comments from reputable sources about perceived bias concerning a specific source. Criticism from two major journal bodies (BMJ & the Lancet) take up some major concerns, of which the ones I cited are only a subsection.
Following your logic we need to present these issues when we mention the PHE report, and actually more so as the ties were mentioned as relating to the report itself — while the anti-tobacco ties to the author of this review are only mildly related. CFCF 💌 📧 18:15, 18 January 2016 (UTC)

I appears we are at an impasse as you have chosen to address other sources/authors while confusing which source applies to which report, and have come to conclusions like paid promotion that are not in your sources. AlbinoFerret 18:31, 18 January 2016 (UTC)

• (ec) Re CFCF's "Having [ecig] industry ties is a far more serious allegation than being an anti-tobacco activist..." - that very much depends on what view you take of ecigs. If you are a hardline opponent of ecigs it may be regarded as dammning, just like getting funding from a tobacco company. If you favour the view that ecigs are a potent source of good in terms of smoking cassation and harm reduction, then it is just like taking funding from big pharma, which many researchers have to do, for lack of other sources. Whether the potential COI should have been disclosed by PHE (it was disclosed in Nutt) is a different question, but the Lancet's apparent view that merely mentioning this omission, regarding one of many authors of the Nutt piece, is sufficient to dismiss the whole paper and its conclusions, won't be accepted by everyone, to put it mildly. Johnbod (talk) 18:32, 18 January 2016 (UTC)

Undisclosed pharmaceutical industry ties are considered a major issue, and a big problem in modern medicine — often prompting front-page headlines and rebuttals:
     Hcpro: "'Undisclosed drug industry ties prompt tighter JAMA policies"' (specifically mentions consultancy)
     WSJ: FDA Advisers’ Financial Ties Not Disclosed (here a consultant is mentioned as having made $100,000 — hardly a negligible amount)
The issue the Lancet and BMJ brought up was that one of the central points of the PHE-report is based upon a source which they found questionable, not that only one of the sources in the paper had issues. CFCF 💌 📧 17:23, 19 January 2016 (UTC)

RFC: Should Stanton Glantz require in text attribution per WP:BIASED

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Should sources that list Stanton Glantz as the author include in text attribution per WP:BIASED as an "anti-tobacco activist"?

Sources on e-cigs and Glantz as an activist

• Reuters [13] "But some researchers say activists like Glantz may have been prejudiced against e-cigarettes by their past battles with the tobacco industry." Linking his activism to e-cigs.
• NewRepublic [14] in a paragraph on anti smoking activists Glantz is shown to be against e-cigs.
• Sacramento Bee [15] "In response, anti-smoking activists are pushing to have them regulated like tobacco. Stan Glantz, a professor of tobacco control at UC San Francisco who supports Corbett's bill, said e-cigarette companies brought the increased scrutiny upon themselves."
• NY Times [16] "Stanton A. Glantz, a doctor and anti-tobacco crusader"

Other sources

• Forbes [17] which includes "Speakers at the meeting included Stanton Glantz, an anti-tobacco activist,"
• CNN [18] "Stanton Glantz, senior researcher on the study, a professor at University of California-San Francisco and tobacco control activist" [19] "Stanton Glantz, a longtime anti-tobacco advocate"
• The Telegraph [20] "Glantz is known for his anti-smoking activism, and is one of the founders of the lobbying group Americans for Nonsmokers' Rights."
• SFGate [21] "Stanton Glantz, a longtime antismoking activist"

Please leave all comments below. AlbinoFerret 18:35, 18 January 2016 (UTC)

Yes

No

• SPACKlick (talk) 18:37, 18 January 2016 (UTC)
• I agree that he is an activist, even his own WP:BLP article tells us so. But i do not agree that we need inline identification of this potential bias. The journal is responsible for vetting the authors, and ensuring that the scientific basis for its inclusion is sufficient. What this may affect is the assessment of the source, but considering the journal this shouldn't be a factor. What is much more problematic is the critiques that we've seen so far... but unless these reach the scientific press, then they can only give us a cautionary approach to the source and its usage. --Kim D. Petersen 21:15, 18 January 2016 (UTC)
• —S Marshall T/C 21:56, 18 January 2016 (UTC)
• No. Any more than we identify sources who are e-cigarette advocates as such. Cloudjpk (talk) 18:45, 19 January 2016 (UTC)
• No to the specific attribution. See discussion below Jytdog (talk) 19:15, 19 January 2016 (UTC)
• No Obviously not. Damotclese (talk) 16:19, 26 January 2016 (UTC)
• No - In text attribution is unnecessary. Meatsgains (talk) 17:56, 26 January 2016

(UTC)

• No - we don't need to attribute to anything in the text. Cheers, Comatmebro User talk:Comatmebro 16:53, 29 January 2016 (UTC)

Discussion

Really we need to answer 2 questions 1) What threshold of sourcing for bias justifies/requires in text attribution of the source of a claim? 2) Does Stanton Glantz meet or exceed this threshold? From my point of view the threshold for 1) Requires multiple RS's on 2) We only really have Reuters here making a claim of a relevant bias. Stanton Glantz is an activist in the area of tobacco control and non-smokers rights and my personal opinion from having read his publications is that he is prejudiced against THR strategies. However, I can only find that sourced to non-RS other than the single reuters quote AF already mentioned. Without better sourcing I don't think he needs in text attribution for claims on the basis of Bias. SPACKlick (talk) 18:37, 18 January 2016 (UTC)

I added a couple more that link his anti tobacco activism to e-cigs and will be looking for more. AlbinoFerret 19:06, 18 January 2016 (UTC)

