Talk:Electronic cigarette

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Recent reports of lung disease and deaths related to vaping[edit]

I assume this article is written under MEDRS rules, rather than newspaper reports. So I'm not going to add this myself, I'll leave it to those of you who are familiar with the rules for content here. But after the recent rash of lung disease and death associated with vaping (CDC reports 450 confirmed or suspected cases in 33 states, and three deaths with a fourth under investigation), the CDC has issued a warning: "While this investigation is ongoing, people should consider not using e-cigarette products. People who do use e-cigarette products should monitor themselves for symptoms."[1] Surely that deserves to be reported here? -- MelanieN (talk) 17:51, 6 September 2019 (UTC)

See https://en.wikipedia.org/w/index.php?title=Safety_of_electronic_cigarettes&type=revision&diff=910209406&oldid=909858441
See https://en.wikipedia.org/w/index.php?title=Adverse_effects_of_electronic_cigarettes&type=revision&diff=912805910&oldid=912393563
The CDC website has some initial findings. There is more probably more information on the CDC website. QuackGuru (talk) 19:25, 6 September 2019 (UTC)
Umm, thanks. That's it? The “safety” article still says prominently, in both the lead and the text, “The risk from serious adverse events, including death, is low.[19]” The CDC report, mentioning several hundred cases of severe pulmonary disease (but not death), is buried in the middle of a paragraph about “effects on breathing and lung function,” and is followed immediately by an earlier report of "11 cases of severe lung disease.”
This article, Electronic cigarette, uses the same “risk is low” sentence in the lead and in the “Safety” section, and AFAICS there is nothing at all about the recent reports. The CDC is quoted as saying that vaping is "likely less harmful" than smoking traditional cigarettes.
Excuse me, but doesn’t it seem as if the new information requires rethinking some things - like whether to keep saying in Wikipedia’s voice that “the risk from serious adverse events, including death, is low”? This article gets thousands of views a day. How many of those people are going away saying “OK, never mind, don’t worry about it, Wikipedia says the risk is low”? -- MelanieN (talk) 01:26, 7 September 2019 (UTC)
See …e-cigarettes are generally seen as safer than combusted tobacco products.[97][98] That's well written.
None of the new sources indicate the risk is moderate, high, or low. I have to follow the sources. You can search the CDC website for more content. It usually takes about 6 months for a review to cover the recent events. QuackGuru (talk) 01:37, 7 September 2019 (UTC)
@DocJames: Are you in agreement with this philosophy? Keep the old and possibly obsolete reports in our article as gospel, and wait 6 months before mentioning that there is new information on the subject of risk? [2]
@QuackGuru: RE None of the new sources indicate the risk is moderate, high, or low. I have to follow the sources. Would you consider the CDC announcement - "While this investigation is ongoing, people should consider not using e-cigarette products" - to be Reliably Sourced new information about risk? Or at least worth mentioning/quoting? We do report/quote other CDC announcements. See …e-cigarettes are generally seen as safer than combusted tobacco products.[97][98] That's well written. Yes, it's well written - and both sources are five years old. Should that trump the more recent evidence? -- MelanieN (talk) 02:47, 7 September 2019 (UTC)
There is no recent information about their safety in general. The subarticles cover the recent information. It is now at 5 confirmed deaths. QuackGuru (talk) 03:37, 7 September 2019 (UTC)
So somebody added this to this article - Following five confirmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products.[1] - important, well written and well sourced information. And you removed it and buried it deep in the text of the most obscure of the multiple spinoffs on the subject. With apparently NO mention of this important development to be allowed anywhere else, not even in the lead of that article, much less in the "safety" or "adverse effects" articles, and perish the thought of even hinting at it here in the main article. Well, I strongly disagree with this approach, and I await the opinions of other people on the subject. -- MelanieN (talk) 04:33, 7 September 2019 (UTC)
@Doc James: Sorry, mis-ping above; that appears to be a troll account. I would like to hear what you think on this subject. -- MelanieN (talk) 04:40, 7 September 2019 (UTC)
That wording and that source was not added to this article. I removed the MEDRS violation and lede violation. I added new content to the subarticle where it belongs. It is a bit too soon to put it in the lede of the subarticle. QuackGuru (talk) 04:47, 7 September 2019 (UTC)
I added it to the summary section. I would of preferred to wait until the investigation was over. QuackGuru (talk) 05:25, 7 September 2019 (UTC)
Looks like QG is just wanting you to use the CDC as a source. The version they removed uses PBS. Will add it back with the CDC. Doc James (talk · contribs · email) 10:24, 7 September 2019 (UTC)
Hum yes QG would do well to stop. Doc James (talk · contribs · email) 10:41, 7 September 2019 (UTC)
Sources

