Talk:Electronic cigarette/Archive 30

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Lead opening statement on safety did not reflect neutral point of view

I removed the opening statement on safety in the lead. It asserted blanketly, "The benefits and the health risks of e-cigarettes are uncertain". This does not reflect a neutral point of view as per WP:NPOV. Below are some excerpts which should leave no doubt:

Public Health England

On current evidence, there is no doubt that smokers who switch to vaping reduce the risks to their health dramatically.link

Royal College of Physicians

In the interests of public health it is important to promote the use of e-cigarettes, NRT and other non-tobacco nicotine products as widely as possible as a substitute for smoking in the UK.link

Benowitz and Burbank

While the role of e-cigarettes for smoking cessation is not established, it is clear that some smokers do quit successfully by using e-cigarettes. . . . If e-cigarettes can be substituted completely for conventional cigarettes, the harms from smoking would be substantially reduced.link

Zvi Zig (talkcontribs 13:09, 20 May 2016 (UTC)

Again, you are completely emphasizing one piece of the issue; the comparison of e-cigs with cigarettes. There is another entirely distinct piece, which is the absolute risk of e-cigs compared to not vaping. Please stop doing that. Thanks. Jytdog (talk) 13:38, 20 May 2016 (UTC)
There is no contradiction between "The benefits and the health risks of e-cigarettes are uncertain" and the statements you quote. The PHE report goes into some considerable detail on the uncertainty. Johnbod (talk) 13:42, 20 May 2016 (UTC)
I concur with the others. It is clear that while some benefits and potential risks have been identified, the overall discussion on this topic is far from over. Calling the state of affairs "uncertain" is pretty accurate, as this is still being debated. --GoneIn60 (talk) 13:52, 20 May 2016 (UTC)
Concur with the three above me. Doc James (talk · contribs · email) 19:14, 20 May 2016 (UTC)
Jytdog makes a good point about the false comparison. A neutral reflection of the mainstream sources acknowledges the uncertainty. PermStrump(talk) 21:55, 20 May 2016 (UTC)
To all above, I've apparently been misunderstood.
How can we imply (in an opening statement, no less) that all the benefits and all risks are uncertain when significant positions hold of certain risks (nicotine, carcinogens) and/or benefits (cessation)?
Please look into this and re-consider JytdogJohnbodGoneIn60Doc James,PermStrump.

Zvi Zig (talkcontribs 23:24, 5 June 2016 (UTC)

You were not misunderstood, you're being deliberately ignored - I've been making that same exact point about known risks for weeks now, and precisely zero people have responded to it - so much for TPG. Well, if you don't count Johnbod's sarcasm (turns out he wasn't requesting a specific suggestion after all). In the unlikely even this latest outbreak of the sound of crickets is accidental, I'm not sure it's the most sensible idea to be making this comment right up here anyway - it took me a while to realise it was new. CrezT (talk) 06:07, 7 June 2016 (UTC)

I can't be the only reader who considers the blanket nature of the statement misleading, perhaps deliberately so since it is clear from the rest of the (ridiculously long) introduction, that the writers of this page clearly appreciate that the consensus on the level of certainty as measured by a wide cross section of qualified opinion, depends on which specific aspect of the debate is being considered - impact on smokers and cessation efforts, impact on non-smoking users, impact on third parties, impact on children, impact of regulated and non-regulated devices and liquids, impacts in the short, medium and long terms, etc, etc, etc.

It's notable that even non-scientific but otherwise credible pieces such as this http://www.bbc.co.uk/news/health-36055500 (which prompted me to come and read this page) studiously avoid any similarly broad sentences - every part of that article which touches on ongoing uncertainty, qualifies which aspect of the debate of is being referred to. Hopefully this is just a case of people not being able to read it with fresh eyes, and nothing more sinister. It really should be removed, as it is completely redundant to the rest of the text immediatelty after it. Maybe there is nothing intentionally non-neutral about it being there, but the presence of a link in it which gives the entirely wrong impression that there is an article on Wikipedia about the "health risks of e-cigarettes" suggests otherwise.

Personally I can see all sides of the debate, but having seen first hand how smokers can often die in horrific and painful ways, in every case people who always thought it would never happen to them, that all due care must be taken not to overstate the potential risks of ecigs if it causes even one smoker to delay quitting. It's not like they need much encouragement to keep puffing away as it is. — Preceding unsigned comment added by CrezT (talkcontribs) 16:37, 21 May 2016 (UTC)

Like the OP you are somehow equating e-cigs with quitting smoking. They are not the same, and it is not true at all that the only people using e-cigs are people trying to quit smoking. Jytdog (talk) 20:08, 21 May 2016 (UTC)
You have good intentions, but Wikipedia should not be used as a means of promoting a particular platform or point of view. Just as with the concern that the risks shouldn't be overstated, similarly, we shouldn't be overstating the benefits. Regardless of which side of the debate you find yourself on (and you might be surprised to learn which side I lean towards), we should all be able to agree that there's a long way to go before the debate is settled. It's not Wikipedia's purpose to analyze the evidence and pass final judgement. We leave that up to secondary and tertiary sources, and so far in many respects they disagree with one another, hence the uncertainty.
In the meantime, we can only do our best to balance the various viewpoints in proportion to their prominence in reliable sources. We should also give the reader some credit. There are a ton of sources cited in the article for those who are so inclined to dig further. --GoneIn60 (talk) 03:18, 22 May 2016 (UTC)
The article would probably be better if people defending it didn't respond to things they think critics of it said. I was quite clear above what I know and what I think - if you're confused, don't substitute your own theories instead of asking for clarification.
I give readers credit - if they read on, here or in other sources, I think they will see that sentence is completely redundant to what follows, perhaps even spotting that there are many risks which are very much certain. Which begs the question, why is it still there? To keep uninformed readers who don't read on in an uninformed state?
I just checked the article on fracking, and it has nothing like this sentence in its introduction. Is anyone here seriously going to suggest that article is worse at conveying that practices many and varied ongoing uncertainties than this one? It is the equivalent of compressing a digital scan of an artwork into a beige blob and calling that a summary.
I linked to a responsible source above, one aimed at uninformed readers looking for an authorative summarisation of the debates that still exist. If we all have good intentions here, perhaps we can agree that this article should try and emulate the way they have portrayed it, which as I said, steers well clear of using any form of complete and total genericicisms. Presumably because they help nobody at all, not even the time poor. — Preceding unsigned comment added by CrezT (talkcontribs) 04:06, 22 May 2016 (UTC)
"they will see that sentence is completely redundant to what follows..."
You are presumably referring to the sentence in the lead section, which is in a section that summarizes the article. So while it may appear "redundant to what follows", this is the point of a summary. If you're not familiar with Wikipedia article layouts, I suggest you start by reviewing MOS:LAYOUT and specifically MOS:LEAD. This should help answer why it's there.
"I just checked the article on fracking, and it has nothing like this sentence in its introduction."
If I understand you correctly, you looked at this article for comparison. The third paragraph does address the controversy, so it is similarly summarizing what to expect to read in the remainder of the article. Since its approach is similar to this article and in accordance with Wikipedia policy, I'm not entirely sure what your point is. Perhaps you can be more specific?
I linked to a responsible source above ... perhaps we can agree that this article should try and emulate the way they have portrayed it"
Given the vast number of sources out there, your mileage will vary depending on which one you come in contact with. I'm not saying this isn't good advice, but your argument here is a bit vague and doesn't offer a specific solution. How about instead of focusing on the cause and effect of a poor summary, why don't we start honing in on specific proposals of what you would like to change. Rewrite that sentence or paragraph in your sandbox and share it with others in this discussion or simply put it here. We can all comment on and tweak it further hopefully moving us closer to some sort of consensus. It might also help us better understand the points of contention. --GoneIn60 (talk) 12:47, 22 May 2016 (UTC)
The fracking article has no sentence in its introduction which even comes close to the seemingly deliberately vague form of "The benefits and the health risks of (fracking) are uncertain". As with the sentences here that follow this one in the introduction (which count as the summary too, hence the redundancy), the sentences in fracking dealing with the ongoing controversy are specific about which aspects/impacts they are referring to, so that there is no potential for readers to be misled by the inevitable consequences of over enthusiastic compression of all that information into one catch all line, as has happened here.
I pointed to how the BBC source does it because they are quite obviously aiming their work at the uninformed reader, and they have a good reputation for being able to write about controversial things like unsettled science in a neutral manner, without bias to any particular lobby or activist agenda. Therefore it behooves people here to take notice when they studiously avoid including useless sentences like this one in their own articles - this one having been specifically aimed at explaining what all the ongoing uncertainties and controversies of ecigs actually are.
If the writers of this article consider themselves to be better at this sort of summary writing style than the BBC, then I admire their confidence, but I'd rather not encourage them by acceeding to some kind of pointless negotiations based on faulty positions (that I have somehow misunderstood the underlying issues or the relatively easy task of writing for Wikipedia - if it was hard, it would be a recognised profession). The simple fact of the matter is the sentence adds nothing, and has the real potential to confuse and mislead, especially if readers stop there, so the obvious way forward is to remove it. There's no way to reformulate it without going into the very specifics that are already included in the sentences that come directly after it, but which are still quite obviously part of the summary. — Preceding unsigned comment added by Crez T (talkcontribs) 15:04, 22 May 2016 (UTC)
There are no "writers" per se, only "contributors". Anyone with an internet connection can jump in and modify text, both registered and unregistered users. So as you can imagine, it takes time for an article to reach a condition that is acceptable to most, especially when the subject is controversial and actively being updated. Reaching a point of stability in an article is the process Wikipedia defines as consensus. This very discussion is an integral part of that process. I'm not denying that this area of the introduction could use some work, but it would be helpful for those interested in changing it to make a concrete proposal we can all look at, tweak if necessary, and then insert it into the article once a general consensus is established.
I have contributed very little to this article and was not involved in the formation of the introductory section (known as the lead section). However, I would be willing to assist if others are interested in further improvements. You may want to start by writing your proposed version of the paragraph below. If your only concern is to remove the opening line of the paragraph, then confirm that so others can comment on whether or not that is acceptable to them and why. That would help move us one step closer to determining a consensus. After further review on my part, it does appear that the paragraph would stand fine on its own without that statement in the opening line. --GoneIn60 (talk) 17:44, 22 May 2016 (UTC)
I've said it so often, I'm quite sure everyone here appreciates my desire is to simply remove that line, for the reasons already given at length now. If you think it doesn't need to be there either, let's do an experiment and see if you get ignored or told you've not understood the issue too. Maybe when enough people get the brush off, something will happen. Or maybe it won't. But let's not pretend such a process is how consensus is made, it's something else entirely. — Preceding unsigned comment added by CrezT (talkcontribs) 20:51, 22 May 2016 (UTC)
Your account was recently created and only shows an edit history in this discussion. So either you are new here, or you're an existing editor with experience that has created another account to shield your identity. In either case, it doesn't seem you fully grasp the concept of WP:BRD. This edit by Zvi Zig was reverted, which has led us to this discussion. This is very much how dispute resolution and consensus works here. Ramming changes into an article in an attempt to overcome multiple reverts often leads to page protection and blocks, hence the need to sort it out on the talk page.
I don't see a problem with removing the statement, but at the same time, I don't really see a problem with keeping it either. Let's see if any opinions change based on your comments above, and if not, you (or another editor) can explore other options such as initiating an RfC to get site-wide feedback. Sometimes asking for outside opinion helps. --GoneIn60 (talk) 13:10, 23 May 2016 (UTC)
What {u|CrezT} is arguing should be obvious. If there's a significant position that e-cigs even have even some benefit, then the blanket assertion that the "benefits and the health risks of e-cigarettes are uncertain" cannot be neutral. If we cannot reach consensus on this simple point then there's no hope.Zvi Zig (talkcontribs 13:11, 23 May 2016 (UTC)
See my comments above about another option for dispute resolution. Yes, it's true that some benefits and risks have been identified. However, the extent of each remain unknown and fairly uncertain. For example, most agree that they are less harmful than cigarettes, but not everyone that supports that view will agree that they're safe. The underlying theme is that people want more research. There could be more in the way of benefits and risks that we don't yet know about. Because the research is incomplete, it makes sense to say there is still a great deal of uncertainty. While I'm not a strong supporter of keeping the statement, I can certainly understand why it's there. --GoneIn60 (talk) 13:30, 23 May 2016 (UTC)
Now I see your point. You are saying that compared with smoking e-cigs are much less harmful. That is true, and is addressed in the very next sentence which is well supported. That doesn't change the overall statement which is also well supported; having less harm than cigarettes is only one piece of the overall picture . Jytdog (talk) 13:33, 23 May 2016 (UTC)
My point is not about relative risk per se, but that the blanket assertion that benefits are uncertain is incorrect according to the significant authorities (above) who hold that e-cigs have certain benefits (in relation to stopping/reducing smoking). Thus, the opening statement cannot be WP:NPOV. Zvi Zig (talkcontribs 13:57, 23 May 2016 (UTC)
That is just blatantly incorrect, every significant authority that has made statements have said they hold risks or that the risks are unknown to this date. When compared to cigarettes, risks are lower, but still marked. Carl Fredik 💌 📧 14:10, 23 May 2016 (UTC)
"...in relation to stopping/reducing smoking"
As others have pointed out on many occasions, this viewpoint is just one piece of the pie. Other pieces include "vaping vs. non-vaping", "vaping vs. other nicotine supplements", and simply vaping's overall effect on the body. These elements of the discussion are much more uncertain than the "vaping vs. smoking" debate. --GoneIn60 (talk) 14:17, 23 May 2016 (UTC)
I created my account to add my voice to the opinion that the sentence adds nothing, and attemt to explain how those who support it are not following the example of professional writers like that BBC source, and are arguably misleading readers looking for unbiased advice, by deliberately including a sentence they surely know to be so broad and devoid of context, but yet so assertive of the existence of uncertainty across all aspects of the health risk debate, that it makes a mockery of the very idea that it is summarising anything that can be found even in the article, let alone in high quality summarising sources like that BBC piece.
I have not made any attempt to remove it, having already seen how that was reacted to above. Looking at what has come since, it seems to me the way consensus seems to work on Wikipedia is to simply ignore people at best, or otherwise insult their intelligence or understanding, in the apparent hope they just go away. I am a highly educated person, with the degrees and pay rate to prove it, and I am not really seeing any reason why it should be assumed by anyone here that I either don't understand the ecig debate, or don't understand how Wikipedia works, yet these insinuations persist, as if it's almost deliberate.
If Wikipedia is supposed to work by reasoned debate leading to good articles, then clearly it is not working - this article is not even considered Good by your own standards, as seen at the top this page. I am quite sure that an article as important as this has had all the outside opinion it is ever going to see, so if the article is still poor as of now, when the debate is at its peak in the media, science and political worlds, then the situation is as irretrievable as suggested above.
Even now it is still being claimed the statement is well supported. By who? Which organisation seeking to summarise this debate is so incompetent, so careless, so lacking in editorial control that they they would let such a statement pass? The BBC evidently wouldn't, so which organization is being maligned here? The real truth here is that anyone who published such a statement, always does it in context, establishing both which aspect of the debate they mean, and what level of uncertainty there is. The way it is presented here, it has no such context, not even through the presence of the lines that follow it, as they clearly come from other sources with their own contexts. This should be a very simple point to grasp, no? It's basic stuff.
The risks of nicotine addiction or ingestion are not uncertain, I have already said that, and so this is just one example of how the statement is demonstrably false when there is no qualification as to what risks are being talked about. And are the risks of short term use still uncertain? I think most people reading this article would conclude they are not. Will these reasons for why the statement needs to go be ignored this time around too? At what point will this start resembling an actual discussion, rather than a series of misdirected rebuttals? I'm quite sure nobody here wants to be told they're idiots any more times than is necessary to figure out why this statement is believed to be adding something. — Preceding unsigned comment added by CrezT (talkcontribs) 14:36, 23 May 2016 (UTC)
"I am quite sure that an article as important as this has had all the outside opinion it is ever going to see..."
Highly doubtful, and no amount of reassurance on your part is going to change that from opinion to fact. I simply suggested starting an RfC, which will land the discussion on a watch list of a lot more editors who have never contributed or even looked at this article. Ranting and raving about the Wikipedia guidelines and policies here will not change them; there are other avenues for that if you wish to pursue them. I also don't quite understand your animosity towards other editors here. It's as if you have experience being shutdown before in another article (or possibly here), but you have this new account with no edit history which doesn't make this evident.
"I'm quite sure nobody here wants to be told they're idiots"
I see no evidence of this occurring. Linking to relevant guidelines and policies is meant to help, not insult, if that's what you are referring to. The best way to solicit participation and cooperation in a contentious discussion is to avoid talking down to your fellow peers and work towards discovering a compromise that is acceptable to all sides. Surely multiple degrees and an important occupation in life would have reinforced the importance of this for you by now, unless of course you are just used to always getting your way. You may mean well with your "wall of text" responses, but it is becoming harder and harder to focus on what you deem to be important in this discussion. Right now, it feels as if you are just as interested in rebuking well-established processes on Wikipedia as you are in resolving the issue at hand.
Bottom line: You've stated your argument and seem fresh out of new ways to explain it further. Let's give it some time to fester and see if some opinions on what you've stated start appearing. The more you assume bad faith about those who are simply trying to understand your point of view, the less likely anyone will want to engage. --GoneIn60 (talk) 15:38, 23 May 2016 (UTC)
You just proved it adds nothing. If this catch all statement is really meant to give the impression that, among all its other meanings, it's trying to convey there is still uncertainty as to whether vaping has any health risks associated with it all, i.e. that a psysician would have no problem at all if a non-smoking patient one day announced they wanted to give vaping a try, then it is obvious nonsense. Nicotine addiction is a known risk, of which there is no uncertainty. The only way it ceases to be nonsense in that case, is if you try and get out of that problem by claiming it's meant to refer to non-nicotine vaping too, in which case the sentence must be so broad it surely also applies to the risks posed to non-users. And again, given there is no uncertainty with regard to things like a accidental nicotine ingestion, we're back to it being total nonsense.
As this debate goes on, it's becoming clear there are two reasons for opposition, those who have simply not thought the whole thing through and so not realised just how broad a statement it is, and those who have, but want to keep it anyway, as they seem to think scaring everybody about the unknown unknowns is the right thing to do, for the public good. The issue of neutrality and bias comes into play when you realise this is not an accurate reflection of what reliable information sources are doing, particularly the ones dedicated to giving a broad overview of the whole subject as it stands from a well regarded and respected position of non-bias, such as that BBC piece. — Preceding unsigned comment added by CrezT (talkcontribs) 15:18, 23 May 2016 (UTC)
CrezT please see your Talk page. Jytdog (talk) 15:20, 23 May 2016 (UTC)