• Being an "anti-smoking activist" does not define a position on e-cigs. Such a person could be predisposed to LOVE e-cigs as a way to get people away from smoking, or HATE them as another way for companies to make a lot of money by getting people addicted to nicotine that is possibly dangerous. In Glanz' case, his opposition to e-cigs appears to arise from his work on regulation and on the effects of smoking on bystanders - from a quick look one of his biggest contributions was helping lead the way on protecting people from second-hand smoke which is what really led to the spread of no-smoking zones. His opposition to e-cigs seems to be related to that - unknown effects of e-cigs on bystanders and the e-cigs industry's efforts to resist regulation (which probably makes them just like the tobacco industry in his eyes - "they brought this on themselves"). If the attribution said something like "a long time antismoking activist particularly concerned with protecting nonsmokers and with industry's resistance to regulation" then I would have supported it. Jytdog (talk) 19:15, 19 January 2016 (UTC)

• I really do not see your point here, An anti-smoker can also be an anti-vaping activist and is highly probable. Same logic really, you wouldn't want someone smoking a cigarette next to you in the movie theater so why would vaping be any different? It still has nicotine to keep people hooked. An Anti-smoking activist is highly likely to be also an Anti-vaping activist too as it is the same logic. Davidbuddy9 Talk  04:08, 27 January 2016 (UTC)

Or strongly pro-them, like Action on Smoking and Health (UK) and many others. Johnbod (talk) 08:27, 27 January 2016 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

POV: Opinion articles used to counter secondary reviews?

I find this edit[22] disturbing. Since it directly breaks with WP:MEDRS and WP:POV. From WP:MEDREV:

Primary sources should not be cited with intent of "debunking", contradicting, or countering any conclusions made by secondary sources. Synthesis of published material advancing a position is original research, and Wikipedia is not a venue for open research. Controversies or uncertainties in medicine should be supported by reliable secondary sources describing the varying viewpoints. Primary sources should not be aggregated or presented without context in order to undermine proportionate representation of opinion in a field. If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.

Here an anonymous editorial (opinion => primary source) is being used in exactly this way. --Kim D. Petersen 15:06, 27 January 2016 (UTC)

I was wonding if the reference name ":0", which looks rather like an emoticon, is used here as WP:POINT? Particularly since it bears no relevance to the reference, if so, then it is really troubling. --Kim D. Petersen 15:10, 27 January 2016 (UTC)

The :0 is added automatically when using visual editor to add references. It then continues with :1, :2, :3, etc. CFCF 💌 📧 15:21, 27 January 2016 (UTC)

Unique but ugly. (The first author's last name followed by year would be less cryptic.) Boghog (talk) 09:39, 6 February 2016 (UTC)

This is the position statement of an authoritative medical organization — namely The Lancet. It is attributed to the journal itself, it is not a primary source and does not present any original results. CFCF 💌 📧 15:22, 27 January 2016 (UTC)

The edits were removed by AlbinoFerret in this edit [23] which is very faulty. CFCF 💌 📧 15:25, 27 January 2016 (UTC)

I can imagine the uproar if someone other than a wikiproject medicine editor inserted an editorial to counter a MEDRS source. AlbinoFerret 15:33, 27 January 2016 (UTC)

No, the Lancet editorial is not a position statement, otherwise it would have been tagged as such. It is simply an anonymous editorial. So Yes, it is a primary source - and opinion to boot. Apologies for misunderstanding the visual editor inserts. Nb: Please do not outdent at level 1, it disturbs the ability to follow and reply to threads in text (see Help:Using_talk_pages#Indentation). --Kim D. Petersen 15:29, 27 January 2016 (UTC)

Btw. Editorials are even within the less restrictive bounds of WP:RS, as opposed to WP:MEDRS, always considered opinion, and thus not usable for general content, and can in no way be considered secondary! That you believe that it should be otherwise within MEDRS is disturbing. --Kim D. Petersen 15:37, 27 January 2016 (UTC)

There is an enormous difference between an "anonymous editorial" and one which the journal body puts its own name behind. The position of the article is endorsed by the Lancet, and is also one which is shared with numerous other sources. CFCF 💌 📧 15:42, 27 January 2016 (UTC)

An editorial (which is a primary source and not MEDRS) is not a good source to counter a MEDRS source. AlbinoFerret 15:46, 27 January 2016 (UTC)

Also note that the Lancet Editorial Board is not anonymous, you have at least twenty people standing behind the position at [24]. It is recognized as one of the most prestigious journals in the world and as such its positions hold much weight, enough that this statement illicited first page news around the world:

• Wired – E-cigarettes 'safer than tobacco' study faces Lancet criticism
• Wall Street Journal – U.K. Government Agency’s E-Cigarettes Report Based on ‘Flimsy’ Evidence, the Lancet Says

Neither does it counter the source, but the criticism should be included in the article, seeing as it comes from a high profile respected source.CFCF 💌 📧 15:52, 27 January 2016 (UTC)

Doesn't change the fact that editorials are opinion and primary sources. Do please read WP:MEDRS#Biomedical_journals(first paragraph) where it makes it very clear that such material is to be avoided. WP:MEDASSESS has two nice images that show you where editorials are placed within the ranking of level of evidence. Your insistance at trying to get opinion in as equivalent to reviews is disturbing. And your reliance here on Wired and the Wall Street Journal to "vet" the opinion is even more disturbing. Newspapers go for the controversy - not for the evidence! As any wikipedia science/medical editor should know. --Kim D. Petersen 16:01, 27 January 2016 (UTC)

I am sure CFCF knows about the ranking images, he had a hand in placing them there. AlbinoFerret 16:08, 27 January 2016 (UTC)

I know. Which makes this discussion even more disturbing with regards to POV. --Kim D. Petersen 16:40, 27 January 2016 (UTC)