  1. ^ "Outbreak of Lung Illness Associated with Using E-cigarette Products". Centers for Disease Control and Prevention. 6 September 2019. This article incorporates text from this source, which is in the public domain.
You would do well to stop. I did add it to the body. QuackGuru (talk) 10:50, 7 September 2019 (UTC)
User:QuackGuru you are at 3 reverts. Next revert you may get blocked.
This is a new significant safety concern by a major medical organization. It belongs in the lead. Doc James (talk · contribs · email) 11:09, 7 September 2019 (UTC)
I am not at 3 reverts. I am at five reverts if you also include this revert and this revert.
See "In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe lung disease.[104]" That is a recommendation by an organisation. The problem with that is that there are other organizations that recommend e-cigarette use. See "Healthcare organizations in the UK in 2015 have encouraged smokers to try e-cigarettes to help them quit smoking and also encouraged e-cigarette users to quit smoking tobacco entirely.[214]" Cherry picking one organisation over another to include in the lede is not neutral. QuackGuru (talk) 20:15, 7 September 2019 (UTC)

───────────────────────── Thank you, Doc James. I would have preferred to see it added to the beginning of that paragraph of the lead, rather than the end - since it pretty much contradicts a lot of what is in that paragraph. IMO that paragraph now needs a rewrite. But at least this is a start. -- MelanieN (talk) 15:46, 7 September 2019 (UTC)