───────────────── Well, in reference to the above, according to Jytdog I have "stepped well over that line.", referring to "One of the cardinal rules here, is that we discuss content, not contributors." Using the information he provided, it did not take me very long at all to establish that on Wikipedia, in certain circumstances, it is very much permissible to talk about the conduct of others. I believe that situation already exists. It is clear to me that some of those who want this sentence to remain, are deliberately ignoring some or all of the reasoning of the people who disagree, and/or are deliberately misrepresenting what they say to otherwise manufacture a reason to ignore them. This appears to me to be a direct violation of "WP:TPG", the very thing Jytdog told me to read. If I am wrong, I'll happily be punished any way Wikipedia sees fit, using one of these "discretionary sanctions".

And to respond to GoneOIn60, from the information Jytdog gave me, it appears my assumption that this article has probably had all the eyes it will ever have is close to the truth - according to him, this article made it all the way to the Wikipedia Supreme Court, and it's not hard to see why if the way this discussion has gone is normal. As such, it's hard to see how there could be anyone out there who is interested in improving it but is not currently watching for comments from people here, who attempt to highlight its faults. I suppose we could press-gang uninterested people into giving an opinion, but I somehow doubt that would advance the situation very much, I can see no reason why they would willingly put themselves through this ordeal.

I am not "used to getting my way" as you put it, but as a professional person I am accustomed to being treated with respect - which includes having all of my opinions heard and responded to if I am led to believe I am participating in a discussion - if this is not a discussion someone should say so, and we can end this charade. My perception that I am not being shown respect is what is fueling my animosity (and I don't discount the possibility that driving me to anger is some people's motivation here - if I snap and really blow my top, no doubt discretionary sanction will occur). And while you're not the worst offender, you personally are disrespecting me by continuing to insist I have somehow misunderstood some aspect of Wikipedia's method of operation, in spite of my objections and requests you explain how that is possibly the case based on anything I've said or done - I had hoped you would get the point, but this latest repetition of the exact same insinuations and accusations suggests not. And of course, I did not literally mean I have been called an idiot, I am referring to the undercurrent of some of the replies directed to me and Zvi Zig.

Like me, he must be extremely tired of having to keep confirming that yes, we are both fully aware the debate referred to in that sentence is not restricted to merely the health effects for smokers. We both know that, because we really aren't morons (again, speaking metaphorically), but yes, we still have objections, so kindly address them, fully and in detail. Or not. But if you don't/won't/can't do that, then please don't pretend like you have, or that there was some genuine confusion - it's simply not possible once it's been explained this many times. It's not like other people can't see for themselves what is and is not being responded to here, and how many times we've had to say the same things.

P.S. Someone moved my last two comments around, so I am moving them back to where I intended them to be, because it's important to know who I was talking to and what messages already existed when I made them - it is my understanding this is permitted and is how it should be, but if not, please do not apply a discretionary sanction, just put them back and explain why they were moved, as I cannot see a good reason for it. — Preceding unsigned comment added by CrezT (talkcontribs) 19:33, 23 May 2016 (UTC)

In spite of the fear that this might invite another wall-of-text response, I wish you well in your endeavor to improve the article, as well as any other editor that wishes to carry on this engagement. For the record, I asked that you allow time for your previous comments to settle in and resonate with other editors that may be interested in responding. I certainly did not ask for you to restate your opinion for a fourth time (or maybe fifth, I lost count). Many of us including myself volunteer our time and energy to Wikipedia, but for me, this is turning into a customer service call (where you're the agitated customer trying to explain they're tired of calling and want the issue fixed now). Sorry to disappoint you, but I don't work for Wikipedia. Wish you the best. --GoneIn60 (talk) 20:29, 23 May 2016 (UTC)

Sorry to have taken up your time. Perhaps there is a fundamental flaw in this volunteering model which would simply not arise in a professional environment like the BBC. As you say, time will tell. CrezT (talk) 16:28, 24 May 2016 (UTC)

In reply to Carl, all agree there is some risk from e-cigs, as CrezT has shown repeatedly. My point is that many hold that there is sufficient evidence to conclude that there are at least some benefits from e-cigarettes. Therefore, the blanket assertion that benefits and risks are uncertain, is wholly incompatible with WP:NPOV.
This should be self-evident. Zvi Zig (talkcontribs 08:14, 25 May 2016 (UTC)

───────────────────────── No-one holds that there is any benefit of e-cigs over using nothing at all. There are risks, the extent of these risks when compared to the control — which should be non-smokers — is still unknown. Carl Fredik 💌 📧 10:23, 26 May 2016 (UTC)

  1. How does that justify the blanket statement "The benefits and the health risks of e-cigarettes are uncertain"?
  2. Would you support placing an identical assertion in the article on nicotine gum? There are no benefits in using nicotine gum over nothing at all, and its long-term health risks are uncertain too.
Zvi Zig (talkcontribs 15:36, 26 May 2016 (UTC)

Noting here for the record these two edits. [1][2], which have markedly changed the disputed wording. No need for anyone else to be confused by this dysfunctional talk page (and yes, I am making this same identical note in three related sections, and that is intentional). CrezT (talk) 18:22, 2 June 2016 (UTC)

Risks of vaping of course have to be compared with risks of smoking. There is no doubt even among anti-vapers that vaping is much safer than smoking, so this is not really controversial. The section should start with a clear statement that vaping is a much less risky alternative to smoking. The concern about non-smokers is legitimate, but fortunately, up to now, only smokers use e-cigarettes. Non-smokers only experiment with them but do not progress to further, let alone daily use. Some US surveys present experimentation as use but this is misleading. PH, 3 June 2016 — Preceding unsigned comment added by 2a01:56c0:8180:400:71ec:a864:5a37:d6c8 (talkcontribs)

New problematic assertion in the lead

The phrase added, "the short term safety profile is difficult to establish due to the lack of standards for devices and e-liquids", is incorrect.

Despite the wide variety of products, no major acute problems have emerged.

See, for example PMID 25078252:

Although surveys of users, prospective clinical studies and randomised controlled trials to date have not found any serious adverse events, several such events have been reported as case studies and in the media. Given high media interest in EC, the number of such reports is remarkably low.

Furthermore, the RCP review seems to be cited as if it says short-term safety is unclear! The RCP review actually says,

E-cigarettes are generally well tolerated. . . . long-term or rare adverse effects will remain uncertain until e-cigarettes have been in widespread use for several decades.

Of course, you can always capitalize on the hypothetical rare adverse effects, these are not excluded in many in regulated medicines.Zvi Zig (talkcontribs 00:15, 6 June 2016 (UTC)

PLease see section 5.3 of the RCP report which makes very clear how variable devices and liquids are. And their webpage summarizing the report has two bullets addressing this:
  • E-cigarettes are not currently made to medicines standards and are probably more hazardous than NRT.
  • Technological developments and improved production standards could reduce the long-term hazard of e-cigarettes.
Every responsible authoritative source notes that devices and e-liquids are not standardized and calls for them to be. The reasons for this are obvious, especially to scientists. All the studies to date are with defined devices and liquids and all of them note that, and also note the difficulty of making generalizations in a world where there is wide variability, including on the level of user customization. Even the RCP and PHE. This is not some huge ding against e-cigs, it is just part of the current landscape that will probably change with time. It is what we have to work with now. Jytdog (talk) 00:44, 6 June 2016 (UTC)
Jytdog, you're ignoring the population evidence for short-term safety above. The RCP review is clear that its concern for some potential hazards are confined to long-term effects and rare short-term effects (the latter a concern in most regulated medicines). Note that even tobacco cigarettes don't increase morbidity until decades of use. Zvi Zig (talkcontribs 08:32, 6 June 2016 (UTC)
Both things are true. Of course! Jytdog (talk) 08:57, 6 June 2016 (UTC)
Excluding all but rare short-term adverse effects is consistent with the terminology "the short term safety profile is difficult to establish"? Zvi Zig (talkcontribs 11:56, 6 June 2016 (UTC)
I would think 'the short term safety profile has yet to be established' would be more accurate. Only in death does duty end (talk) 12:06, 6 June 2016 (UTC)
If all but rare adverse short-term effects are excluded, I don't see how that would be consistent with Only in death's proposal (thanks for staying!). Furthermore, these are all WP:OR anyway.
Why not convey what the report actually says: "E-cigarettes are generally well tolerated. . . . long-term or rare adverse effects will remain uncertain until e-cigarettes have been in widespread use for several decades". Zvi Zig (talkcontribs 12:34, 6 June 2016 (UTC)

─────────────────────────I consider it to pretty accurately portray that assertion - but the solutions is nonetheless not to remove it entirely, but to rewrite it: please come with a suggestion instead of blanking content. Carl Fredrik 💌 📧 11:38, 8 June 2016 (UTC)

  • Sure: While they are generally well tolerated, uncommon serious adverse events cannot be ruled out. Zvi Zig (talkcontribs 20:08, 8 June 2016 (UTC)

Propose removing the uncertainty line

In the face of continuing stonewalling and other TPG non-compliant responses (misdirection, misrepresentation and even sarcasm) to the totality of the specific objections laid out above in detail in several sections, I hereby formally propose the removal of the line "The benefits and the health risks of e-cigarettes are uncertain." It is clear from Wikipedia's code of ethics that faulty text with the capacity to harm human health (by needlessly scaremongering through the sowing of unwarranted confusion and doubt in this case) should not remain in articles, and those who violate WP:TPG to ensure it stays, regardless of motive, are as guilty of abusing Wikipedia as any common or garden scammer or snake oil salesmam. Enough time has passed and enough attempts have been made on our part to explain and expand on our positions and respond to what little has been said in reply, that it now has to be assumed this TPG non-compliant behaviour we have seen in response (or lack thereof) is wholly deliberate, and therefore objectors have forfeited any rights to further objection, per WP:CON and WP:OWN. CrezT (talk) 14:27, 13 June 2016 (UTC)

I agree. It is inconceivable that the opening statement makes two assertions which are irreconcilable with major recognized authorities.
  1. "The benefits... of e-cigarettes are uncertain".
  2. "The... health risks of e-cigarettes are uncertain".
    • This assertion is irreconcilable even with EC proponents who conclude that they are not harmless e.g..
It is unacceptable that such a decidedly non-neutral declaration remains in the lead as the opening statement on safety for this long.Zvi Zig (talkcontribs 22:20, 13 June 2016 (UTC)
Here is an interesting paper that just came out which found specific harms from e-cigs in kids.[3] Basically their use appears to increase latter smoking by an absolute percentage of 30%. Will be interesting to see how the reviews summarize this primary source. Doc James (talk · contribs · email) 15:54, 14 June 2016 (UTC)
Similar studies have already shown such results. However, the PHE and RCP reports conclude that such studies do not suggest causality, as the outcomes are explained by shared liability for using both products. For the appropriate study-designs needed to establish such 'gateway' claims, see PMID 26006122. Zvi Zig (talkcontribs 22:22, 14 June 2016 (UTC)
Agree, there are uncertainties about the risks and benefits of e-cigs but the current phrasing and context overstates than uncertainty. As for the Paper Doc James links, firstly I don't see the relevance and likely there's an example of causation and correlation not being adequately separated in that paper. I don't think anyone would struggle to believe and I think some studies have implied, that the subset of people likely to smoke and the subset of people likely to use e-cigarettes overlap therefore by identifying a group of teens that fall into one you are disproportionately selecting a group that fall into the other, even accounting for known and obvious factors. It is possible in principle that e-cigarette use among never smoking adolescents is a marker for those who would have begun to smoke even if e-cigarettes were not available. In these adolescents, the availability of e-cigarettes use may have delayed the initiation of smoking among those who would have gone on to smoke anyway.. SPACKlick (talk) 16:05, 14 June 2016 (UTC)
It is also possible that e-cigs will lead to greater nicotine addiction and subsequent greater rates of smoking with its higher associated risks of death. Doc James (talk · contribs · email) 17:13, 14 June 2016 (UTC)
With increases in EC use there have been sharp declines in youth smoking (source) (source). In Sweden, low-risk nicotine have contributed to by lowest smoking rates in the EU far the (PMID 25191176). State restrictions on EC access are associated with smaller declines in youth smoking (PMID 26583343, PMID 26971853). Zvi Zig (talkcontribs 22:22, 14 June 2016 (UTC)
A number of sources have rightly discussed the fact that ecig users tend to vape more often and may be exposed to significantly higher doses of nicotine, which is currently not even discussed in this article. So there is absolutely relevance in the source that Doc James linked.
Also, from the source I link below (PMID 27153077)