What is clear is that The Lancets position is permitted by WP:MEDRS, it is accordingly on the top of those pyramids (which I created). CFCF 💌 📧 16:52, 27 January 2016 (UTC)

No, The Lancets editorial (not position) is not permitted by WP:MEDRS. Position statements are a specific category of statements - that are always marked as such. They are formal, and from medical bodies - not journals. --Kim D. Petersen 17:01, 27 January 2016 (UTC)

• The stances being taken here are tendentious. The editorial in the Lancet is by the editorial board; it is not your common editorial signed by Dr Ima GeniusWIthaStrongOpinion, and the Lancet has a lot of prestige in the UK, where of course the report is generated. It deserves to be in the article. No, it of course is not of equal with weight with PHS itself per MEDRS but it serves as a significant remark on what the stronger MEDRS source says. I will bring this to WT:MED and post it there to get more feedback. It would be useful to get actual feedback there, so please do not carry the acrimonious and transparently partisan backbiting above there, or everyone will vomit and ignore the post, and there will be no useful feedback. It will be up in a moment. Jytdog (talk) 06:53, 6 February 2016 (UTC)

  How is it "tendentious" to state that A) The Lancet editorial is a WP:MEDRS primary source and B) The PHE report is a WP:MEDRS secondary source. And C) We cannot use a primary source to debunk a secondary source per WP:MEDPRI? --Kim D. Petersen 09:31, 6 February 2016 (UTC)

<squeeze>t is clear how you are applying the definition of "editorial" in MEDRS to this specific editorial, and the logic that follows from that application is also clear. You don't need to keep repeating it. Jytdog (talk) 15:58, 6 February 2016 (UTC)

The editorial board did not publish original research findings in this editorial and hence it cannot be considered primary. The editorial board reviewed the reviews hence it should be considered tertiary. Furthermore this a very reliable tertiary source and per WP:PSTS can be used to comment on conflicting secondary sources. Boghog (talk) 09:50, 6 February 2016 (UTC)

We should not be using editorials to counter MEDRS secondary sources. We have been over this topic before. There are no conflicting MEDRS secondary sources that I know of, otherwise they would have been added instead of an editorial. AlbinoFerret 14:07, 6 February 2016 (UTC)

@AlbinoFerret: I was not a party to the previous discussion. What MEDRS says is that we should not use primary sources to debunk secondary sources. We have already established that the editorial is not a primary source. The editorial is a secondary/tertiary source that is highly respected. Surely you will agree that MEDRS demands that we must cite this source. Right? Boghog (talk) 20:16, 6 February 2016 (UTC)

It is the definition of TENDENTIOUS to keep repeating yourself. Everybody understands your perspective. Please stop repeating it already. It is clear that we have an impasse on this. Jytdog (talk) 15:45, 6 February 2016 (UTC)

@Boghog, After doing a little looking I dont think this editorial fits the definition of a tertiary source which are described as textbooks and encyclopedias. Its a opinion piece from an unknown author. Per the core policy WP:RS editorial commentary, analysis and opinion pieces are primary sources. AlbinoFerret 18:53, 7 February 2016 (UTC)

• I just closed the thread I opened since Kimmy could not restrain himself from entering the conversation to push his POV - what he wrote there clarified nothing, as everybody at WT:MED knows exactly what I meant by "statement by major health authority". Everybody in WP is sick of you guys. You don't seem to understand that. Am thinking about what the appropriate DR forum for this is, now that Kimmy tanked the most appropriate one. Jytdog (talk) 15:06, 6 February 2016 (UTC)

• OK, here is my thought, and is what I should have done before posting at WT:MED. Kimmy and Albino, would you please frame the question that you would like the folks at WT:MED to respond to? And if we can agree on the question, will you and CFCF and other participants here, please agree to stay out of the ensuing discussion so that we can get actual feedback? I will stay out of it too. Jytdog (talk) 15:48, 6 February 2016 (UTC)

The key point here seems to be "Can an editorial in the lancet be used as an RS to contradict the conclusions of a secondary source?". However all of this can be avoided if both sides will bend a little towards reasonability. It's fair to say the lancet editorial is not alone in its criticisms of the PHE Report so why not include the note that the PHE's verdict is not universally acknowledged (or similar words to say it's not the only accepted mainstream scientific view) citing the Lancet as an example of that. For instance

Public Health England report stated that e-cigarettes are estimated to be 95% less harmful than smoking, although the basis for that figure is not universally accepted.

References

SPACKlick (talk) 16:57, 6 February 2016 (UTC)

That is a useful move toward the middle and was the focus of the Lancet's editorial board's statement. The conclusion went farther however: "Tobacco is the largest single cause of preventable deaths in England—e-cigarettes may have a part to play to curb tobacco use. But the reliance by PHE on work that the authors themselves accept is methodologically weak, and which is made all the more perilous by the declared conflicts of interest surrounding its funding, raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency's peer review process. PHE claims that it protects and improves the nation's health and wellbeing. To do so, it needs to rely on the highest quality evidence. On this occasion, it has fallen short of its mission." (source is here, for handiness).