On 02:44, 7 September 2019 an editor added "Following three deaths, on September 6, 2019, the Centers for Disease Control and Prevention recommended against the use of electronic cigarettes. There have been 215 formally reported cases of possible pulmonary disease related to e cigarette use.[115]"[3] The content was sourced to a news article and failed MEDRS.
You stated on 04:33, 7 September 2019: "So somebody added this to this article - Following five confirmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products.[1]" The content was not added to this article before 04:33, 7 September 2019. I added it to the subarticle that included the typo. You copied the content and the source from the subarticle and corrected the typo.
I added on 05:20, 7 September 2019 "Following five firmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products."[4] It had the typo that was corrected on 06:39, 7 September 2019.
It would POV to start that paragraph with the CDC content. The CDC source does not contradict any content in that paragraph. Not a single sentence is contradicted by the CDC statement. The CDC source does not quantify the risks. QuackGuru (talk) 19:47, 7 September 2019 (UTC)
At least we have now qualified that flat statement "the risk of serious adverse effects, including death, is low", so that it now says "was reported as low in 2016". You say the CDC does not quantify the risks? You mean they don't say low, medium, high? The CDC is still investigating, but "We suggest you not use this product" seems kind of like evaluating the risk as high. But I'm not going to go to the mat on that one. Putting it last at least makes chronological sense.
My issue right now is at another related article. The CDC information is now in all three related articles - this one, the Safety one, and the Adverse effect one. As it absolutely should be since it is highly relevant info for those three subjects. At the article Safety of electronic cigarettes I added the CDC information to the text and the lead. QuackGuru removed this - In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe respiratory disease.(CDC reference) - from the lead, with the edit summary Center for Disease Control and Prevention statement is in another subarticle in the lede and is mentioned twice in the e-cig article. It is not a summary of the body. I disagree with this. The informtion is vital and absolutely belongs in the lead. Just because something is in one article doesn’t mean it can’t be in related articles too if it is relevant and important. And if the problem was that the actual warning is not described in the text, that's easily solved: let’s add it to the text. Nothing could be more relevant to safety than a CDC warning! -- MelanieN (talk) 20:33, 7 September 2019 (UTC)
Stating "We suggest you not use this product" does not quantity the risk.
Other organisations recommend their use. That's the reason it should not be in the lede in this article or across subnarticles. The Positions of medical organizations on electronic cigarettes article has a recommendation in the lede. See "Healthcare organizations in the United Kingdom in 2015 have encouraged smokers to try e-cigarettes to help them quit smoking and also encouraged e-cigarette users to quit smoking tobacco entirely.[10]" It is better to stick to the facts rather than add recommendations or warnings from organisations to the lede. QuackGuru (talk) 20:50, 7 September 2019 (UTC)
Well, I disagree. This is not just an "organisation", this is the CDC, warning that use of these products is associated with serious illness and death, and recommending that people not use them. That is "the facts", far more than any years-old article. The situation has changed, there is new information. I wonder what those "healthcare organizations in the United Kingdom" are going to say now. BTW note that you are not the sole judge of what goes into these articles. User:Doc James appears to agree that this material is important enough for the lead. -- MelanieN (talk) 23:46, 7 September 2019 (UTC)
And I see you have now removed it from the lead of the "Adverse effects" article too, claiming it is "off topic." -- MelanieN (talk) 23:51, 7 September 2019 (UTC)
This is not occurring in the "United Kingdom". This is a US-centric event. The content added to the lede is too US-centric. The US FDA acknowledges it was the cannabis vaping products rather than all vaping products in general. There is a disagreement between the CDC and US FDA.
It was the use of vitamin E-containing cannabis products that caused the illnesses rather than e-cigarettes in general, according to preliminary findings. QuackGuru (talk) 00:27, 8 September 2019 (UTC)
None of which is relevant; we are not going to put any of that preliminary/still being investigated stuff in the article, although you seem awfully sure of yourself that it's been established. I just maintain that the CDC warning should be in the lead of all three articles. Let's wait to see what others think. -- MelanieN (talk) 03:25, 8 September 2019 (UTC)
It is a valid argument this is only an outbreak in the US. An article on beef does not have a warning of E. coli bacteria in the lede. While the investigation is preliminary/still being investigated there should not be a warning in the lede in this article. You have not made a case for the CDC warning to be in the 'Safety' section here. It is in the 'Positions of medical organizations' section. Mentioning it twice in the body is excessive. When it is in the lede of the safety article it should be in the safety section per SYNC. But no argument has been made to add it to the lede of multiple articles. Since it is only a US-centric event and it is not e-cigarettes in general it should not be in the lede. It was cannabis e-cigarette products that contained high amounts of vitamin E acetate in the US, according to preliminary lab results. QuackGuru (talk) 09:02, 8 September 2019 (UTC)

2019 US outbreak of lung illness associated with vaping products[edit]

───────────────────────── In my opinion the second paragraph of the lead should start with an overview of the risks which it does. Agree that the specifics of the current outbreak are not yet defined but the concerns raised by the CDC is sufficiently notable to be in the lead at the end of the second paragraph. The CDC said "The investigation has not identified any specific substance or e-cigarette product that is linked to all cases." Doc James (talk · contribs · email) 11:20, 8 September 2019 (UTC)