Among never-smoking adolescents and young adults, e-cigarettes use was associated with increased smoking intention

Carl Fredrik 💌 📧 17:59, 14 June 2016 (UTC)
This must be your own personal interpretation of the sources, because afaik, no conclusions are possible on the gateway hypothesis using any of the sources available to us. In fact, in your source, it is made abundantly clear in section 4 Discussion, last paragraph. Paraphrased: No causal interpretation possible because the underlying data is cross-sectional.
But a more important question is why we are discussing the gateway hypothesis here? Since it is an entirely different discussion, than the safety/harm aspect, unless we go into the speculative/philosophical, which btw. the source you mention below does excellently (by looking at a libertarian and utilitarian interpretation). --Kim D. Petersen 22:32, 14 June 2016 (UTC)
(ec)...and it is also possible that a future Mars mission will fail b/c of a faulty lithium battery that was once used in an e-cigarette. How does such opinion help here in improving the article and how is it related to this section's topic? In other words, if you think your post is not off topic please explain how it relates to and furthers article improvement. Thank you.--TMCk (talk) 18:00, 14 June 2016 (UTC)
The reason behind this is that so many sources are low quality, and if you look at the meta-analyses and systematic reviews they point to these issues.
Check out Electronic Cigarettes for Smoking Cessation: A Systematic Review. (PMID 27113014) which states as its main finding:

While the majority of studies demonstrate a positive relationship between e-cigarette use and smoking cessation, the evidence remains inconclusive due to the low quality of the research published to date.

Carl Fredrik 💌 📧 18:08, 14 June 2016 (UTC)
1. No one suggested that PHE is a consensus. 2. The second review you mention is not about causal effects.Zvi Zig (talkcontribs 22:22, 14 June 2016 (UTC)
You choose to cherry-pick sources and quotes in one direction and want to have it reflected this way (POV) instead of presenting all major directions (NPOV). Not only here on talk but in the article and the latter is a problem.--TMCk (talk) 18:26, 14 June 2016 (UTC)
That is probably the most absurd allegation so far on this talk page. If you were to even give it a moments thought and actually look at what I quoted it is the conclusions section of the abstract nearly in full (yeah I left the part where they suggested further research is needed) of what is the newest systematic review on just the topic you were discussing. Get your facts straight. Carl Fredrik 💌 📧 19:52, 14 June 2016 (UTC)
Wrong place to re-argue ARBCOM's fact findings.--TMCk (talk) 20:15, 14 June 2016 (UTC)
It would be, but there are no such findings. Carl Fredrik 💌 📧 20:21, 14 June 2016 (UTC)

As for your first statement Zvi Zig — that is only because those sources in turn clash with a sizable portion of other sources, including a number of meta-analyzes and systematic reviews which land higher up on the scale of reliablity (see WP:MEDASSESS) Concerning what you are discussing: Doc James and SPACKlick, there is a recent meta-analysis on the topic: Electronic Cigarettes Use and Intention to Cigarette Smoking among Never-Smoking Adolescents and Young Adults: A Meta-Analysis. (PMID 27184265) Which states among many thing (but this is from the first paragraph):

…there is little evidence on the impact of e-cigarettes use on never-smokers.

That for me is enough to keep the sentence, seeing as there is such a disagreement among different sources. Carl Fredrik 💌 📧 17:56, 14 June 2016 (UTC)

Have you linked to the wrong review CFCF, because i cannot find that particular quote anywhere in the source(PMID 27184265), and i think i've looked very carefully, since the quote can mean several things depending on context, for instance (as the source also notes) that there has been no notable uptake (impact) amongst never-smokers. Aside from that it is a very good meta-analysis, which i read with interest, and which probably should be used more. It enters into a good discussion on many of the topics that we cover here. --Kim D. Petersen 21:56, 14 June 2016 (UTC)
Interestingly, CFCF's source thinks that

Overall, the safety profile of e-cigarettes is unlikely to warrant serious public health concerns,...

and even more so

...given the known adverse health effects associated with tobacco cigarettes.


They don't seem to agree much with the blunt statement of the unknown.--TMCk (talk) 22:30, 14 June 2016 (UTC)
I find this particular section very interesting, and may be something that we should summarize if other sources state similar things:

A useful paradigm that reconciles liberalism and utilitarianism in illustrating the impact of displacing a high-risk activity with a low-risk one is the risk/use equilibrium (Fig. 1) [47]. For instance, if e-cigarettes reduced a smoker’s risk by 99 %, for every smoker who switched to e-cigarettes, 100 non-smokers would need to initiate e-cigarettes to attain no net public health benefit. Were e-cigarettes so little as 95 % less harmful than tobacco cigarettes, 20 % of non-smoker uptake of e-cigarettes would be required to offset the public health benefits of 1 % of smokers switching to e-cigarettes, generally representing the upper limit of nicotine usage prevalence worldwide [6]. Consequently, it is unlikely that e-cigarettes would result in net public health harms despite the inevitable uptake of the product in a non-smoking fraction of the population. This framework provides nuance to the absolutist position that any non-smoker uptake of e-cigarettes would have overall adverse effects on population health. In practice, sound public health policy can sustain autonomous choices with deleterious consequences to the extent that these do not outweigh net public health benefits.

It is in the philosophical department, but we are already addressing the gateway hypothesis. --Kim D. Petersen 22:36, 14 June 2016 (UTC)

Issues with weight of Public Health England review

We're giving this source quite significant weight, and I honestly haven't up until now had very much time to read or assess it, which is why I have refrained from commenting surrounding it. But even at a cursory glance it becomes apparent that it should not be given the weight that it is. I did not truely realize how flimsy it was, but having had some time now to look into it, it isn't looking very good. It's a massive report, but it seems to have tried to much for its own good, and the actual evidence assessment isn't the same as other available sources (both older, but also newer ones that are more thorough).

According to WP:MEDASSESS we assess the quality of the article-type and quite evidently the PHE review amounts to a narrative review, which is lesser than meta-analyses or systematic reviews in weight of evidence. See page 17:

For the evidence review (1) above, given the short timeframe for this report, a systematic review of the literature was not possible

Neither does it amount to a clinical practice guideline (which is the other highly-valued type of source according to MEDASSESS) in that it is solely a commissioned report, aimed at providing a review the evidence.

There are a number of meta-analyses and systematic reviews out there which more thoroughly summarize the evidence, and these should be given more weight than the PHE-review. I will over the coming days/weeks take time to thoroughly go through the most recent sources, and to point out where we give the PHE-review undue weight. Carl Fredrik 💌 📧 20:18, 14 June 2016 (UTC)

You got WP:MEDORG all wrong. Major institutional reviews incorporating systematic reviews and meta-analyses are the ideal sources for clinical evidence.

Systematic reviews and meta-analyses of randomized comparative (or controlled) trials can provide strong evidence of the clinical efficacy of particular treatments in given scenarios, which may in turn be incorporated into medical guidelines or institutional position papers (ideal sources for clinical evidence).

To date, there is no other review of equal size or scope to those of PHE and RCP.Zvi Zig (talkcontribs 22:22, 14 June 2016 (UTC)
No, MEDORG actually states about such reviews:

The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature.

Essentially what this means is that the variation in such institutional reviews is large and that we should balance their weight with more thorough reports.
What you mention of size is also true, but it is actually negative in that a too broad scope is unlikely to herald actionable evidence and meta-analyses and systematic review of more specific questions trumps such a broad scope review in the weight of its evidence.
Also, this section of the report falls strictly under the scope of a narrative review and not under the scope of position statements. Carl Fredrik 💌 📧 04:49, 15 June 2016 (UTC)
PHE's report obviously falls into the category of a "formal scientific report" not "public guides and service announcements".Zvi Zig (talkcontribs 10:29, 15 June 2016 (UTC)
Excuse me? You are quoting a section in MEDORG about position statements, and not the section on reviews and reports.
As for your bolded "too broad a scope" thing, that seems to be your personal view, and would exclude things like very comprehensive scientific meta-sources, that generally are considered authoritative in other branches of science. [for instance the IPCC reports on climate change]. While your sentence would make sense in the context of individual papers, where the text has to be kept short, it doesn't match in these instances, where the authors/reviews have ample space to explore and expand on the available evidence and interpretations. --Kim D. Petersen 06:08, 15 June 2016 (UTC)
I agree. The two reports from PHE and RCP are currently the most comprehensive sources on electronic cigarettes in english, i'm only aware of one other source with as broad a scope, which unfortunately is a norwegian one (in norwegian), as the two british ones.
Another thing to note about the PHE and RCP reviews, are that they are written in large part by active researchers on the topic. --Kim D. Petersen 22:45, 14 June 2016 (UTC)
This was also one of the criticisms of the review, and it is not necessary that such reviews should be written by active researches in the field. When using appropriate systematic review methodology looking at efficacy it is often not needed — and having independent researchers perform the review leads to less risk of systemic bias. These is a general rule of the field, and one of the reasons Cochrane are considered so authoritative. Carl Fredrik 💌 📧 04:49, 15 June 2016 (UTC)
I think that you are confusing "independent researchers" with "researchers without conflicts of interests", because as far as i can tell, Cochrane reviews use experts within a field when reviewing. As far as i can tell you have given no methodological reasons for dismissing these two reports. Btw. as far as i can tell the PHE and RCP reports rate higher on an AMSTAR quality assessment than most of our current reviews.... — Preceding unsigned comment added by KimDabelsteinPetersen (talkcontribs)

─────────────────────────This discussion is a time-waster based on a basic misunderstanding of WP:MEDRS. We should go to WP:RSN, but WP:MEDRS states explicitly:

Systematic reviews and meta-analyses of randomized comparative (or controlled) trials can provide strong evidence of the clinical efficacy of particular treatments in given scenarios, which may in turn be incorporated into medical guidelines or institutional position papers (ideal sources for clinical evidence).

Indeed, PHE and RCP incorporate systematic reviews such as Cochrane and others. These are also clearly institutional position papers with sections related to conclusive policy decisions ultimately communicated in press-release. Zvi Zig (talkcontribs 08:56, 15 June 2016 (UTC)

Posted on WP:RSN.Zvi Zig (talkcontribs 11:02, 15 June 2016 (UTC)
Direct link, for the lazy. :) PermStrump(talk) 02:47, 16 June 2016 (UTC)

Advocates or names?

With this edit [4] TracyMcClark has reverted giving these organizations names rather than calling them advocates. They are not traditional advocacy groups in any sense of the word, I hotly contest that and can not see that anyone would find the: The National Association of County and City Health Officials as well as the Heart and Stroke Foundation to be what we should prefix with advocates. I have reverted. Carl Fredrik 💌 📧 14:35, 15 July 2016 (UTC)

Well the H&S foundation is a charity, and while charities do perform advocacy (its part of their remit after all to advocate on behalf of their charitable cause) you dont label them advocates, they are either callled a charity or referred to by name. Unless the sources used refer specifically to 'advocates'- just use the name of the groups. Only in death does duty end (talk) 15:06, 15 July 2016 (UTC)
  • We've gone through this shit before over and over again. So yes, CFCF, I'm worn out just like everybody else who has ever made an attempt in improving this series of articles while leaving politics out of science.--TMCk (talk) 18:31, 15 July 2016 (UTC)
NPOV would be to call these major organizations by their names. Heart and Stroke Foundation is fairly well known medical organization. Doc James (talk · contribs · email) 19:10, 15 July 2016 (UTC)
I'm wondering what makes them "major"? When i recall the threads about European organizations (for instance about ASH), and the dismissal of these... i have a hard time figuring out how "major" is defined. Can you please explain? I've never heard about these two organizations - just as i believe that you've never heard of "Kræftens bekæmpelse" (the major danish cancer organization). --Kim D. Petersen 17:34, 17 July 2016 (UTC)

Aerosol or vapor?