Instead of the content being insert where it was, I think adding something like the following, after a description of the PHE statement is given, something like. "The editorial board of The Lancet responded to the PHE report, criticizing the claim that e-cigarettes are estimated to be 95% less harmful than smoking, which was emphasized in the PHE's press releases, and questioning the conclusions of the report." and provide the quotation above in the reference. This gives the greatest WEIGHT to the PHE report but gives a significant dissent a voice, but with appropriately lesser WEIGHT. Jytdog (talk) 19:35, 6 February 2016 (UTC)

I disagree, Jytdogs suggested edit creates a false balance giving "a significant dissent a voice" to a much lower weighted source. I will have to think on SPACKlick's suggestion a little, but it looks like it might be a possible compromise. AlbinoFerret 20:08, 6 February 2016 (UTC)

• shall we tee up various versions of proposed content, or tee up the underlying question to use for DR? I am fine with either, and have proposed one of each. Let's move forward with some DR process to resolve the impasse. Jytdog (talk) 21:00, 6 February 2016 (UTC)

The source is reliable, a tertiary source. As to weight, WP:PSTS says tertiary sources are themselves "helpful in evaluating due weight, especially when primary or secondary sources contradict each other" which is the case here. Cloudjpk (talk) 18:26, 7 February 2016 (UTC)

Insertion of image dealing with illegal drugs

CFCF inserted an image without discussing it.[25] The top image is an electronic cigarette. The bottom one contains images of illegal substances and devices used to inhale them which are not e-cigs. AlbinoFerret 15:30, 27 January 2016 (UTC)

The source PMID 26308021 makes it entirely clear that these are electronic cigarettes, it is even in the caption of the image. That they can be used for other things has no impact on whether they are ecigs or not. This article overlooked the use of cannabis in electronic cigarettes, something which is covered heavily in the literature. CFCF 💌 📧 15:39, 27 January 2016 (UTC) 

No, an electronic cigarette and a Vaporizer (inhalation device) are very different things, you should move them to that page if you feel they belong on WP. E-cigs are one type of vaporiser, but not all vaporisers are e-cigs. AlbinoFerret 15:44, 27 January 2016 (UTC)

I prefer to follow the statement from the review article that I linked above instead of your personal definition. It clearly states (not only from its title E-Cigarettes: A Review of New Trends in Cannabis Use.) in the first sentence:

The emergence of electronic cigarettes (e-cigs) has given cannabis smokers a new method of inhaling cannabinoids.

CFCF 💌 📧 15:59, 27 January 2016 (UTC)

It is disturbing, that when looking upon the article and only taking in the pictures, then we get a different view of what the article is about, than when reading the article. --Kim D. Petersen 15:55, 27 January 2016 (UTC)

I agree with Albino here. The Giroud paper uses a definition of e-cigarettes that is significantly different from the norm. The majority of those devices are vaporisers and not e-cigarettes. SPACKlick (talk) 16:01, 27 January 2016 (UTC)

I agree, its a very fringe view. AlbinoFerret 16:06, 27 January 2016 (UTC)

No it isn't. It is a view shared by a number of sources, among others:

• PMID 26347431 – High School Students' Use of Electronic Cigarettes to Vaporize Cannabis.
• Healthline – Teens Using E-Cigarette Devices to Smoke Marijuana
• PMID 24680203 – E-cigarette prevalence and correlates of use among adolescents versus adults: a review and comparison.

You can not chose terminology according to your personal preference, this is in established sources, you have yet to provide sources that make the clear distinction, or that say how e-cigs can not be used with cannabis or cannabinoids. CFCF 💌 📧 16:50, 27 January 2016 (UTC)

The healthline link uses the same definition used on this page and that the rest of the world uses, that e-cigarettes vaporize liquid using a heating element. Items which vaporise solids, which have been used for cannabis inhillation long before e-cigarettes were invented are a different thing both in terms of engineering and health effects. The third link (Chapman paper) also uses that definition. It is atypical use to refer to vaporisers as e-cigarettes. SPACKlick (talk) 17:04, 27 January 2016 (UTC)

Portion cropped out

Original image

SPACKlick, they are categorized as ecigs as per the source, which also takes up the difference between traditional vaporizers and e-cigs used for cannabis/cannabinoid e-liquid.
Would you be more comfortable using the image: File:Ijerph ecig variants.jpg which has that section cropped out?

Neither as it still includes non e-cig hardware. AlbinoFerret 18:37, 27 January 2016 (UTC)

That is your interpretation, not that of the source which starts off a rather lengthy caption with:

Some models of e-cigs for vaping [...]

See: Figure 2

CFCF 💌 📧 18:44, 27 January 2016 (UTC)

The image contained ileagal substances before you edited it, and it now contains hardware for those substances.AlbinoFerret

The hardware isn't different because it is used for something else – the article makes that clear. Check the citation which I've already linked multiple times. CFCF 💌 📧 21:49, 27 January 2016 (UTC)

Actually what the image illustrates is that the hardware is different. Of the 6 devices boxed, only #2 and #6 are e-cigs - the others have different atomizers for dry-herb and gel. While they may look similar, they aren't.--Kim D. Petersen 22:04, 27 January 2016 (UTC)

No surprise because the source that the image comes from makes the same distinction. AlbinoFerret 18:25, 3 February 2016 (UTC)

Non consensus edit

CFCF has added more illegal drug usage to the article against consensus above that shows it does not belong in this article.[26] AlbinoFerret 18:33, 27 January 2016 (UTC)

The added content is properly sourced to both drugabuse.gov as well as a secondary sourced review article.

• DrugFacts: Electronic Cigarettes (e-Cigarettes) on drugabuse.gov
• PMID 26308021 E-Cigarettes: A Review of New Trends in Cannabis Use.

The discussion you speak of concerns the use of a specific image. CFCF 💌 📧 18:47, 27 January 2016 (UTC)

It is off topic and against consensus above. AlbinoFerret 18:50, 27 January 2016 (UTC)

What is the prevalence of such usage? How much is this covered in the secondary literature? How do you justify the WP:WEIGHT put on this - with a new section and only two sources, where only one is a WP:MEDRS review? From the last many discussions it rather seems like you are on a path of advocacy against, rather than an NPOV description of, ecigs. --Kim D. Petersen 20:40, 27 January 2016 (UTC)

I have found no data on prevalence, but the topic is available in the literature, a quick PubMed search will find you articles with ["electronic cigarette" AND cannabis] [27].