See "In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe lung disease in the US.[104]"
This is now an "outbreak" rather than isolated cases in a few US states. Therefore, this new sentence should be rewritten to summarise the 2019 US outbreak of lung illness associated with vaping products without including in the lede CDC's statement recommending against their use. Sticking to the facts is far more neutral rather than the current opaque sentence that does not explain there is an outbreak. QuackGuru (talk) 18:45, 8 September 2019 (UTC)
Yes, the outbreak (good that you are now using that wording) should be summarized in a sentence in the lead and should be in the body of the article somewhere. But I still say the CDC warning SHOULD be in the text and in the lead. The fact that the CDC has advised people not to smoke these things is actually the single most important "fact" that should be in this article. But most people will leave here no wiser than they got here. Here's why: like all of your e-cig articles (how many are you up to now?), this article is a daunting wall of text. They consist of hundreds of thousands of bytes, where every published journal article is given a sentence, regardless of how old they are or what the most current information is - with the effect that no significant information can gleaned from the article by most readers. Some kind of digesting and summarizing is desperately needed. -- MelanieN (talk) 21:53, 8 September 2019 (UTC)
Since this is a US-centric event the CDC warning should not be in the lede. The current evidence indicates it was the illegal cannabis vaping products containing the Vitamin E that resulted in the outbreak in the US. That's not e-cigarette products in general. Therefore, it is overkill to mention the CDC warning in the lede. QuackGuru (talk) 22:04, 8 September 2019 (UTC)
I have rewritten that sentence to include the outbreak as a reason for the recommendation. It is NOT yet established that the vitamin E is responsible. On the contrary, the CDC says their reports include people who used various devices and liquids. The FDA has a much smaller sample and less rigorous evaluation methods; they may be jumping to a conclusion. (The media is picking it up, which is why we don't use media reports.) And the CDC has not retracted their recommendation to avoid e-cigarettes. -- MelanieN (talk) 22:12, 8 September 2019 (UTC)
Including the part "and recommended that people not use the devices while the outbreak is being investigated." is breaking news type content that definitely should not remain in the lede. QuackGuru (talk) 22:18, 8 September 2019 (UTC)
You have said that about eight times now. Doc James and I disagree. Consensus rules here; you don't WP:OWN the article even though you appear to think you do. -- MelanieN (talk) 01:38, 9 September 2019 (UTC)
Doc James has not commented about rewriting the content or removing the part about the CDC's recommendation based on further comments.
It looks a bit silly to keep a temporary recommendation in the lede. The FDA has come to a different conclusion but those details are in the subarticle. I have made a "new" argument that it is a "breaking news type content" because the recommendation is only "...while the outbreak is being investigated." That's only a temporary recommendation. If editors still want to keep it in the lede the recommendation part should be cut out IMO. It was *not* a recommendation in general that people should consider stop using e-cigarettes. The CDC said it is only while they are investigating the matter for people to consider stop using e-cigarettes. Therefore, by the time they are done investigating their recommendation is no longer relevant to the lede. What is the point to keeping a moot recommendation in the lede? QuackGuru (talk) 03:08, 9 September 2019 (UTC)
Just to break your argument about consensus. For once i agree with QG. This is US-centric, it is an ongoing case (not news), and it is also US politics to the highest degree. This kind of thing, is exactly what Wikipedia is not. If there is a need, then start a subarticle on this particular outbreak, where it is also possible to cover the regional responses, as well as the linkage to blackmarket THC and Vitamin E acetase -- Kim D. Petersen 06:12, 10 September 2019 (UTC)
Someone can draft a RfC I guess. But a one sentence summary in the lead is perfectly appropriate IMO. Doc James (talk · contribs · email) 13:17, 10 September 2019 (UTC)
The current sentence in the lede is not a good summary of this section. Either fix it or remove it, is the best approach. QuackGuru (talk) 13:28, 10 September 2019 (UTC)

QG, I find it hard to believe your approach. We can report that there is an outbreak of lung disease and death associated with vaping, but we can't report that the country's top health agency recommends against vaping? We can't even mention a warning unless the warning is infinite? Oh, and the AMA is now also "urging the public to avoid the use of e-cigarette products until health officials further investigate and understand the cause of these illnesses."[5] Are we not allowed to mention that either? I would add it, but I don't remember which of your multitudinous articles is allowed to have medical society recommendations in it. And BTW Kim D. Petersen, in what possible sense is this issue "US politics to the highest degree"? Is one political party taking one side and the other another side? I have seen no evidence of that. Up to this point the issue and reporting have been focused on the facts and the science. Let's discuss without trying to cloud the issue. -- MelanieN (talk) 18:19, 10 September 2019 (UTC)