We all by now know that what is inhaled is an aerosol, and the sources tell us that. Despite this there are attempts to retain the vapor wording despite inaccuracies. Comments appreciated. Carl Fredrik 💌 📧 01:51, 22 July 2016 (UTC)

And we all know that what physicists call an aerosol the public call vapor. Not just in the context of e-cigarettes. Using overly technical language is misleading. It's not an inaccuracy to use to common noun rather than the technical one. We've been through this before and the page was stable until recent changes. SPACKlick (talk) 08:01, 22 July 2016 (UTC)
There has been an RfC about this. So why start it up again? If we take the prevalence of vapor vs. aerosol in the available WP:MEDRS literature, there isn't a definite conclusion to be drawn (see the RfC), and within common parlance there is no doubt as to vapor being the significantly most prevalent wording. So get over it :) See WP:TRUTH and WP:WEIGHT. --Kim D. Petersen 11:46, 22 July 2016 (UTC)

Relative harm of nicotine products

This file was recently added and I wonder if someone else could take a look at it, because I'm not sure it accurately represents the source or if the source is reliable for this kind of info. The file says the source is this article in the Guardian, which shows the data as percentages (not on a scale of 1,000 undefined markers) on a scale of 100, instead of 1,000 and without the fancy color scheme. Thoughts? PermStrump(talk) 19:21, 22 July 2016 (UTC)

Actually they're not showing a percentage but scores, a proportional view that doesn't change when moving a decimal.
I corrected my comment (additions underlined) per the unsigned comment above. IMO the different scale changes the perception of the data, especially with the added color scheme. PermStrump(talk) 19:43, 22 July 2016 (UTC)
The numbers appear to check out, this appears to just be a different way of displaying the same data. SPACKlick (talk) 19:49, 22 July 2016 (UTC)
Permstrump: Not sure what you mean. Can you elaborate on the perception? I basically agree with Spacklick that this is "just be a different way of displaying the same data" and I personally perceive both graphs as equals.--TMCk (talk) 20:16, 22 July 2016 (UTC)

It's a primary source, we can't use this for these articles. See WP:MEDPOP, a part of MEDRS. At least base it on a secondary source if you want it included. Carl Fredrik 💌 📧 22:58, 23 July 2016 (UTC)

P.S. not saying that such a graph shouldn't be included, but we can impossibly use on that has as its source the Guardian. The fact that it is in an image doesn't matter at all. Carl Fredrik 💌 📧 23:00, 23 July 2016 (UTC)

The graph in question also fails to explain that what is covered is societal effects, not risk of individual use. The colors are entirely original research and while cigars may be less of a burden on society that doesn't mean they are a 4th as dangerous as cigarettes. This image is very unclear. Carl Fredrik 💌 📧 23:07, 23 July 2016 (UTC)

Fwiw, I'm pretty sure this gives the scores that the Nutt group came up with a few years ago, which were accepted as the best available by the PHE report, including the "95% safer" assessment. I don't think it's true to say that "what is covered is societal effects, not risk of individual use" either. Whether the image is from PHE or Nutt I don't know, but one could find out. The Guardian gives "LSE" as the source. I agree the colours are probably OR. Johnbod (talk) 02:55, 24 July 2016 (UTC)
PHE presents this graph here. Zvi Zig (talkcontribs 10:21, 24 July 2016 (UTC)
Right - no colours or numbers on the axes, referenced to "McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD010216. DOI:10.1002/14651858.CD010216.pub2", which maybe explains the "LSE". But I think they are Nutt et al's scores originally. Johnbod (talk) 11:26, 24 July 2016 (UTC)
Here's the graph + there is also a more detailed one: In html and PDF format.--TMCk (talk) 15:07, 24 July 2016 (UTC)
See similarities in pages like Cannabis (drug). Zvi Zig (talkcontribs 15:41, 24 July 2016 (UTC)
Thanks, so they are the Nutt figures. I note that the original's cigarette score combines elements for risk to the user and risk to others, a more important way to use colour than an OR traffic light code, one might think. Johnbod (talk) 16:47, 24 July 2016 (UTC)
Of course, if it's perceived by some as green being a "safe zone" instead of lower range all could be displayed from light to dark red. But I would argue for the more detailed combined element graph Johnbod is pointing out. Way more informative.--TMCk (talk) 17:00, 24 July 2016 (UTC)

Recent revert re: aerosol -> vapor

I attempted to improve the article, using the term "aerosol" in the first instance in addition to the use of "vapor" for two reasons: 1) it is the technically correct term, and 2) it is the terms the sources cited use. I was reverted with the rationale "Language has been through RFC please discuss on talk". The only RfC that I know of that discussed this was this RfC which did not specify that either "aerosol" or "vapor" be used, but rather be determined in the context of the sentence. In this case, we are using a piped link to "Electronic cigarette aerosol" and both sources uses the term "aerosol" (with the first source saying it is also "commonly known as vapor") which is why I added the phrase. It is not clear to me why we would use the word "vapor" only and not add mention of aerosol when the sources cited preferentially uses the word "aerosol" to describe it and the Wikipedia page we are linking also calls it an aerosol. Note that I did not change every instance of the word "vapor", just added context that the technically correct term is aerosol. Yobol (talk) 20:01, 30 July 2016 (UTC)

I changed it back. I'm sure SPACKlick agrees but didn't see it's the first instance.--TMCk (talk) 20:41, 30 July 2016 (UTC)
Apologies, misread the location of this change. I thought this was further down the page where we should be using the common name but you're absolutely right for the first introduction of the term. SPACKlick (talk) 21:08, 30 July 2016 (UTC)

Newest review on Pubmed: "appear to be efficacious and are safer than smoking"

Beard et al (July 2016) "New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?" CNS Drugs PMID 27421270

Can anyone with access to the full text of that please say what the reported quantitative efficacy is? EllenCT (talk) 00:23, 1 August 2016 (UTC)

The article has this "key point" wrt e-cigs:

Although many of these products are in the early stages of clinical trials, of all of the medications considered, cytisine appears to offers the best prospect for the future, having established safety and efficacy and being very inexpensive. Electronic cigarettes have become very popular in some countries, but their efficacy and long-term safety in comparison with other treatment profiles require further consideration.

In the discussion of e-cigs the point is made:

Only two randomized controlled trials have assessed e-cigarette use for smoking cessation, with a combined sample size of 662 participants

Alexbrn (talk) 07:48, 1 August 2016 (UTC)
Did they report the efficacy? EllenCT (talk) 19:01, 1 August 2016 (UTC)
The conclusion is "efficacy" needs further consideration (because of lack of evidence). Alexbrn (talk) 19:10, 1 August 2016 (UTC)
My question is: does the review put the efficacy, as measured, in quantitative terms, along with the other therapies studied? I seriously question how there can only be two randomized trials when in 2014 there were "2 randomized controlled trials and 1 large cross-sectional study". What happened to the large cross-sectional study?
Furthermore, given that the title of the review ends with "What Is in the Pipeline" do they say whether there are sufficient trials to settle the question in progress? EllenCT (talk) 01:32, 2 August 2016 (UTC)
It just cites Cochrane for the RCTs and their reported efficacy, and mentions some surveys seem to confirm this, but concludes (this time I quote the Conclusion) just that "Electronic cigarettes have become very popular in some countries, but their efficacy and long-term safety require further consideration." So that it all we can reflect, as we can't pick anything out of the middle of the article to present a conclusion that runs against the grain of the article's own. Alexbrn (talk) 06:18, 2 August 2016 (UTC)
I am trying to ask for specific numbers. What percentage of e-cig users quit smoking? What's the same measurement for cytisine? For the other nicotine replacement therapies? EllenCT (talk) 19:21, 2 August 2016 (UTC)
You might get a faster answer by requesting the source at Wikipedia:WikiProject Resource Exchange/Resource Request ;) --TMCk (talk) 20:23, 2 August 2016 (UTC)
You'd be amazed how many obvious trials have not been done, still. Especially head to head. Does this help? The Lancet Respiratory Medicine August 2016 seems to be a special on e-cigs, which will keep this page busy. Johnbod (talk) 03:27, 3 August 2016 (UTC)

Ethics review by Franck et al (2016)

Another recent review conspicuously missing from the article is Franck et al (May 2016) "Ethical considerations of e-cigarette use for tobacco harm reduction" Respiratory Research PMID 27184265, which has a fascinating risk analysis based on the fact that the best available therapies' efficacy for smoking cessation, the top cause of avoidable death in many populations, are all pretty low.

Any objections to including the boldfaced portions? EllenCT (talk) 01:42, 2 August 2016 (UTC)

Also, does anyone know what "tensions between utilitarian and liberal ethics" is supposed to mean? EllenCT (talk) 05:17, 2 August 2016 (UTC)

They seem to contrast utilitarianism with consequentialism, where the latter has no moral bindings and allows even dishonest approaches while the former is strictly evidence based science.--TMCk (talk) 14:01, 2 August 2016 (UTC)
Correction: Make that deontological ethics.--TMCk (talk) 14:10, 2 August 2016 (UTC)
They set this out in some detail in the paper, with a graph! Johnbod (talk) 14:25, 2 August 2016 (UTC)
Since different sources have different takes on the possible safety of ecigs, our article must relfect the spectrum of views. Alexbrn (talk) 06:37, 2 August 2016 (UTC)
So what are the ethical conclusions from this review?--TMCk (talk) 14:15, 2 August 2016 (UTC)
Well, it's a bit nothing-y but the upshot seems to be: because big ethical issues are in play, we urgently need to know more so we make an ethical decision. Alexbrn (talk) 14:38, 2 August 2016 (UTC)
Skimming the text for "ethic" shows a lot more interesting points than this.--TMCk (talk) 14:58, 2 August 2016 (UTC)
This makes the same arguments as the PHE Report and other expressions of the same harm reduction case, but trying to tease out more and even quantify the risk balance. It is interesting it is from Canada, where e-cigs are still, sort of, illegal. Some mention in the article would be good. Johnbod (talk) 14:25, 2 August 2016 (UTC)

I don't agree it comes with anything novel — I'm more concerned that we aren't including "Employing the Precautionary Principle to Evaluate the Use of E-Cigarettes." PMID 26870723

The tobacco crisis justifies the current application of the PP to e-cigarette use. E-cigarettes are devices that deliver nicotine to the body with vaporized delivery mechanisms that were introduced to the US market in 2004. Currently, although e-cigarettes are regulated by the Food and Drug Administration (FDA), research on risks and benefits of their use is scant. The FDA found that some e-cigarettes contain known carcinogens (e.g., anabasine, nitrosamines, diethylene glycol, etc.) (2). However, the FDA stated that conclusions cannot be drawn due to product variability (2). Research has revealed 466 different e-cigarette brands in the US (39). In fact, US researchers examined one e-cigarette brand and found nanoparticles, silicate beads, and metals (lead, nickel, and chromium) in the aerosol vapor and cartomizer fluid (40). These metals have a well-documented history of causing lung (e.g., impaired function, cancer, respiratory irritation, and pulmonary fibrosis), nervous system, and kidney damage when inhaled and/or digested (40).

Carl Fredrik 💌 📧 13:26, 3 August 2016 (UTC)

Note the article you cite ignores that these materials were quantified at levels posing minimal risk, as shown in PMID 25988311 PMID 24406205 PMID 25078252. It ignores the simplest principle of toxicology: The dose makes the poison. Zvi Zig (talkcontribs 13:56, 3 August 2016 (UTC)
Two points to disqualify your argument:
  1. Any dose is higher than none — what is considered safe exposure levels is not universal, so far there are no specific levels for this type of exposure.
  2. Your interpretation of primary sources is not a valid argument on Wikipedia — see WP:OR, WP:SYNTH — there is quite a lengthy portion on WP:MEDRS about why not to do this.
Can you find any secondary source that directly refutes the Bush source — or claims that such an analysis is invalid? If not you have no argument. Carl Fredrik 💌 📧 10:39, 5 August 2016 (UTC)
  1. Indeed, the page clearly notes this.
  2. I cited 3 secondary sources - you can ignore what I wrote afterwards. Zvi Zig (talkcontribs 11:29, 5 August 2016 (UTC)
But the point is that you are trying to disqualify this source based on the fact that you do not like its conclusions, terrific WP:MEDBIAS. Carl Fredrik 💌 📧 11:42, 5 August 2016 (UTC)
The ethics article from a problematic journal ignores the conclusions of three scientific reviews. Zvi Zig (talkcontribs 11:58, 5 August 2016 (UTC)
we probably should mention the precautionary principle - this paper, from the other side of the argument, confirms that is behind most current regulation. We use it as a ref once, but on a different point. It was published slightly before the first one, but I think anticipates all its arguments, which are hardly new. It's always been recognised that the precautionary principle itself carries risks, and that is the case here. Johnbod (talk) 13:20, 5 August 2016 (UTC)

The name "Electronic cigarette" vs "Vaping"

I understand that a large portion of people vaping use it as a cessation tool for cigarettes, but I feel as though it's unrelated enough that it seems silly to have the article itself be named exclusively "Electronic cigarette".

Its like calling a car an "Electronic horse" At what point do we vote or deliberate on a name change for the article? — Preceding unsigned comment added by Tiptup300 (talkcontribs) 13:53, 18 August 2016 (UTC)

Once another name becomes more common. Carl Fredrik 💌 📧 14:23, 18 August 2016 (UTC)
I agree with CFCF, inside the vaping community Personal Vaporiser is more common (at least within some groups) and the verb vaping is the most common. But as a general rule the common name is still e-cigarettes, closely followed by electronic cigarettes. SPACKlick (talk) 14:45, 18 August 2016 (UTC)
Agreed, in UK. I find most people except users still don't recognize the "vape" terms. Johnbod (talk) 15:07, 18 August 2016 (UTC)

New Cochrane Review On E-Cigarettes

"A new Cochrane Review paper provided an independent, rigorous assessment of the best available evidence to date about electronic cigarettes for quitting smoking and found that electronic cigarettes may help smokers stop their smoking, and there are no serious side effects associated with their use for up to two years." New Cochrane Review On E-Cigarettes--77.20.206.37 (talk) 08:05, 13 September 2016 (UTC)

Associated is an interesting interview with the lead author in the Guardian. Including such quotes as overall the evidence suggests that (1) e-cigarettes with nicotine can help people quit smoking, (2) they don’t seem to have any serious side effects in the short- to mid- term (up to 2 years), and (3) in some cases, switching to them leads to changes in your blood and breath that are consistent with the changes you’d see in people who give up smoking altogether., By ‘safe,’ do you mean completely without risk? No, they’re not – not much is. We’ve seen stories about people catching fire and puppies with nicotine poisoning. Plus, in general, it’s not a great idea to inhale chemicals into your lungs if you can avoid it. Experts basically agree on that – I’ve yet to come across a tobacco researcher or policy maker who would recommend you start using e-cigarettes if you aren’t already a smoker. SPACKlick (talk) 04:33, 15 September 2016 (UTC)
77.20.206.37, I added the new Cochrane Review. QuackGuru (talk) 17:37, 15 September 2016 (UTC)
The Guardian cannot be used for WP:MEDRS claims. QuackGuru (talk) 17:37, 15 September 2016 (UTC)
Nobody suggested it could be, however the authors thoughts are useful to keep near the review in case any disputes over interpretation come up later. SPACKlick (talk) 18:21, 15 September 2016 (UTC)
The authors thoughts in The Guardian cannot be used in case any disputes arise later. QuackGuru (talk) 18:23, 15 September 2016 (UTC)

BMJ finds e-cigs helped 18,000 quit in UK

http://www.bmj.com/content/354/bmj.i4645 Key Findings The increase in e-cigarette use in England has been positively associated with the success rates of quit attempts after adjustment for a range of confounding variables. No clear association has emerged between e-cigarette use and prevalence of quit attempts or use of licensed NRT bought over the counter, prescription treatment, or behavioural support. However, use of e-cigarettes in quit attempts has been negatively associated with use of NRT on prescription. also of note The findings of the present study conflict with the hypothesis that an increase in population use of e-cigarettes undermines quitting in general SPACKlick (talk) 04:28, 15 September 2016 (UTC)

It is a study (PMID 27624188) and not MEDRS compliant. Probably in about 6 to 9 months it will be picked up by a review. QuackGuru (talk) 17:37, 15 September 2016 (UTC)
Claims about sociological data such as correlation trends aren't medical claims. SPACKlick (talk) 18:23, 15 September 2016 (UTC)
The source is also making medical claims that cannot be used. It is a primary source. A study is not a WP:SECONDARY source. QuackGuru (talk) 18:25, 15 September 2016 (UTC)

Usage studies - geographical scope

The "Frequency" section cites several meta-analyses of e-cigarette usage in a general way, implying that their results are globally valid. However, it's not clear that they are actually global in scope. The Cochrane meta-study by McRobbie et al., for example, was restricted to studies in Italy and New Zealand. I don't think it's reasonable to conclude something about the whole world based on just two countries, considering the great variance in levels of regulation. The others are even less clear - I can only see the abstracts, which say nothing about geographical scope. Someone with access to these studies should clarify this. Hairy Dude (talk) 22:47, 15 September 2016 (UTC)

Deciding who is "right"

Our work as Wikipedians is to reflect the best avaliable evidence. When high quality sources contradict each other we simply attribute, we do not decide who is "right". Therefore I reverted this change.[5] Different organization are allowed to come to different conclusions. Doc James (talk · contribs · email) 14:23, 6 November 2016 (UTC)