Outside of the medical literature there are a number of sources concerning the topic:

• More teens are using e-cigarettes for marijuana, police say – crime statistics, MEDRS not applicable in this sense
• YaleNews – E-cigs work well with pot too, teenagers find
• Drugfree.org – E-Cigarettes Being Used to Vaporize Marijuana
• Medscape – High School Students Using e-Cigarettes to Vape Cannabis (we use this source for other claims in the article)
• etc. I don't think I have to labor the point.

Neither would I categorize 2,360 bytes out of 136,969 as undue weight, making up less than 2% of the article. CFCF 💌 📧 21:17, 27 January 2016 (UTC)

So in other words: 1 (one) review - and 7 primary sources listed on PubMed. And a lot of newspaper articles, where sensationalism is in the main seat. Do you really consider that enough to merit a whole section and the WP:WEIGHT here? [had you btw. looked at the review, it noted that prevalence even amongst marihuana users is infrequent. (very small sample size though)] --Kim D. Petersen 21:39, 27 January 2016 (UTC)

Yes, the prevalence is low, but it also takes up less than 2 % of the article. These sources are sufficient, we could potentially expand the section with the police reports. The fact that the National Institute on Drug Abuse (NIDA) singles it out in its report on electronic cigarettes would on its own be enough. I created the new section because it doesn't really fit anywhere else. CFCF 💌 📧 21:45, 27 January 2016 (UTC) 

It is a non notable subtopic at the moment, which might at the most, elicit one or two sentences of mention based upon that one review. Just because it exists doesn't mean it belongs on Wikipedia, see WP:IINFO. Also seems to be more relevant to the safety article. --Kim D. Petersen 21:54, 27 January 2016 (UTC)--Kim D. Petersen 21:54, 27 January 2016 (UTC) [2% of an article where other more relevant stuff is left out, or delegated to subarticles - is actually quite a lot. And you seem to believe that it even needs its own subsection! --Kim D. Petersen 21:58, 27 January 2016 (UTC)]

The main source for this has an impact factor of 2 for 2015, its highest ever. The Giroud C source is also cited by a whopping 3 other sources, one a survey. The other source, Pisinger, doesnt mention cannabis or marijuana. AlbinoFerret 18:45, 3 February 2016 (UTC)

It is completely unreasonable to say that this belongs only under safety, there is no rationale whatsoever for that. There are a number of sources supporting this, two of which are in the article now, including the NIDA-page. Seeing as this is a legal issue beyond beyond the purely medical aspects, we can expand with non-MEDRS sources as well.
The Medscape – Medscape article would also be an acceptable source to expand/support the section. CFCF 💌 📧 19:31, 3 February 2016 (UTC)

The question is how many sources, compared to the number of sources that talk about e-cigs using nicotine? So far you have 3 or 4 vs hundreds. Very WP:UNDUE As for expanding sources, I dont think so when you are talking about a dangerous illegal drug. AlbinoFerret 22:44, 3 February 2016 (UTC)

(edit conflict)CFCF i'm not sure why you would really argue this? Cannabis and e-cigarettes is (at the moment at least) a fringe concept, as acknowledged in the very source (Giroud) that you cite, and that fringe is within the cannabis user milieu, not the e-cigarette one. So why put this much emphasis on it here? WP:DUE weight, as i mentioned above would be to mention it in passing with one or two sentences at the most. But the place where it makes the most sense is in the safety article - because it is related to safety. --Kim D. Petersen 22:58, 3 February 2016 (UTC)

I have so far not found anything that says it is fringe. That it is rare does not make it non-notable, certainly not when so many non-medical sources discuss it. It is common enough that it is taught in medical schools, so that doctors should know about the concerns. Certainly there are aspects of this that belong under safety as well as here, but with limited time I have not been able to expand the content in that article, you may feel free to.

As it is both rare and distinctly different from other uses having a separate subheader is far better than to split the content under the existing headings — were the phenomenon is mention in one section and the health effects in another, this muddles up the other sections and might give the impression that it is more common that it actually is if we repeat it in every section. CFCF 💌 📧 16:49, 4 February 2016 (UTC)

Per WP:FRINGE "We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field." The overwhelming view of sources is that e-cigs are used to vape nicotine. This source departs from that and suggests that they are used for other substances calling them "e-cigs" when few other sources if any do. A perfect description of a fringe source. AlbinoFerret 18:00, 4 February 2016 (UTC)

You have under no circumstance explained how it amounts to being fringe. Far from it— we have established its presence in the CDCs/NIDA information pages, in the medical literature and abundant sources in the non-medical literature. Being rare or not common is not the same thing as fringe, and though it is evident you want to discredit the sources—that is not sufficient. Show some refutations instead of continually repeating yourself. CFCF 💌 📧 18:57, 7 February 2016 (UTC)

Consensus for change of image

Is this image a good example of an "odd" ecig?

CFCF changed the image of the Construction section here.[28] The image is of an older device from 2013, around the date of the image. Its a unusual design that has to my knowledge never been copied and is no longer available. Few things if any from 2013 are in the fast paced development of the e-cig. This image replaces one (discussed above) that replaced the common cigalike broken into components. Does this image help the reader understand construction of ecigs? Is it an improvement to the article? I would say no and one of the component images should take its place. AlbinoFerret 19:28, 7 February 2016 (UTC)

This image does not replace anything? The age of the device is completely irrelevant as it is its characteristic shape that is what is on display — and the fact that ecigs come in very many different shapes and sizes. And the device is actually still manufactured, so I don't at all see your point. Similar oddly-shaped devices exist today and it is better to show one weird device than to show none because each individual specimen is rare. This is nit-picky bordering on inane. CFCF 💌 📧 19:46, 7 February 2016 (UTC) 