OK, I found the "medical society section" here and in its separate article, so I added the AMA warning. -- MelanieN (talk) 18:39, 10 September 2019 (UTC)
No editor would write an opening sentence with a warning for an article. That's not neutral to include a warning in the lede. Hence, the tag. The CDC and AMA said it is "e-cigarette products" rather than "e-cigarettes". Soon I will be forced to create a new article or stop adding content. New sources are mounting. QuackGuru (talk) 18:28, 10 September 2019 (UTC)
So let me get this straight. At the section in the Safety article, we have paragraph after paragraph quoting multiple reports from multiple states; a full paragraph from the vaping industry saying “it’s not us!”; and every hot new detail about individual brands. The sources for this material are appalling, especially for the stuff about individual brands - it’s websites like Leafy and The Next Web, local newspapers like the Willamette Weekly, and publications like Rolling Stone. Whatever happened to MEDRS? Whatever happened to WP:NEWS? QuackGuru, all of this stuff was added by you; the improperly sourced stuff should be removed by you. And I see you are perfectly comfortable with news reporting on subpoenas issued by state health departments, and quotes from the industry - and yet you continue to insist that we mustn’t quote the nation’s own health agencies. You say that wouldn't be neutral, and yet you quoted in full the warning against street products from the FDA! Obviously this is just a particular "thing" you have about the CDC warning, rather than any objection to warnings in general. I am going to restore the CDC warning to that article, and I am going to remove the "Neutrality is disputed" tags from this article, since obviously you don't have a problem with including such warnings. -- MelanieN (talk) 19:59, 10 September 2019 (UTC)
For the new article there will be the CDC warning in the lede. You can see it in the draft. The safety article is the wrong place to put a warning in the lede. The draft will be completed by this weekend. This has became a major news event and has received significant news coverage. The first sentence will not be a warning. That would be silly. QuackGuru (talk) 20:08, 10 September 2019 (UTC)
Oh, so first it was non-neutral, and now it's "silly"? OK. I would like to hear your comments about the badly sourced information, violating MEDRS and NEWS, in the Safety article. -- MelanieN (talk) 20:28, 10 September 2019 (UTC)
In the Safety article, I have removed the paragraph that had no reliable sources (not even meeting Wikipedia standards, much less MEDRS). And I have added to the lead a sentence about the outbreak (without mentioning the warning). -- MelanieN (talk) 16:07, 11 September 2019 (UTC)
See "He's written for WIRED, Rolling Stone and Billboard, and is the former cannabis editor of the San Francisco Chronicle, as well as the author of several cannabis books".[6] He is an expert on the subject of cannabis vapes and others are linking to the articles.
The sentence about the outbreak (without mentioning the warning) is poorly written and the other sentences about the outbreak should be deleted. It is too much detail for a summary. The lede here should be changed without mentioning the warning. QuackGuru (talk) 19:01, 11 September 2019 (UTC)

Just an opinion after reading but if FDA and CDC are issuing warnings and the yet to be resolved epidemiology is just that then a banner should be placed upon the article stating that severe problems exist and extreme care should be taken with these products. We do not know and that is a risk, QG is far from objective on this basis, wikipedia should not as a group act to propogandise a specific activity when that could create harm. A specific a factual warning at the top of these pages is warrented in "real time" until causality is estabilished. The very concept of "warning" anything else is against the concept of truth and the antithisis of the purpose of a reference document which wikipedia is ? So forget any preference and act to reduce harm until the current issues can be resolved. Anything else is dangerous speculation. Bodconn (talk) 23:40, 11 September 2019 (UTC)

See ""The legal vapes have been actively regulated by FDA since Aug 2017. FDA has conducted thousands of inspections of manufacturers and vape stores, published manufacturing guidance, sought product removals etc. These tragedies point to illegal vapes and THC," former FDA Commissioner Scott Gottlieb tweeted in August 2019.[245] Gottlieb was interviewed on CNBC's Squawk Box on September 9, 2019: he said "the current belief is the illnesses are linked to illegal vapes containing vitamin E oil."[246]" The evidence is pointing towards the thickening agents in cannabis vapes. How would you write an introductory sentence? MOS:LEADSENTENCE ("The first sentence should tell the nonspecialist reader what, or who, the subject is." A warning does not do that. The sentence here should be a summary and an introduction to the topic. QuackGuru (talk) 23:52, 11 September 2019 (UTC)