In fact they are quite a bit more reliable. There is some valid criticism of PHE's report that we ought include in the article as well. Carl Fredrik 💌 📧 14:45, 6 November 2016 (UTC)
I think we can include more signage and more factoids. The tags added to the wording in the images are inappropriate. There is no dispute over the undisputed factoids. The Public Health England latest report was written in part by writers who have a COI according to Lancet. QuackGuru (talk) 16:16, 6 November 2016 (UTC)
They are one of the National Institutes of Health, the largest single health research organization in the world. The NIDA itself has a budget of one billion USD. It grow out of an organization started in 1935.
Public Health England was founded in 2013. It has a budget of about 378M USD.[6] so is a smaller and newer organization.
Both positions are from major health organizations and belong in this article. Doc James (talk · contribs · email) 16:45, 6 November 2016 (UTC)
@Doc James: Excuse me? The Operating budget of PHE is £3.941 billion (or 4.9 billion USD) [see page 81 "Financial performance" in the report you yourself link to]. And considering that this is an organization in a country significantly smaller than the US... hmmm.
As for the creation year, that is a misnomer, since the PHE was split out of the NHS - ie. they have existed for a lot longer, just not as a seperate organization. --Kim D. Petersen 03:22, 7 November 2016 (UTC)
Ah. No, I think you're mistaken. Public Health England is an arm of the National Health Service, which is the largest and oldest healthcare body in the world, and which originated and first funded the Cochrane Collaboration. Public Health England is a new name for a very old and well-established organisation with no commercial axe to grind.—S Marshall T/C 17:09, 6 November 2016 (UTC)
No, they're in fact entirely independent from the NHS—and have received disproportionate criticism for their young age. Carl Fredrik 💌 📧 17:31, 6 November 2016 (UTC)
According to BMJ, "In the two and a half years since then, PHE has been embroiled in a series of controversies about the quality and credibility of advice it has issued on topics including fracking, NHS health checks, and the NHS Diabetes Prevention Programme, raising concerns about both its competence and its supposed independence (box)."[7]
We do not add in-text Simon says attribution where there is no serious dispute. The tags do not help resolve this non-issue IMO. QuackGuru (talk) 17:47, 6 November 2016 (UTC)
Any such major organization can be said to have "been embroiled in a series of controversies about the quality and credibility of advice it has issued" by a partisan writer. Certainly the big US ones. Actually compared to the (different) UK Senior Government Medical Advisor they have got off pretty lightly, imo. Johnbod (talk) 02:11, 7 November 2016 (UTC)
  • "No serious dispute?" Public Health England found no evidence that e-cigs increase tobacco smoking in teens; and whatever the US body finds that they do; and you call that "no serious dispute"? You do adopt very strange positions sometimes, Quack. Still, I think it's probably my turn to make a concession on this article, so let's leave this particular pair of contradiction tags off.—S Marshall T/C 18:21, 6 November 2016 (UTC)
Calling the CDC's position undue weight is silly. First you were wondering if the largest health care organization in the world was reliable and now your are trying to tag the position of the second largest health care organization in the world as undue weight. Seriously drop the stick. The World Health Organization I think is the third largest. Doc James (talk · contribs · email) 18:46, 6 November 2016 (UTC)
Erm..... Any view can be presented as WP:UNDUE when there are contradictory views about it. Thus your remark that "Calling the CDC's position undue weight is silly" is either a misunderstanding about WP:WEIGHT or an unstated specific objection that you have regarding the merits of the CDC position. Could we focus on that part? Instead of trying to minimize the importance of the PHE and overstating the importance of US agencies? --Kim D. Petersen 03:50, 7 November 2016 (UTC)
They are talking about different countries, for one thing, and by and large different research and "reports". It is not inconceivable that there are different patterns in US and UK - public perceptions seem pretty different. Johnbod (talk) 02:11, 7 November 2016 (UTC)
I agree completely Johnbod. There are significant methodological differences as to how the US and the brits have reached their conclusions on youth and vaping. The British derives their statistical information from "The Smoking Toolkit", where the US one is derived from (mostly) disparate surveys done from schools. --Kim D. Petersen 03:54, 7 November 2016 (UTC)

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Recent edits by S Marshall

3 recent edits by S Marshall have set into dispute whether we engage in undue weight and criticism, as well as potential copyright violation (no similar text provided). [8]

Traditionally Wikipedia does not attribute every statement, and this article in fact inaccurately attributes far to many statements to various reviews. This is counterproductive and decreases readibility. Please comment here to engage in discussion about these edits.
Carl Fredrik 💌 📧 13:05, 29 October 2016 (UTC)

Issues:

  1. [9] Does attributing this statement to NACCHO serve any purpose? The message is fairly vague and only states that there are concerns. The issue is neither that attribution strengthens or weakens the statement, but that it retracts from readibility.
  2. [10] These images have been present in the article for a longer period, and are both very small in size. They have two very different messages associated with them, one about the actual e-cig, one about the liquid used in ecigs. It is unclear why this would be overtly negative, and if so it would require discussion here.
  3. [11] Is there any indication that this was copied? If not, which sentences have been closely paraphrased? In fact the article is CC-BY, making this entire issue moot, especially as there is attribution.
  • That revert was a technical breach of your Arbcom restrictions in this topic area, CFCF, so I would advise you to restore the contested content for the time being. Substantive response follows.—S Marshall T/C 13:27, 29 October 2016 (UTC)
  • Substantive response:-

    1 and 2) These concerns do exist, but the emphasis given to them in this article before my edit is out of all proportion to their prevalence in reliable sources. It constitutes WP:UNDUE weight contrary to NPOV. When I first noticed them, the concerns were sourced to a professional lobbyist writing in a Welsh regional newspaper. Since I made a fuss about it, they're sourced to some US non-regulatory body which at least is a medical source, but they're presented in Wikipedia's voice, in an article where even the Cochrane Collaboration's views are given in-text attribution!

    I see no real distinction between those two messages. They both amount to this:- "Look at the colourful packaging! E-cigarettes are being marketed to children!" And there's not enough prominence in the sources for that concern to have two illustrations. The medical sources pay this very little attention. Giving it this much prominence amounts to using a Wikipedia article to convey a talking point. I don't object to one illustration and the claim being made with in-text attribution, but I do object to saying it in Wikipedia's voice with two.

    3) I'll quote.

Our content Source abstract, copy/pasted
The emergence of e-cigs has given cannabis smokers a new method of inhaling cannabinoids. E-cigs differ from traditional marijuana cigarettes in several respects. It is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette. Recreational cannabis users can discreetly "vape" deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection, known as "stealth vaping". While cannabis is not readily soluble in the liquid used for e-cigs, recipes containing synthetic cannabinoids which are soluble may be found on the Internet. Electronic cigarettes may be used with other substances and cartridges can potentially be filled with e-liquid containing substances other than nicotine, thus serving as a new and potentially dangerous way to deliver other psychoactive drugs, for example THC. Cannabinoid-enriched e-liquids require lengthy, complex processing, some being readily present on the Internet despite lack of quality control, expiry date, conditions of preservation, or any toxicological and clinical assessment. The health consequences specific to vaping these cannabis preparations remain largely unknown. The emergence of electronic cigarettes (e-cigs) has given cannabis smokers a new method of inhaling cannabinoids. E-cigs differ from traditional marijuana cigarettes in several respects. First, it is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette. Recreational cannabis users can discretely “vape” deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection. There are nevertheless several drawbacks worth mentioning: although manufacturing commercial (or homemade) cannabinoid-enriched electronic liquids (e-liquids) requires lengthy, complex processing, some are readily on the Internet despite their lack of quality control, expiry date, and conditions of preservation and, above all, any toxicological and clinical assessment. Besides these safety problems, the regulatory situation surrounding e-liquids is often unclear. More simply ground cannabis flowering heads or concentrated, oily THC extracts (such as butane honey oil or BHO) can be vaped in specially designed, pen-sized marijuana vaporizers. Analysis of a commercial e-liquid rich in cannabidiol showed that it contained a smaller dose of active ingredient than advertised; testing our laboratory-made, purified BHO, however, confirmed that it could be vaped in an e-cig to deliver a psychoactive dose of THC. The health consequences specific to vaping these cannabis preparations remain largely unknown and speculative due to the absence of comprehensive, robust scientific studies. The most significant health concerns involve the vaping of cannabinoids by children and teenagers. E-cigs could provide an alternative gateway to cannabis use for young people. Furthermore, vaping cannabinoids could lead to environmental and passive contamination.

I think that's all I need to say.—S Marshall T/C 13:52, 29 October 2016 (UTC)

Agree with S Marshall on all three points. POV in limited sources should be attributed or removed and shouldn't have two images. The cannabis portion does seem overly copied from the source. SPACKlick (talk) 16:13, 29 October 2016 (UTC)
SPACKlick, yes that is very similar. But it's CC-BY.
Awaiting more comments for the other issues.
Carl Fredrik 💌 📧 16:40, 29 October 2016 (UTC)
And I agree with you, we attribute far too much as it is, but we don't solve that by adding more attribution where it isn't necessary. The Cochrane collaboration is attributed because it is an exceptionally good source. Carl Fredrik 💌 📧 16:42, 29 October 2016 (UTC)
  • The fact that it's CC-BY means we're entitled to use the text. The many small superscript references give the misleading impression that this text is a condensed version of the source, when in fact it's just copypasta from the source's abstract. We've lifted such a large amount of text that it should be in a quote box with one source link, and I think it would be right to indicate that this text is available under a less restrictive licence than Wikipedia's standard one.

    If you're going to go through this article reducing the amount of in-text attribution then I would, generally, welcome that approach and re-evaluate my position on the in-text attribution in the disputed text. If you're not going to do that, then the views of this US non-regulatory body will need in-text attribution like everything else.

    This is part of a larger slant in the article. What's happened is that historically editors who wanted to promote e-cigarettes were active here, and they were driven off but in the process of doing so, the article's become tilted to the anti-e-cig view. Hence a criticism of the e-cigarette industry (which can only benefit big tobacco), which originates in one minor source, gets what amounts to a whole sidebar with two illustrations. It's also why this source is cited 21 times and other research led by Rachel Grana gets another four citations. Compare that with Cochrane which only gets 11: Rachel Grana draws conclusions negative to electronic cigarettes, so of the medically reliable sources she receives the most weight. It's not deliberate bad faith but it's very poor editorial judgment. Wikipedia is peddling a false balance between less credible anti-e-cig sources and more credible pro-e-cig ones. Please do read the 2016 update to the Cochrane review closely. We can start de-emphasizing the non-regulatory bodies and lean less heavily on Rachel Grana's opinion now, and I'm of the view that future edits should not just add Cochrane's conclusions to the article, but also remove older, less reliable results that contradict them.—S Marshall T/C 11:13, 30 October 2016 (UTC)

If the text is CC BY we can use it verbatim. We just need to reference it but than we do that routinely. Doc James (talk · contribs · email) 11:26, 30 October 2016 (UTC)
Yes, it's definitely CC-BY (a point which I missed when I originally tagged it as a close paraphrase). Yes, we can use it verbatim; but I was talking about what we should do. When we lift such a lot of text, it's more transparent and less misleading to put it in a quote box. From your silence on the other points, I presume you take no position on them.—S Marshall T/C 12:27, 30 October 2016 (UTC)
I just looked at the CC BY issue. Would need to look at the other points to come up with a position. Paraphrasing would be perfectly appropriate aswell. Doc James (talk · contribs · email) 12:50, 30 October 2016 (UTC)
It can be difficult to give attribution even for CC-By text. A guide is at Wikipedia:Adding open license text to Wikipedia. Blue Rasberry (talk) 14:05, 4 November 2016 (UTC)
User:Bluerasberry, the cut and paste in both paragraphs above are not attributed. Is that a violation of WP:COPVIO? QuackGuru (talk) 18:47, 4 November 2016 (UTC)
QuackGuru Wikipedia is at the state of the art of remixing text in ways that have never happened before, and this kind of use is unprecedented. No one really knows what to do with free text, and Creative Commons does not publish clear guidance on this.
I feel that cut and pasted content is a violation of WP:COPYVIO and that reviewers in academic publishing would agree with that. It is unorthodox. Wikipedia has no good system for giving attribution, which would require an additional note beyond citation. I think it would be best to re-write even CC-By text, especially in a high-traffic, highly copied article like this one. In articles with no traffic, like specialized topics with no edits and copied CC text which establishes the article, then copied text is more manageable. Blue Rasberry (talk) 20:56, 4 November 2016 (UTC)
User:Bluerasberry, what would be the benefit of rewriting the cute and paste text on the talk page? Both paragraphs above have no attribution. I am referring to the text in both paragraphs above on the talk page. QuackGuru (talk) 15:04, 5 November 2016 (UTC)
QuackGuru There is no benefit to rewriting the text on the talk page. I misunderstood and thought that one of these paragraphs was going into the article. I do not know how to feel about copied text on talk pages without in-line attribution. It might be copyvio or might not... I am not sure. I think that the attribution for these texts is described but not in a standard attribution format. Blue Rasberry (talk) 21:07, 7 November 2016 (UTC)
COPVIO applies to all pages. I think it is better for the text to be a quotation even on the talk page or userpage. See Wikipedia:Copying_text_from_other_sources#Can_I_copy_text_into_a_user_page_or_talk_page_in_order_to_work_on_it.3F.
If policy is unclear then the policy should be made clear. QuackGuru (talk) 04:53, 8 November 2016 (UTC)
Which two editors supported the change? Each image makes a different claim and are relevant to the section. The first image is about the device and the next image is about the e-liquid. They are different. QuackGuru (talk) 02:14, 1 November 2016 (UTC)
We do not need to attribute every sentence. Doc James (talk · contribs · email) 03:52, 1 November 2016 (UTC)
There seems to be no consensus for removing the image, I will restore it momentarily. Carl Fredrik 💌 📧 20:29, 3 November 2016 (UTC)
I think there should be an image what a typical e-cig bottle looks like. More than one editor disagrees with removing it. Readers should not be expected to go to a subpage to find out what an e-liquid bottle looks like. QuackGuru (talk) 20:34, 3 November 2016 (UTC)
  • Then you're welcome to exchange the image for the other one. You may not have two images to illustrate this minor point because it's WP:UNDUE emphasis, out of all proportion to the weight the sources give to this very minor concern.—S Marshall T/C 20:56, 3 November 2016 (UTC)
    • The lede and body discuss in detail regarding e-liquid. Both images and text makes different points. There is concern the flavors appeal to younger people. That is not a minor point. QuackGuru (talk) 21:20, 3 November 2016 (UTC)
      • Of course it's a minor point; don't be silly. The most reliable sources in this topic area pay it no attention at all.—S Marshall T/C 21:23, 3 November 2016 (UTC)
The images are small, and I disagree entirely with your assertion that this is undue or a minor point. You have now reverted two independent editors and are frankly being disruptive. Please restore the previous content and desist making more unelicited edits. Frankly you've performed far too many edits these past few days, and for an article this controversial no one should making controversial edits without discussion. Carl Fredrik 💌 📧 21:25, 3 November 2016 (UTC)
See "Youth are targeted with the addition of attractive candy or fruit flavours."[12]
See "We are aware of one unconfirmed newspaper report of a fatal poisoning of a two-year old child [70] and of three published case studies of small children who drank e-liquid. A two-year old was admitted to hospital with vomiting, ataxia, and lethargy, and was discharged after 24 hours of observation [71]. In the second report, an 18-month old girl drank 24mg nicotine in e-liquid, vomited and was irritable, and recovered fully within an hour or so [72]. The third article presented a case of a 30-month old child suspected to have ingested e-liquid. The quantity of e-liquid was uncertain and the child was asymptomatic with all clinical observations reported to be normal [73]."[13] Death after drinking e-liquid is not a minor point. QuackGuru (talk) 21:33, 3 November 2016 (UTC)
  • I absolutely agree that toddlers drinking e-liquids and dying, or suffering any harm at all as a result, is a terrible tragedy. But these illustrations are being used to support your claim that e-cigarettes are marketed to children. Is it your position that the toddlers bought the e-liquids?—S Marshall T/C 21:36, 3 November 2016 (UTC)
    • Toddlers have drank the e-liquid. Youth have bought the e-liquids.
    • See "One of the main concerns is the use of E-cigarettes among children and adolescents. As mentioned earlier, the E-cigarette liquid may contain various flavorings that could be especially attractive to children or adolescents. According to the FDA, marketing of E-cigarettes has been directed at young adults and children.6"[14] This is a major concern. QuackGuru (talk) 21:42, 3 November 2016 (UTC)
  • If it was a major concern Cochrane would have mentioned it. I'll check to see if the recent Cochrane revision has anything to say on the subject.—S Marshall T/C 21:46, 3 November 2016 (UTC)
Systemic reviews target specific questions, not general reviews of a topic. This is incidentally one of the reasons the Grana report is cited so often here, because it makes up one of few high quality articles that looks into more general aspects of electronic cigarettes. Carl Fredrik 💌 📧 21:48, 3 November 2016 (UTC)
The 2016 Cochrane review is about smoking cessation. What does the Cochrane review have to do with e-liquid appealing to youth? QuackGuru (talk) 21:53, 3 November 2016 (UTC)
  • The 2016 Cochrane review that I've just read contains an extensive analysis of the risks of using e-cigarettes, and it doesn't appear to mention any disproportionate risk to children.