What source shows this device is still being made? What source shows similar devices being made today? AlbinoFerret 20:07, 7 February 2016 (UTC)

It's still on innokin's product website. It's not a bad example of an odd design. Shame we can't point to some of the mods out there like these SPACKlick (talk) 21:07, 7 February 2016 (UTC)

Yes, its on the Inokin website, but its been discontinued. Cant find the article I remember reading long ago but this site tells the tale.[29] It was a faulty design and Inokin pulled them because of button issues. At one point they were even giving people refunds if they returned them. I do agree its a shame we cant use some of those you linked to SPACKlick. But is it an improvement to replace an image of them broken down to show components with an assembled image? If the device was more broken down it wouldnt be an issue. I also wouldnt have a problem showing it in another area. But it doesnt seem to fit what the section is about. AlbinoFerret 21:25, 7 February 2016 (UTC)

I don't know where else it could belong. Neither can I see any reason not to include another image as well. This article is still text-dense when compared to the amount of images. CFCF 💌 📧 22:32, 7 February 2016 (UTC) 

I recently found this image which shows the internals of cigalikes. Maybe this could be included, it's higher quality than what was in the article a couple of weeks ago. CFCF 💌 📧 23:07, 7 February 2016 (UTC)

That would fit better with Construction. AlbinoFerret 01:00, 8 February 2016 (UTC)

Youth vaping images

To expand: 5 out of 16 pictures are on the subject of youth vaping. With WP:WEIGHT in mind, this is disturbing. And now a push for an image that indicates that e-cigarettes are associated with illegal drug usage? Hmmm. The CDC's view is also rather overrepresented in the images, considering that the US view and (as an example) the UK view is, if not directly opposite, then certainly not in agreement, i would consider that something to fix as well. --Kim D. Petersen 16:49, 27 January 2016 (UTC)

The reason we use CDC content to such an extent is because of their licensing practice, that is to say beyond the face that their positions holds very much weight. Their most recent position also concerns young and e-cigarettes, and making up less than 30% of the articles images is not undue burden. Neither do 5 out of 16 images have to do with use among youth, that is a miscategorization. CFCF 💌 📧 16:58, 27 January 2016 (UTC) 

(edit conflict)Lets count the images then[30], since you seem to think that it is a miscategorization:

• image 1-3 not about youth
• image 4 "showing teens using e-cigarettes are more likely to start smoking tobacco"
• image 5 "may appeal especially to younger users"
• image 6 "may appeal to younger users"
• image 7 "middle and highschool students"
• image 8 "Ads and Youth which concerned marketing towards adolescents"
• image 9-13 not about youth
• image 14 "Youths are exposed to e-cigarette advertisements..."
• image 15 not about youth.

You are correct - i miscounted. There are 6 images out of 15 that are about youth, which is 40% of all images. An even higher percentage than i counted. Lets talk about WP:WEIGHT again? --Kim D. Petersen 17:12, 27 January 2016 (UTC)

Way to many images on one subject. AlbinoFerret 17:21, 27 January 2016 (UTC)

Agree, too many images on the same subject. The images currently in the article create a POV problem.

Total number of images = 16

Images (including captions) of:

• positive content about ecigs = 0
• neutral content about ecigs = 8
• negative content about ecigs = 8
• negative content about ecigs cited to US government-funded sources = 8

There are problems with some of the individual images and their captions, but that's probably the subject of a different discussion. P Walford (talk) 15:19, 3 February 2016 (UTC)

The images are factual and represent the literature well, with poignant captions and a good representation of common topics. The literature discusses use among adolescents to an extensive degree, and this is represented in the article, the CDC focuses on young potential users — as do traditional anti-smoking campaigns. The point is neither to shine a negative nor a positive light on electronic cigarettes, but to have factual images with well supported captions. CFCF 💌 📧 19:26, 3 February 2016 (UTC)

Factual does not mean NPOV. You do know that don't you? Please refer to WP:UNDUE for a good read. What we need is not an article that presents a negative, positive or neutral view.... but an article that presents the information gathered from secondary sources in proportion to the prominence in the reliable secondary literature on the topic. --Kim D. Petersen 21:00, 3 February 2016 (UTC)

• re "factual images with well supported captions":

• "National Institute on Drug Abuse director Nora Volkow discussing a National Institutes of Health-funded study showing teens using e-cigarettes are more likely to start smoking tobacco." Dr. Volkow mentions a study, but nowhere in the article or the source is a link or even a title of the study provided. Thus, as it stands, it's a primary source. Dr. Volkow said, "..that's actually what they seem to have found", which sounds less definitive than the caption.

• "There are concerns that colorful electronic cigarettes may appeal especially to younger users." This is cited to a dead link. I can't find this point in the archived version.

• "Candy, fruit and coffee flavored e-liquid may appeal to younger users of electronic cigarettes." It has been mentioned already that it's cited to primary sources.

• "2014 Centers for Disease Control (CDC) press release concerning e-cigarettes." It's not a press release, it's a marketing image in a press release. The fact that it's an estimate needs to be mentioned. How many middle and high school students were there in the US? "Had used e-cigarettes" is not accurate as it is based on ever-use figures. "Had used an e-cigarette" would be more accurate, but unfortunately the CDC didn't use those words.

• "The United States Centers for Disease Control and Prevention released a 2016 report titled E-cigarette Ads and Youth which concerned marketing towards adolescents." The only thing this image has to do with marketing towards adolescents is the fact that it's a CDC image marketing towards adolescents. The image says "continued tobacco product use among youth". Yes, the CDC consider ecigs to be tobacco products, but this is not a consensus view of the reliable sources. "Youth" and "adolescents" need to be defined.