Time is a factor, epidemiology is unknown. This is not having a go at this technology, it is reasonable to issue a warning when causality is unknown. That should be obvious, QG is attempting to reduce the ability of warnings to be seen, that is spin at the least. We should take a lede or lead from the FDA CDC and others, this is being closely watched by all health organisations. But the aformentioned have "issued" warnings and these should be accepted in "real time" to reduce harm. The rest is just a noise. Bodconn (talk) 00:06, 12 September 2019 (UTC)

According to your statement when the epidemiology is known the warning should be removed. Is that correct? See "Wikipedia's articles are not meant to provide medical advice."[7] A warning rather than following MOS:LEADSENTENCE or writing introduction on the topic is like giving medical advice. Timeless content will remains in the lede. Time sensitive content is like breaking news. QuackGuru (talk) 00:15, 12 September 2019 (UTC)

The facts are this is happening and a warning is warrented until such time it is not. I am not above the authority of FDA CDC and until such time that is closed out by these bodies then are you? Because you are acting as if you are. Do no harm. Inform people upfront with authority from estabilished healthcare professionals. If it eventually comes to pass this is a contaminant issue, fraudulent materials ie. Pg vg peg or it is an allergic issue that presents a risk to small populations then you can do as you wish and probably will. But are you doing any good. Issue is we you me do not actually know, and if that is the case we should warn until that is not the case? Bodconn (talk) 00:35, 12 September 2019 (UTC)

I've seen enough. I will create a new article with both warnings in the lede. Then the content can be moved to the subarticle and a brief mention here. Sounds reasonable? QuackGuru (talk) 00:39, 12 September 2019 (UTC)

I am not issuing advice FDA CDC is..... Bodconn (talk) 00:38, 12 September 2019 (UTC)

I am not issuing advice FDA CDC is..... Bodconn (talk) 00:38, 12 September 2019 (UTC)

US-centric[edit]

I'm really sorry for the people in the US, and particularly for those that have become sick from a contaminated product. BUT this is US-centric, and there is no indications, that the outbreak/product has implications in any other part of the world. Therefore it doesn't belong in a generic article about the topic. Kim D. Petersen 13:58, 12 September 2019 (UTC)

Two articles on "Safety" and "Adverse effects"[edit]

I've started a discussion on whether two articles on Safety of electronic cigarettes and Adverse effects of electronic cigarettes (created in Feb) are needed. See Talk:Safety of electronic cigarettes#Why two articles?. Fences&Windows 11:49, 8 September 2019 (UTC)

Opening sentence[edit]

Resolved

"Without burning tobacco" is not a behavioral aspect, as suggested currently. The simulation of smoking is not merely a behavioral aspect, but also chemical and constructive. Suggest dropping "by providing some of the behavioral aspects of smoking" as redundant and verbose. "...simulates smoking, including the hand-to-mouth action of smoking, but without burning tobacco" would be sufficient. Brandmeistertalk 17:25, 15 September 2019 (UTC)

See "An electronic cigarette or e-cigarette[notes 1] is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without burning tobacco.[76]" That is a very good opening sentence.
The part "but without burning tobacco." does not indicate it is a behavioral aspect, but the aerosol does simulate the look of smoke.
"It says "...by some of the behavioral aspects of smoking". That explains what is meant by "simulates smoking".
There is content for both "chemical and constructive". See "Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor.[77]" Also see "E-cigarettes are automatically activated by taking a puff;[78] others turn on manually by pressing a button.[3] Some e-cigarettes look like traditional cigarettes,[79] but they come in many variations.[3] Most versions are reusable, though some are disposable.[80]"
For the uninformed reader I think the first sentence is fine. QuackGuru (talk) 17:41, 15 September 2019 (UTC)
The point is that "by providing some of the behavioral aspects of smoking" means it's only about behavior which it's not. The word "simulates" is sufficient for that matter as it includes all intended aspects - behavioral, chemical and constructive. Brandmeistertalk 18:16, 15 September 2019 (UTC)
If you don't like the word "providing" then try "replacing" it with another word or adjusting the sentence. QuackGuru (talk) 18:35, 15 September 2019 (UTC)
Fine by me with "and provides". Brandmeistertalk 19:12, 15 September 2019 (UTC)