    The fact is that the article while it was under your stewardship has developed an entire sidebar featuring two illustrations, under "motivation", which is about this allegation that e-cigarettes are being deliberately marketed to children, and there's a further illustration under "Marketing" which shows how, you claim, e-cigarettes are being marketed to the people you persist in describing as "youth". Then under "Positions of medical organisations", on the left hand side, there's an image which talks (in text in the image) about the rise in the number of high and middle school children who're using them. So while the article was under your tender care we've got four illustrations demonising the e-cigarette industry (and this, I would point out, benefits nobody but big tobacco). I do agree that the concern exists. I do agree that it might proportionately have an illustration. All I'm questioning is whether the huge emphasis you and CFCF are trying to lay on this point is appropriate, and with all due respect I think you're displaying poor editorial judgment. You need to consider the illustrations in proportion.—S Marshall T/C 22:08, 3 November 2016 (UTC)

I have no idea what you mean by stewardship, and I disagree entirely that it is anything but proportional. The images are a very small part of the article, and both illustrate important points of how electronic cigarettes and e-liquids look as well as important high-lighted details. By disregarding other users you are being disruptive. Carl Fredrik 💌 📧 22:51, 3 November 2016 (UTC)

The images have been in the article for some time. I am not see any consensus for their removal and thus am restoring. Doc James (talk · contribs · email) 12:10, 4 November 2016 (UTC)

  • So I removed a different one of the four images that are currently overemphasizing the concern. You do need to address the substantive point I've made here.—S Marshall T/C 17:37, 4 November 2016 (UTC)
    • The other image you deleted is specifically about marketing which makes a different point. The said the "four illustrations demonising the e-cigarette industry (and this, I would point out, benefits nobody but big tobacco)." An image of e-liquid bottles did not demonising any e-cigarette company. Including the images does not benefit Big Tobacco. Big Tobacco now owns all the largely successful e-cigarette companies. It is an undisputed fact that adolescents are exposed to e-cig marketing. There is also evidence the e-cig marketing could increase e-cig use. See "Exposure to e-cigarette advertisements may be contributing to increases in e-cigarette use among youth."[15] QuackGuru (talk) 18:47, 4 November 2016 (UTC)
      • Which big tobacco companies own Joyetech, Kangertech, Aspire, Totally Wicked, Innokin or Smok? They are all successful.--Fahrenheit666 (talk) 18:40, 16 November 2016 (UTC)
      • Yes, this is a complete myth, Quack, which I'm surprized to see you trot out, even given your prejudices. Big baccy owns a lot of the cigalike brands in the US (which have little or no international reach), but almost none of the sector which regular vapers actually patronize, for e-liquid and refillable devices, which also very largely escapes conventional so-called "industry" statistics based on regular supermarkets etc. as it is sold online or at tiny independent stores. We have discussed this before. Johnbod (talk) 18:54, 16 November 2016 (UTC)

WP:COPYVIO violation?

─────────────────────────See WP:COPYPASTE: "While your user page and talk page may include brief quotations from copyrighted text, Wikipedia cannot host extensive copying of non-compatible copyrighted material anywhere, not even in talk or user pages, not even temporarily." The paragraph above titled "Our content" and paragraph above titled "Source abstract, copy/pasted" both contain text that is not attributed to the source. That means there is a WP:COPYVIO on the talk page. QuackGuru (talk) 03:54, 10 December 2016 (UTC)

@QuackGuru: If you had bothered to read the above discussion, you would have noticed that the text is CC-BY, and thus that there isn't a copyright violation. --Kim D. Petersen 18:47, 10 December 2016 (UTC)
The text on the talk page is not attributed according to CC-BY. Thus it is a WP:COPYVIO violation. QuackGuru (talk) 20:54, 10 December 2016 (UTC)

Convenience break

  • Strictly speaking, you're right. Strictly speaking, the images don't demonise the e-cigarette industry; strictly speaking, it's your captions that do the demonising. So I need to amend my position. I'm happy for you to retain the images if you change the captions. As long as only one or two of the images in the article are attached to text alleging that e-cigarettes are marketed to people under the age of 16, then I would think we've got the balance about right.—S Marshall T/C 18:54, 4 November 2016 (UTC)
I'm fully willing to use a footer in the {{multiimage}} instead of two separate captions. However this is primarily a stylistic change and I oppose removing any of the information or images. Carl Fredrik 💌 📧 20:15, 4 November 2016 (UTC)
  • No intention to remove any information whatsoever. Throughout this discussion I've been entirely clear that the information that some people are worried about e-cigarettes being marketed to children should still be in the article, and it should still be supported by images. All I'm saying is that this article has 17 media files (16 currently because I have removed one). Of these 17 images 4 are of e-cigarettes of various kinds; 2 are of e-liquids; 2 are of people smoking; 1 is a diagram of an exploded e-cigarette; 1 is an anatomical diagram; 1 is a vape shop; 1 is a no vaping sign; 2 are videos; and of these, 4 images and one video are all captioned or linked to text about marketing or risk to under-18s. That's 30% of the media files in this article.

    Imagine if this number of media files was about another claim. Say if someone introduced four pictures and a media file all showing how e-cigarettes are cheaper than tobacco ones in various jurisdictions, for example. You would be alarmed about undue emphasis on that point introducing bias into the article, wouldn't you? If not, you should be. Images and videos draw the eye and lay stress on whichever point they illustrate.—S Marshall T/C 21:26, 4 November 2016 (UTC)

Well it happens to be a major concern of the NIH's, and we're simply presenting it as is and as the reliable sources present it. Carl Fredrik 💌 📧 16:47, 5 November 2016 (UTC)
It is not the first time that it has been pointed out that the images are used to present material in an WP:UNDUE fashion... see for instace Youth vaping images and the discussion around that time. --Kim D. Petersen 17:56, 5 November 2016 (UTC)
I think joining the two captions together would make sense. Doc James (talk · contribs · email) 05:01, 6 November 2016 (UTC)
This discussion has expanded to include all the pull quotes alleging that e-cigarette marketing targets children, so to reduce confusion I have tagged them all.—S Marshall T/C 14:34, 6 November 2016 (UTC)
We're currently discussing this and you are so far the only one that considers it undue, please don't plaster the article with undue tags. Carl Fredrik 💌 📧 14:43, 6 November 2016 (UTC)
You seem to have missed Kim Petersen's post above. Tagging isn't vandalism, and it's normal to allow tags to remain during the discussion, because they're intended to attract attention from previously uninvolved editors who see them.—S Marshall T/C 14:50, 6 November 2016 (UTC)
No, the tags you inserted are intended to throw doubt into readers. I never claimed it was vandalism, but it is clearly disruptive and not intended to help produce better discussion. KPD has a declared association to the topic, and since we have a handful of editors without conflicts of interest that disagree with your assessment we go with those instead. Carl Fredrik 💌 📧 14:56, 6 November 2016 (UTC)
This continued on my talk page until Doc James made this edit, partly resolving the NPOV issue.—S Marshall T/C 19:39, 8 November 2016 (UTC)

Overemphasis on marketing to children

Why all this inappropriate focus on one point? Other things discussed in the sources are not illustrated at all. Your attention is drawn to WP:CHERRY.—S Marshall T/C 00:07, 10 December 2016 (UTC)

This is part of the over-emphasis on the US in this article. Johnbod (talk) 03:50, 10 December 2016 (UTC)
One of the things that particularly annoys me about our friends from MEDRS is that they'll revert edits to the article within minutes but ignore talk page discussion forever. I'll put my edit back in to stimulate discussion.—S Marshall T/C 18:51, 11 December 2016 (UTC)
Try a RfC. The United States has the largest health care organizations in the world. So yes they are a major player in the health care area.
We reference "Public Health England" a great deal. Doc James (talk · contribs · email) 20:46, 11 December 2016 (UTC)
You repeat yourself here.... Yes, we know that it is a major organization - that is not what is at hand. The issue is WP:WEIGHT that gets attached to a specific issue - an issue where the major organizations disagree strongly.. and one that proportionally fills up very little text space as opposed to picture space. Hopefully you will address the WP:WEIGHT issue this time around. --Kim D. Petersen 01:18, 12 December 2016 (UTC)
There is an underemphasis with using other images. For example, "Related technologies" does not have an image. That is a WP:WEIGHT issue. QuackGuru (talk) 01:34, 12 December 2016 (UTC)
That's nice Quack, but it's a separate issue. This talk page section is about the three images focussing on Children. If you wish to discuss the need for images on related technologies, which by the way I think would be excessive, then start a separate section.
On topic, I agree with getting rid of one of the images, although I don't have a strong preference for which one on encyclopedic grounds. SPACKlick (talk) 04:11, 12 December 2016 (UTC)
  • I strongly endorse QuackGuru's suggestion to replace one of the "marketing to children" images with one about related technologies.—S Marshall T/C 18:22, 12 December 2016 (UTC)

Should we look at the major health organizations that are overall supportive versus those that are not?

  • Supportive: Public Health England
  • Non supportive: World Health Organization, Center for Disease Control and Prevention, Surgeon General of the United States, National Institutes of Health, Food and Drug Administration

PHE even states that they recognize that their position is at odds with that of most of the rest of the world. Doc James (talk · contribs · email) 22:16, 12 December 2016 (UTC)

By the way this was just published by the US Department of Health and Human Services a couple of days ago after a "comprehensive review".[16]
It says "Research has found that youth who use a tobacco product, such as e-cigarettes, are more likely to go on to use other tobacco products like cigarettes."
"nicotine in e-cigarettes and other tobacco products can prime young brains for addiction to other drugs, such as cocaine and methamphetamine"
"Nicotine exposure during pregnancy can result in multiple adverse consequences, including sudden infant death syndrome (SIDS)." Doc James (talk · contribs · email) 22:18, 12 December 2016 (UTC)
  • Isn't that rather tangential to what everyone else except Johnbod is talking about?—S Marshall T/C 22:37, 12 December 2016 (UTC)
You are saying that having 1 video from the NIH, 1 video from the CDC, and 2 images from the CDC is undue weight. I disagree. We have 1 image of a good looking female smoking near the top of the article. We have two images of very well presented e-cigs in the lead. We have another presentation of nice colorful techy looking e-cigs in the body with appetizing looking flavors. We than have a super techy looking e-cig all black and chrome. And the health concerns are shuffled to near the bottom. And here you are going on about undue weight.
Gah seriously. We already know we have an active community of people working to promote these products.
Get PHE to release an image and we can look at using it. Doc James (talk · contribs · email) 22:51, 12 December 2016 (UTC)
No, he's saying three images and a wall of text on marketing to children is undue weight. Only Jonbod talks about US/UK balance.SPACKlick (talk) 22:54, 12 December 2016 (UTC)
  • Well, I am saying that, but I think that this time around what Doc James says is relevant. And true, and I agree. The image of the lady giving a sultry sidewise glance at the camera as she tokes on the e-cigarette is one we could usefully replace with something less advertlike. And the colourful appetising e-cigarette flavours could quite reasonably be replaced with less appealing images. If we're going to be more intelligent with our image choices in those articles let's do that as well.—S Marshall T/C 23:19, 12 December 2016 (UTC)
I would strongly support images that are less like advertising and more to the point. Several pictures should imho be substituted, or left out (i can't for instance see why we are advertising for a CBD e-liquid). --Kim D. Petersen 05:04, 13 December 2016 (UTC)
Yes, that image is also clearly inappropriate.—S Marshall T/C 17:37, 13 December 2016 (UTC)

Proposal 1

Proposal 1 looks like this. Intention is to address all of my concerns, Doc James', and Kim Petersen's to produce an article that makes e-cigarettes look less appealing ---- and also to remove the overemphasis on sales to children previously noted. It does not yet address QuackGuru's wish to include more images re related technologies, because I don't know which images QG would suggest. (I'm numbering this "Proposal #1" because experience with this talk page tells me I will need to revise it...)—S Marshall T/C 18:44, 13 December 2016 (UTC)

  • Looks better to me. Johnbod (talk) 19:27, 13 December 2016 (UTC)
  • How does using e-liquid images that look "less appealing" look better? One of the e-liquid bottle images has four e-liquid bottles out of focus (blurred or fuzzy). QuackGuru (talk) 18:16, 14 December 2016 (UTC)
I disagree there is an overemphasis on sales to children. The proposal looks much worse, especially the cluttered e-liquid bottles. The cluttered e-liquid bottles reminds me of the cluttered second image in the article. QuackGuru (talk) 19:49, 13 December 2016 (UTC)
Disagree with the removal of the CDC. So not really better. Doc James (talk · contribs · email) 02:25, 14 December 2016 (UTC)
I can only second QG and DJ's opinions. Carl Fredrik 💌 📧 13:45, 14 December 2016 (UTC)
Which of the media files about marketing to children would you prefer to lose? I don't mind which of the three is removed.—S Marshall T/C 22:26, 14 December 2016 (UTC)
I third QG and DJ's opinions. Cloudjpk (talk) 00:28, 15 December 2016 (UTC)
Not seeing consensus on the change of images. Doc James (talk · contribs · email) 22:33, 18 December 2016 (UTC)

If we do go with this image [17] we need to at least trim the half that is the back of someone's head. Doc James (talk · contribs · email) 22:35, 18 December 2016 (UTC)

Sure, Doc. When discussion stalls I edit; that's normal behaviour intended either to accept my edit or else to create further discussion. See WP:BRD. If editors weren't allowed to do this then progress on articles could be permanently stalled by people who raise objections without giving intelligible reasons, which is hardly in the encyclopaedia's best interests. Could you explain why you've reverted edits that you yourself have advocated? Didn't you want to replace the image of Naomi a couple of days ago?