• "Adolescents are exposed to electronic cigarette marketing in a number of ways, many of which are not available to traditional cigarettes." Again, "youth" and "adolescents" need to be defined. If it's desirable to include an image in the Marketing section, perhaps an example of marketing would be better, maybe the 2012 advert that merits four sentences in the second paragraph? It's an even better idea to stay away from marketing images entirely, regardless of their sources. P Walford (talk) 15:32, 4 February 2016 (UTC)

Your comments are both inaccurate and disruptive.

• The video is released by the CDC and can be said to show their position, it is both a primary source and its inclusion is supported by MEDRS because it is released by the CDC as a health information body.
• Please clarify which link this is, the sources were all fine less than a week ago. I will be able to provide the source for inspection if you are unable to find it.
  Edit: archived version
• There are multiple citations backing that statement, none of the ones in the article are primary.
• If you disagree with the CDCs analysis you should take it up with them.
• This is an informative image released by the CDC, and I strongly disagree that youth or adolescents need to be defined seeing as the CDC does not see the need to do so. CFCF 💌 📧 16:43, 4 February 2016 (UTC)

The observations look accurate for the most part to me. Please WP:FOC. The video is a primary source and not a formal position statement. I think we should stay away from sources that have been removed by the creators because one reason it may have been removed is errors in the source. I think we need to move off of primary sources, they seem to be piling up. Press releases really need to go, yet another primary source. Youth and adolescents appear to be the same group from various dictionary searches. AlbinoFerret 17:55, 4 February 2016 (UTC)

The observations are not accurate, despite the fact that you believe so. The video is not a primary source, it does not present original research, and even if it were it is a position of the CDC. As for the NACCHO source, there is nothing to indicate that it has been retracted, websites are restructured continuously and it does impact its credibility. I find it entertaining that you suggest press releases should be removed from sources while advocating strongly for the inclusion of the NHS Smokefree Electronic cigarettes site as well as the Press release – E-cigarettes: an emerging public health consensus used for the statement "In a 2015 joint statement, Public Health England and twelve other UK medical bodies concluded "e-cigarettes are significantly less harmful than smoking." Youth and adolescents are pretty similar groups, and the terms are often used interchangeably — mostly for variation. CFCF 💌 📧 18:59, 4 February 2016 (UTC)

The NHS Smokefree Electronic cigarettes site, is just that a site, not a press release. As for E-cigarettes: an emerging public health consensus, I direct your attention to the subtitle "Joint statement on e-cigarettes by Public Health England and other UK public health organisations." The Joint statement was released to the press. But it is a position statement. As for the video on the CDC website. From the source itself, my bold "NIDA Director Dr. Nora Volkow discusses NIH-funded study which shows possible link between teens use of e-cigarettes and initiation of tobacco use.". It is a discussion of a primary source by a member of the same group that funded it. This is not a position statement. Its not setting forth their position, its a discussion about a study that was funded by the NIH which she is a part of. The caption is also inaccurate as the source says its a "possible link" where the caption states it as a fact. AlbinoFerret 19:54, 4 February 2016 (UTC)

Ingredients, additives and adulterants

What are we trying to say here? If it's an ingredient, it isn't an adulterant in my book. Tobacco extract is presumably for flavour, and ? cannabis left over from production runs of cannabis e-juice on insufficiently cleaned equipment. What are the sources saying? Johnbod (talk) 13:03, 31 January 2016 (UTC)

Adulterant was a direct quote from the second source and concerns what is not expressly declared on the list of ingredients. It was changed to additives by Doc James, but this isn't entirely correct — though I can't think of any other simple synonym for adulterant. CFCF 💌 📧 19:18, 3 February 2016 (UTC)

I think adulterants are a type of additive. But either way. Doc James (talk · contribs · email) 19:27, 3 February 2016 (UTC)

Maybe undeclared additives would work?CFCF 💌 📧 19:33, 3 February 2016 (UTC)

Keeping "adulterant" and removing "ingredient" is fine The latter strongly implies it is in the "recipe". Johnbod (talk) 20:52, 4 February 2016 (UTC)

I restored adulterant as per the source wording (CC-BY). CFCF 💌 📧 23:13, 4 February 2016 (UTC)

The lone source on cannabis is Giroud C. Copied from above "The main source for this has an impact factor of 2 for 2015, its highest ever. The Giroud C source is also cited by a whopping 3 other sources, one a survey." The other source, Pisinger, doesnt mention cannabis or marijuana. AlbinoFerret 18:47, 3 February 2016 (UTC)

Oops, I just removed the wikilink as an "easter egg" before I saw this section. Putting cannabis in it sounds like Lacing (drugs), but I'm not sure if saying e-cigs are sometimes "laced with cannabis or tobacco extracts" is representative of the sources cited. ~Awilley (talk) 21:34, 4 February 2016 (UTC)

No, definitely not. It concerns specific e-liquids which contain cannabis or cannabinoids. See the source. CFCF 💌 📧 23:10, 4 February 2016 (UTC)

Awilley—do the last edits help? CFCF 💌 📧 23:18, 4 February 2016 (UTC)

I don't much care what word is used as long as it adequately represents the source. If you want a layman's opinion, I don't think I've ever seen the word "adulterant" before today, though I didn't have trouble figuring out its meaning either. In my opinion, if "adulterant" is a subset of "additive", and "additive" is also acceptable per the source, then I guess I'd have a preference for "additive" as being more accessible to the reader. (Something along the lines of WP:JARGON) My main concern was WP:EGG—saying "additive" and linking to "adulteress." (kidding) ~Awilley (talk) 05:28, 5 February 2016 (UTC)

A note

I made a few changes to the article (mostly Lead section) today. Most of it was stylistic, merging sentences, rephrasing, moving stuff around, but I hope people will review them for any unintentional errors I might have made. ~Awilley (talk) 21:27, 4 February 2016 (UTC)