Also, @Cloudjpk:, please could you explain to me why it's appropriate for Wikipedia to advertise this brand of THC-containing e-juice?—S Marshall T/C 21:38, 19 December 2016 (UTC)

Wikipedia is not advertising a brand. The point is there are other uses than using e-liquid containing nicotine. E-cigarette users are also using THC-containing liquid. I agree with both Doc James and Cloudjpk restoring the images. QuackGuru (talk) 21:48, 19 December 2016 (UTC)

Proposal 2

Should we add "Young people who use e-cigarettes are more likely to go onto smoke cigarettes.""E-Cigarette Use Among Youth and Young Adults A Report of the Surgeon General" (PDF). US Department of Health and Human Services. 2016. Retrieved 12 December 2016. to the lead?

This is supported by a review just published by the US Department of Health and Human Services / Surgeon General. Doc James (talk · contribs · email) 03:42, 15 December 2016 (UTC)

Not without telling the other side - since we have the UK NHS saying the exact opposite... (ie. weight is roughly equal) And they actually have more data to back their position up (via the smokers toolkit). And imho this is just Gateway hypothesis rewrapped, which is not uncontroversial by itself. So it should not go in like that. --Kim D. Petersen 07:26, 15 December 2016 (UTC)
This should certainly be included, making clear the Surgeon General's Report doesn't conclude that the link is causal. For WP:NPOV, the methodological issues underscored in RCP and PHE reports against a causal interpretation of this association should be noted as well.
Similarly, we should also present the Surgeon General's Report's finding that: "past-30-day e-cigarette use was rare (2.8%) among middle school students who did not use other tobacco products in that time period... . among high school students, past-30-day use of e-cigarettes was also rare (3.4%) among never users of other tobacco products" [18]. Zvi Zig (talkcontribs 12:41, 15 December 2016 (UTC)
And all that is too detailed for the lead, though worth covering in its place. Johnbod (talk) 14:50, 15 December 2016 (UTC)
We have a sentence in the lead that reads: "There is evidence they can help some people quit smoking". Let's revise it to read: "They can help some people quit smoking, but they are also correlated with taking up smoking in young people." This should be combined with taking out one of the undue images about marketing to children in the body text, and removing all the advert-like images with the products attractively displayed for sale.—S Marshall T/C 17:48, 15 December 2016 (UTC)
The part "but they are also correlated with taking up smoking in young people." is a SYN violation and misplaced text in the lede. The part "correlated with taking up smoking in young people." is too vague. The reason it is misplaced text is because it is not about "Smoking cessation". The 4th paragraph is for text about "Frequency". As for the images there is another section discussing it. The text and images are not directly related. QuackGuru (talk) 17:57, 15 December 2016 (UTC)
You don't decide what each paragraph is for, QG. You aren't the article manager. Quitting smoking and starting smoking are closely related concepts because one is the counterpart to the other, so it's an appropriate and reasonable editorial decision to contrast one concept with the other and therefore to place that text together. Furthermore it's a constructive suggestion aimed at achieving DocJames' objectives. Still further, it's not too vague for the lede, which has to be a quick high-level overview of the subject. The corresponding sentence in the body text would of course specify that this was a US study of US subjects in a particular age range.—S Marshall T/C 19:10, 15 December 2016 (UTC)

How about we replace "There is evidence they can help some people quit smoking" with "They may help some people quit smoking, but when used by young people are related to later smoking of cigarettes." Doc James (talk · contribs · email) 19:33, 15 December 2016 (UTC)

The first claim is causal, while the seccond is just an association. Putting them together gives the false implication that they're both causal, which is misleading. Zvi Zig (talkcontribs 19:44, 15 December 2016 (UTC)
If the part "however" is a SYN violation[19] then "but" may also be a SYN violation, right? QuackGuru (talk) 19:48, 15 December 2016 (UTC)
OR and SYN reside in the overall meaning, and implications, of a sentence, paragraph or article. They are about the flow of ideas in an article and the emphasis given to facet of a subject. It's not useful to try to identify OR or SYN at the level of individual words.—S Marshall T/C 19:58, 15 December 2016 (UTC)
S Marshall, that makes no sense at all... However when it comes to James's suggestion this most assuredly is neither OR or SYN. Carl Fredrik 💌 📧 10:00, 20 December 2016 (UTC)
If you're struggling to understand my point then I'm happy to explain it in other words for you. QG has a habit of looking at individual words in terms of WP:V and WP:OR, and he's doing it again here. That's an error because he's looking at the lexicon rather than the semiosis. WP:V and WP:OR are semiotic concepts. That means they're not about the exact word choice but about the underlying meaning.

Or to put the same thing even more simply: despite what QG says, Doc James' suggestion is neither OR nor SYN.—S Marshall T/C 17:43, 20 December 2016 (UTC)

Are you implying that words can not incur meaning? When QG says that a word is a WP:V or WP:OR-violation I assume what he means is that the phrase including that word is in violation, but the phrase without the specific word is not. This doesn't strike me as especially controversial. Carl Fredrik 💌 📧 16:01, 21 December 2016 (UTC)
I don't blame you for assuming that, because it would make sense. But QG's edits show otherwise: he genuinely tries to verify individual words against the sources and genuinely copies source wording exactly. It's one of his characteristic behaviours.—S Marshall T/C 19:36, 21 December 2016 (UTC)
Words can convey very specific meanings where the use of synonyms is inappropriate. The distinction of "children" and "younger users" is such a case, especially seeing as there is no accepted definition of the vague term "younger users". To me it seems as if this is only controversial because the term "children" is loaded, and that certain groups very much wish to avoid mentioning marketing to children, despite the CDCs and NIH expressing clear concern about this. Carl Fredrik 💌 📧 15:49, 22 December 2016 (UTC)
Oh, indeed. It's absolutely appropriate to mention the concern about marketing to children in the article, and to draw attention to that concern with one image or video, in proportion to the attention it receives in the decent sources. But my point, that QG fixates on individual word choices rather than the overall meaning of a phrase or sentence, is well borne out by my diffs.—S Marshall T/C 23:03, 22 December 2016 (UTC)

Nicotine

Should there be more of a distinction between nicotine and merely flavored vapors? Benjamin (talk) 07:23, 28 September 2016 (UTC)

There certainly should be a section at Electronic cigarette aerosol and e-liquid, and a bit more emphasis here. But I think that as their use becomes more widespread, nicotineless e-liquid is a small and falling proportion of usage. Johnbod (talk) 17:03, 28 September 2016 (UTC)
I'd agree with small, I'm not sure I'd agree with falling, plenty of people get to nic-less juice as they reduce their intake, people who have sub-ohm drippers often use nic-less juice because the volumes they use are so high that nicotine juice is a bad plan. We could do with some demographic sourcing. SPACKlick (talk) 19:00, 28 September 2016 (UTC)

Especially when talking about the health effects, a distinction would be important. Benjamin (talk) 10:15, 30 September 2016 (UTC)

It's not entirely clear that it is in fact. And afaik there is virtually no research specifically into 0-nicotine vaping. Johnbod (talk) 11:53, 30 September 2016 (UTC)
the wikipedia article itself states that in a survey only one percent of vapers use 0% nicotine liquid Sassmouth (talk) 07:44, 24 October 2016 (UTC)

Where is the history of the vaping product that had nicotine in it, was FDA approved, and had POS grocery and convenience store sales, supported by TV commercials in c.1985 in Texas. It was designed to appear to be a cigarette, with the traditional white, slender tube, and a tan mouth holder. The product was sold in packs of 3. After the TV campaign started, the FDA reversed course, and the company's sales disappeared. It was definitely approved for a short time, and for Texas, however. NOW, I cannot find reference anywhere on the internet yet. I cannot recall the product brand, or company name. — Preceding unsigned comment added by 2600:8801:1180:450E:CD2E:F9F5:30E2:33F3 (talk) 21:22, 2 January 2017 (UTC)

I'm assuming that you are talking about Premier (cigarette), which was a Heat-not-burn product. --Kim D. Petersen 16:32, 3 January 2017 (UTC)

Risk of vaping compared to smoking

I suggest that the word "likely" is removed from "they are likely safer than tobacco cigarettes" so it reads "they are safer than tobacco cigarettes" for the reasons gıven in http://www.theguardian.com/science/sifting-the-evidence/2017/jan/02/ill-say-it-again-e-cigarettes-are-still-far-safer-than-smoking

Your comments? — Preceding unsigned comment added by Chidgk1 (talkcontribs) 20:53, 11 January 2017 (UTC)

Please read a WP:MEDRS compliant review. "However, a more recent study utilizing the newer “tank-style” systems with higher voltage batteries reported that these e-cigarettes might expose users to equal or even greater levels of carcinogenic formaldehyde than in tobacco smoke.40"[20] They can be more dangerous than smoking. QuackGuru (talk) 21:11, 11 January 2017 (UTC)
QG: You really shouldn't refer to the Kosmider study (which is what the above is based upon), since it was conducted under conditions that are not found in the "wild". It produced alot of formaldehyde, because they dry-puffed the e-cigarette - something that is almost impossible to stomach for a vaper. (see Farsalinos(2015)[21]). Under non dry-puff conditions an e-cigarette doesn't produce formaldehyde at problematic levels. --Kim D. Petersen 02:09, 12 January 2017 (UTC)
I was referring to a MEDRS review. I did not cite a study. PubMed lists it as a review. QuackGuru (talk) 02:45, 12 January 2017 (UTC)
One cannot just blindly claim that everything read in a review is correct - you need to know the context and the information that is cited... which in this case is entirely reliant on Kosmider, which made a blunder. Research/data is subject to falsification, replication, korrections etc. In this case newer reviews will include the caveat about dry-puffs while older ones (such as this one) didn't. What you did is very close to cherry-picking (both review and data) --Kim D. Petersen 06:33, 12 January 2017 (UTC)
You previously claimed "You really shouldn't refer to the Kosmider study". I did not refer to a study. You did. Please WP:DONTSHOUTBIAS. QuackGuru (talk) 17:23, 12 January 2017 (UTC)
Since you referred not to the conclusions, minor or major, of the review, but to a specific subsection, and a specific observation in the review - then you are not referring to the review itself... but are instead relying on the individual studies. And that particular factoid is based entirely on one single paper: Kosmider. In fact you went into rather alot of detail on this particular finding, to the extent that you informed Chidgkl that one of the main authors of the NHS review report was wrong.
Your answer to Chidgkl was therefore both biased, and showed lack of insight into the issue of research that you focused on. Ie. you stated that Chidgkl was wrong because you could find a cherry-picked issue that might be problematic, in fact you went so far as to state that e-cigarettes thus might be even more dangerous than smoking! Which is WP:POV and not supported by sources. --Kim D. Petersen 20:19, 12 January 2017 (UTC)
In a nutshell: Wikipedia goes by the opinion expressed in the aggregated body of research - not by your opinion, or the views expressed in a single paper or review. see NPOV, and more specifically WP:WEIGHT. --Kim D. Petersen 20:23, 12 January 2017 (UTC)
The text I cited is a quote from the source and is supported by the source. I will also refer to another conclusion. See "As e-cigarette manufacturing changes, the newer and “hotter” products may expose patients to higher levels of known carcinogens."[22] QuackGuru (talk) 20:26, 12 January 2017 (UTC)
  • First: Where in the review do you find the view that "They can be more dangerous than smoking"? That was entirely your own POV!
  • Second: How can you leap from the presence and amount of a single chemical, to a global conclusion on the whole product? You can't. Again entirely POV.
  • Third: NPOV requires that we consider the entire body of research when we make conclusions - even on single issues. Did you do that? Again entirely POV.
So the excuse "a quote from the source" is not valid. Sorry. What you did is called cherry-picking. --Kim D. Petersen 20:36, 12 January 2017 (UTC)
KDP, I think you've misunderstood the difference between primary and secondary sources, and why we give more weight to one over the other. Carl Fredrik 💌 📧 20:39, 12 January 2017 (UTC)
Nope. I very much understand the difference between secondary and primary sources. And i also know that you can't cherry-pick a secondary source for a tidbit of information, without validating that the aggregate of the body of knowledge on that particular tidbit is upheld.
And i also know that we as wikipedians are not allowed to draw our own conclusions from secondary sources - such as interpolating that because one source might say that there is formaldehyde in much the same/or higher levels as in cigarettes into conclusions such as "They can be more dangerous than smoking".
Had it just been noted that the article that Chidgkl referenced, was a primary source, and unusable here - then everything had been pico bello - but instead it was replied to with personal opinion not supported by sources (secondary or otherwise). Clear enough? --Kim D. Petersen 21:15, 12 January 2017 (UTC)
QG: Thanks for explaining about WP:MEDRS compliant reviews and thanks to the other guys for your comments. I searched using Google Scholar and found http://journals.sagepub.com/doi/abs/10.1177/2042098614524430 which I guess will be enough of a citation for me to make the change unless anyone explains otherwise here. Chidgk1 (talk) 21:22, 12 January 2017 (UTC)
That source is a secondary one, and if was only about having a source to back it up, then the PHE report, which Linda Bauld refers to, would have been sufficient. The trouble is, as mentioned above, that we need to reflect the WP:WEIGHT of sources, which is a fancy wikipedian way of saying that we should reflect the opinion in all sources, in proportion to the body of evidence. Personally i think the waste majority of sources at this point are in agreement that e-cigarettes are safer than cigarettes, and thus that we should remove the likely. But we need a more thorough review of sources to figure this out. Indicating the lack of sources that claim that e-cigs are more dangerous or equally as dangerous than cigarettes is one way to go. --Kim D. Petersen 21:31, 12 January 2017 (UTC)
The review concludes "Existing evidence indicates that EC use is by far a less harmful alternative to smoking." If that is not enough please could you explain in simple terms what I need to do in order to be allowed to make the change without someone undoing it? Chidgk1 (talk) 21:37, 12 January 2017 (UTC)
Another review concludes "At present, it is impossible to reach a consensus on the safety of e-cigarettes...".[23] Another review concludes that the increase in vaping may be atributed in part to "the misperception that e-cigarettes are a safer alternative to traditional cigarettes."[24] The statement in the lede can be more neutral. QuackGuru (talk) 22:18, 12 January 2017 (UTC)
That is one of the most blatant examples of deliberate cherry-picking i've seen so far from you QG! You end the sentence "At present, it is impossible to reach a consensus on the safety of e-cigarettes" with ellipses. WHY? Because the rest of the sentence is: "...except perhaps to say that they may be safer than conventional cigarettes but are also likely to pose risks to health that are not present when neither product is used." - So contrary to what you said, the paper actually states that there is a consensus on e-cigarettes being safer than cigarettes. What on Earth??? --Kim D. Petersen 00:20, 13 January 2017 (UTC)
And the second review is not about electronic cigarettes, is published in a psychiatric journal?? And the sentence is a throwaway line - not a conclusion at all! - what on earth??? There is no review of relative harms in the paper at all. --Kim D. Petersen 00:28, 13 January 2017 (UTC)
You stated "So contrary to what you said, the paper actually states that there is a consensus on e-cigarettes being safer than cigarettes." It does not. When they stated "it is impossible to reach a consensus on the safety of e-cigarettes..."[25] then it is impossible according to the review.
The other review is about electronic cigarettes and other tobacco products. We do not dismiss a review because it is published in a psychiatric journal. The source did not state the sentence is a "throwaway line". QuackGuru (talk) 00:37, 13 January 2017 (UTC)
The only reason that you can wiggle out of the source saying the e-cigarettes are safer than cigarettes, is based upon word: "may". But once more you are cutting off the source right before it states something about relative risk. The whole sentence is: "At present, it is impossible to reach a consensus on the safety of e-cigarettes except perhaps to say that they may be safer than conventional cigarettes but are also likely to pose risks to health that are not present when neither product is used." The underlined part is about relative risk - the rest is not. You continue to misrepresent what the source is actually saying! --Kim D. Petersen 01:24, 13 January 2017 (UTC)
I concur with QG.Carl Fredrik 💌 📧 22:22, 12 January 2017 (UTC)
You concur based on that "evidence" from QG?? Blatant misrepresentation of the first source, and misuse of a psychiatric journal as if it reviews harm??? --Kim D. Petersen 00:29, 13 January 2017 (UTC)
You stated "So contrary to what you said, the paper actually states that there is a consensus on e-cigarettes being safer than cigarettes." That's a misperception (failed verification). QuackGuru (talk) 00:40, 13 January 2017 (UTC)
Let me quote: "...impossible to reach a consensus on the safety of e-cigarettes except perhaps to say that they may be safer than conventional cigarettes..." - do we at least agree that you misrepresented what the source said - and probably deliberately cut away what it said about relative safety to cigarettes?? --Kim D. Petersen 00:47, 13 January 2017 (UTC)
Do you still stand by your comment that "So contrary to what you said, the paper actually states that there is a consensus on e-cigarettes being safer than cigarettes."? That is original research to state that "There is a consensus on e-cigarettes being safer than cigarettes." See WP:V. QuackGuru (talk) 00:55, 13 January 2017 (UTC)
I asked the question first QG. Did you or did you not cut away the relevant sentence from the source that you quoted? I know that it is common way to disarm criticism to try to reverse it towards the critic. But not going to work. --Kim D. Petersen 00:57, 13 January 2017 (UTC)
See "Although some studies suggest that smoking e-cigarettes may be less dangerous than smoking conventional cigarettes, more needs to be learned."[26] The source did not state it is safer than smoking. It is imposable to reach a consensus that it is safer. That was the point I made. The paper does not state that there is a consensus that e-cigarettes is safer than cigarettes. QuackGuru (talk) 01:04, 13 January 2017 (UTC)
Once again: Did you or did you not cut off the quote so that the statement about relative safety was removed? As for the rest: "more needs to be learned" is not incompatible with "we know something". --Kim D. Petersen 01:19, 13 January 2017 (UTC)
I quoted the part "At present, it is impossible to reach a consensus on the safety of e-cigarettes...".[27]
You already know what I quoted and did not quote. Therefore there is no need to ask the question when you already know the answer. You stated in part "So contrary to what you said, the paper actually states that there is a consensus on e-cigarettes being safer than cigarettes."[28] The source does not verify what you stated. The part "...except perhaps to say that they may be safer than conventional cigarettes...".[29] is different than your interpretation of the source because the source does not verify there is a consensus that e-cigarettes is safer than cigarettes. They may be safer than traditional cigarettes is verifiable. QuackGuru (talk) 03:28, 13 January 2017 (UTC)
So you acknowledge that you converted a sentiment of "there may be a consensus on e-cigarettes being safer than cigarettes" into "it is impossible to reach a consensus on the safety of e-cigarettes" by leaving out part of the original quote - try reading those two sentiments, and try to figure why i'm upset it. --Kim D. Petersen 06:57, 13 January 2017 (UTC)
These are two different statements. It is still impossible to determine a consensus on its safety according to the review. The review also confirms that perhaps they may be safer than combustible cigs. I did not cite a study. You did.[30] It was not contrary to what I said. The paper did not actually state that there is a consensus on e-cigarettes being safer than cigarettes.[31] See WP:V policy. QuackGuru (talk) 12:12, 13 January 2017 (UTC)