Thank you, most of the changes look good. Is there a reason the phrase "but reduced voltage e-cigarettes produce very low levels of formaldehyde" was removed? P Walford (talk) 16:19, 5 February 2016 (UTC)

Thanks for your feedback. On the voltage phrase, I was trying to make it more accessible to normal readers and take out redundancy. So instead of talking about high and low "voltage", which might alienate some readers ("what's a voltage and how do I reduce it?") I put it in terms of high and low "power". The sentence "Using later-generation e-cigarettes on high power can generate more formaldehyde than tobacco does" implies that using them at low power doesn't. It's not necessary IMO to follow that up with "but using e-cigarettes on normal power doesn't generate very much formaldehyde." You can add it back if you want. ~Awilley (talk) 18:25, 5 February 2016 (UTC)

@Doc James: Regarding this I did a quick search of the archives and found a lot of RfCs, but I couldn't find the one you're talking about. I don't doubt your word, but would you mind pointing me to this particular one?

On whether Health is more notable than History, I would say that the latter is more important for an encyclopedia, but I can understand why you, in particular, would disagree with that. In any case, I don't think "notable" is a good criteria for determining order. That should be done logically, preferably chronologically, with the reader in mind. To me it makes sense to start with the general introduction, then talk about the history, and then talk about safety, health, cultural impact, etc. I realize all articles will do it differently, but I looked up the most closely related article I could think of (cigarette) and it fits that pattern fairly well.

Last point: If you think that Healthy/Safety is indeed the most important thing, you should be trying to end the Lead section with the paragraph on health/safety, since that's the last thing most visitors will read. See our article on serial position effect for why that might be a good thing. ~Awilley (talk) 04:47, 6 February 2016 (UTC)

It is normal in health-related articles to put History much lower than on many other types, and I think this is absolutely correct. Few readers of pancreatic cancer will be very interested in the history, I suspect. Putting history generally first is a WP tradition, but one I think we overuse, especially when the section is long. Cigarette should probably change too - at present the "Health effects" section begins at (on my m/c) the 16th screen down, which is downright bizarre, but at least that story is no secret. Certainly we should not use that as a model here - I think a very different crowd edits there. I think the RFC the Doc refers to was a general one at the MED project,not specific to this article. Johnbod (talk) 05:53, 6 February 2016 (UTC)

@Awilley There have been a few RFC's on page order. Archive 16, Never closed and archive 17 no consensus and archive 22 no consensus, I may have missed the one DJ is referring to. The topic keeps coming up every so often. I wonder if a list somewhere near the top of all the RFC's this page has had would be helpful to avoid this kind of thing in the future. AlbinoFerret 06:29, 6 February 2016 (UTC)

Thanks Albino for providing the links. The order has been controversial. Doc James (talk · contribs · email) 15:13, 6 February 2016 (UTC)

Good heavens, let's not start that up again. There are more significant improvements that can be made without starting another RfC to change something as mundane as the section order. ~Awilley (talk) 17:03, 6 February 2016 (UTC)

Glanze Redux

Just listened to an interesting 5 mins or so feature on Glanze's recent paper (see above) on today's More or Less (radio programme), a BBC radio programme covering statistics etc. Some of you should be able to pick it up online from the website linked at the article, starts about 5 mins in. Linda Bauld, Ann McNeill, Peter Hajek (co-author of the Cochrane Review - "grossly misleading" he says), Robert West ("mashed together very different studies") - all saying the paper should not have been published, as did an un-named person who peer-reviewed it for the Lancet sub-journal. Glanze & the editor unrepentent. Johnbod (talk) 16:52, 5 February 2016 (UTC)

That's what you get when you mix activism with science. I'm sure it will be straightened out in coming reviews.--TMCk (talk) 18:11, 5 February 2016 (UTC)

Well from a WP stance, as i mentioned earlier[31] its simple: The Glantz paper is a secondary WP:MEDRS review, thus reliable and can be used. The More or Less program is interesting - but cannot really be used. If the paper is flawed then we as WP editors must wait until it gets resolved in the peer-reviewed press. --Kim D. Petersen 09:39, 6 February 2016 (UTC)

Diacetyl - toxicology section added to main article. Consensus on moving it to Safety

CFCF has added a section to the page dealing with Diacetyl. This is a toxicology section and IMHO belongs on safety instead of adding it here to a summery section. Opinions? AlbinoFerret 01:23, 8 February 2016 (UTC)

I strongly disagree, this information is florating in the popular press and while this does not give indication to the strength of the information it says a whole deal about its relevance to the main article.

• Wired
• Motherboard
• Washington Post
• National Law Review

The source of the commotion is a new research paper (yes primary, so I chose not to include it) from Harvard claiming: Diacetyl was found in "39 of the 51 flavors tested" [32]

This is not only important as health information for anyone considering buying such e-liquids', but due to recent events also important as a source of proper information in a sea of missinformation claiming that all flavorings are poisonous' or even than all ecigs may cause bronchiolitis obliterans. CFCF 💌 📧 06:56, 8 February 2016 (UTC)

Term "NRT" used without definition

The "Smoking Cessation" section frequently uses the term "NRT", without defining it. I'm guessing that this is an acronym for "Nicotine Replacement Therapy", but I'm not sure, and I think many readers of the article wouldn't be either. Could someone who knows for certain what it means please put the full term at the location of first usage? ie: Nicotine Replacement Therapy ("NRT"). Marcus erronius (talk) 01:31, 8 February 2016 (UTC)

Done; there was a disguised link in para 2 of the lead. I don't think we should tak of "NRTs" myself - "NRT products" is better. Johnbod (talk) 03:41, 8 February 2016 (UTC)