It seems from previous comments that I needed to look at the weight of the scientific reviews. As far as I can see the weight of the reviews is that ecigs ARE safer than traditional cigs. So I have made the change but as I don't want to spend my time edit warring or discussing this further I will try not to look at this article or talk page again for several months at least. Thanks for your help. Chidgk1 (talk) 16:57, 13 January 2017 (UTC)

The source does not assert they are safer than smoking. That is original research. The other review says "...perhaps to say that they may be safer than conventional cigarettes...".[32] QuackGuru (talk) 17:00, 13 January 2017 (UTC)
What are you talking about QG? Here is a direct quote from the abstract of the Farsalinos review: "Currently available evidence indicates that electronic cigarettes are by far a less harmful alternative to smoking and significant health benefits are expected in smokers who switch from tobacco to electronic cigarettes." - please tell me again that the source doesn't "assert they are safer than smoking" Is misrepresentation of sources going to be a new thing. --Kim D. Petersen 17:35, 13 January 2017 (UTC)
The other two sources previously used that were not deleted did not verify the change and "indicates" does not mean they are safer than tobacco cigarettes. QuackGuru (talk) 17:44, 13 January 2017 (UTC)

"Likely" should remain until proper evidence and sources back up its removal. Doc James (talk · contribs · email) 18:55, 13 January 2017 (UTC)

Doc James: Is this new study which finds "substantially reduced levels of measured carcinogens and toxins relative to smoking" enough?

http://www.webmd.com/news/20170209/ecigs-cut-smokers-level-of-toxic-chemicals http://annals.org/aim/article/2599869/nicotine-carcinogen-toxin-exposure-long-term-e-cigarette-nicotine-replacement

If not what evidence and sources are needed please?

Chidgk1 (talk) 19:51, 12 February 2017 (UTC)

[1]
  1. ^ Shahab, Lion; Goniewicz, Maciej L.; Blount, Benjamin C.; Brown, Jamie; McNeill, Ann; Alwis, K. Udeni; Feng, June; Wang, Lanqing; West, Robert (2017). "Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users". Annals of Internal Medicine. doi:10.7326/M16-1107. ISSN 0003-4819. PMID 28166548.
Webmd.com mentioned it is a study. The other source is also a study. I formatted the study. See WP:MEDRS again. QuackGuru (talk) 20:29, 12 February 2017 (UTC)

Semi-protected edit request on 8 March 2017

107.178.11.33 (talk) 18:11, 8 March 2017 (UTC)
Not done: as you have not requested a change.
Please request your change in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ".
Please also cite reliable sources to back up your request, without which no information should be added to, or changed in, any article. - Arjayay (talk) 18:39, 8 March 2017 (UTC)

The picture showing vapourizers.

It's says "Various types of e-cigarettes." When they are not e-cigarettes. I'd get rid of the photo since it isn't related to the article. E-cigarettes look like cigarettes, hence the name. AntonFMD (talk) 17:56, 19 March 2017 (UTC)

No, in the normal vocabulary, cigalikes look like cigarettes, and e-cigs just act like them. Has Quack cleared the talk-page AGAIN??? Johnbod (talk) 18:07, 19 March 2017 (UTC)
Agree we keep the image. Bot cleared the page. Doc James (talk · contribs · email) 08:00, 20 March 2017 (UTC)

Passive vaping

I came to this page to learn about passive vaping, what the risks are, etc, but found it isn't even mentioned in the article. Surely passive vaping occurs??? I have walked past vaping shops and smelled SOMETHING. Has passive vaping never been talked about in the business/industry? Surely it has. Thanks in advance to anybody who knows this subject. — Preceding unsigned comment added by Betathetapi545 (talkcontribs) 10:16, 7 April 2017 (UTC)

can this be changed to what the citations write?

It says on top "They are likely safer than tobacco cigarettes" but the citations don't say likely. can this be changed to "The scientific evidence suggests that they are far safer than tobacco cigarettes" or similar just as they write in the citations? >Bo — Preceding unsigned comment added by 169.54.65.167 (talk) 23:38, 27 February 2017 (UTC)

In my opinion, I agree with you. I've seen many sources say it's far safer. I don't see why not. AntonFMD (talk) 17:53, 19 March 2017 (UTC)

I made this edit but it got changed back, twice, with no satisfactory explanation. Seems like this article's just gonna say what certain editors want it to. I can't be assed trying to fix it.--Fahrenheit666 (talk) 03:28, 29 March 2017 (UTC)
Does this clarify the picture? QuackGuru (talk) 12:00, 29 March 2017 (UTC)
WTF? How's that supposed to clarify anything? I could shoot you down with a hundred pics of house fires caused by tobacco cigarettes, but I can't be assed, because you and your buddy have a death grip on this page and you'll never let it be edited to reflect the science.--Fahrenheit666 (talk) 21:56, 29 March 2017 (UTC)
Did you read the edit history? QuackGuru (talk) 22:53, 29 March 2017 (UTC)
Yes. Every time someone adds balanced info to the article you or Doc James removes it. Trying to improve this page is a waste of time. I'm not even gonna bother trying.--Fahrenheit666 (talk) 01:25, 30 March 2017 (UTC)
There are lots of sources that state the degree of safety over traditional cigs is not entirely clear. Actually that is the position of the majority of high quality sources.
For example the NIH says "Because they deliver nicotine without burning tobacco, e-cigarettes appear as if they may be a safer, less toxic alternative to conventional cigarettes."[33] Doc James (talk · contribs · email) 01:35, 30 March 2017 (UTC)
Fine. I already said I'm not gonna bother. I just tell anyone who wants facts about ecigs, "Don't read Wikipedia."--Fahrenheit666 (talk) 02:12, 30 March 2017 (UTC)

Summary

There are more than just these two major opions:

"According a 2016 World Health Organization report "no specific figure about how much 'safer' the use of these products is compared to smoking can be given any scientific credibility at this time".[1] According to a 2016 Royal College of Physicians report, "Although it is not possible to estimate the long-term health risks associated with e-cigarettes precisely, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure".[2]"

  1. ^ Cite error: The named reference WHO2016 was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference RCP was invoked but never defined (see the help page).

There is also the CDC, NIH, AHA, etc. These all belong in the body of the article rather than the lead which is an overall summary. Doc James (talk · contribs · email) 01:59, 6 May 2017 (UTC)

These two viewpoints must be reflected in the lead.Zvi Zig (talkcontribs 18:07, 6 May 2017 (UTC)
It is not a good summary of the body. They do not belong in any lede. The Royal College of Physicians is not even a review. QuackGuru (talk) 18:11, 6 May 2017 (UTC)
Then the body should be changed. The 95% estimate versus the position that reduced risk is not quantifiable, is a central disagreement in this debate. The quoted statement from the RCP, is in the RCP report titled Nicotine Without Smoke p 87.Zvi Zig (talkcontribs 18:23, 6 May 2017 (UTC)
The RCP statement is very tentative. The two are thus somewhat in agreement. Doc James (talk · contribs · email) 18:56, 6 May 2017 (UTC)
All this should be reflected accurately. The WHO position is already and the RCP-PHE position should be manifested in the lead.Zvi Zig (talkcontribs 19:25, 6 May 2017 (UTC)
The 95% claim is disputed. If you want PHE's position in the lede it would reflect reviews which show that position is a farce. The safety of e-cigarettes remains unknown while later-generation e-cigarettes can produce more formaldehyde than tobacco cigarettes. QuackGuru (talk) 20:33, 6 May 2017 (UTC)
I presented the 95% estimate as disputed. Even later-generation e-cigarettes produce far less formaldehyde than cigarettes under real-world conditions of use, as PHE's 2015 review explains. While long-term epidemiology is unavailable, comparing the toxicology of EC aerosol and tobacco smoke is the basis of the estimate. Zvi Zig (talkcontribs 20:43, 6 May 2017 (UTC)
You did not show the 95% estimate being directly disputed. As I said previously, the PHE's position has been disputed as a farce. See "As e-cigarette manufacturing changes, the newer and “hotter” products may expose patients to higher levels of known carcinogens."[34] QuackGuru (talk) 21:00, 6 May 2017 (UTC)
The study you cite was submitted prior to PHE's report. So, I'm not sure how it can dispute it. The review was also submitted prior to the publication of PMID 25996087, which shows that under realistic conditions even new generation products produce far less formaldehyde. Zvi Zig (talkcontribs 21:12, 6 May 2017 (UTC)
I never said that review (not a study) disputed PHE's report. I was providing an example that shows not asserts that e-cigarettes can produce more formaldehyde than tobacco cigarettes. I cited a review and you come back with a study (PMID 25996087). Hmm. QuackGuru (talk) 21:17, 6 May 2017 (UTC)
PHE's review cites PMID 25996087 to conclude that formaldehyde isn't an issue in newer ecigs. The source you cite couldn't because it preceded that finding. Zvi Zig (talkcontribs 21:32, 6 May 2017 (UTC)
The PHE's position is not a systematic review and other organisations including CDC, NIH, and AHA do not support the PHE's disputed position. QuackGuru (talk) 22:26, 6 May 2017 (UTC)
Again, both sides of the dispute should be reflected.Zvi Zig (talkcontribs 22:31, 6 May 2017 (UTC)
The PHE's position is disputed. Therefore, it can be argued to delete it off the page and off of Wikipedia. QuackGuru (talk) 22:32, 6 May 2017 (UTC)
Wrong, see WP:DUE. Furthermore, cite a review disputing it. Zvi Zig (talkcontribs 22:42, 6 May 2017 (UTC)
See WP:MEDINDY. If an editor cites a review showing a COI or dispute then do you agree you will remove the PHE's position? QuackGuru (talk) 22:55, 6 May 2017 (UTC)
PHE is a reliable source. If every disputed position is removed, then we can erase a substantial part of the page. Zvi Zig (talkcontribs 23:22, 6 May 2017 (UTC)
I have not read other positions being directly disputed as having a major COI. WP:MEDINDY advocates to use independent sources. QuackGuru (talk) 23:27, 6 May 2017 (UTC)
PHE's review isn't disputed as having a major COI. That's baseless. Zvi Zig (talkcontribs 23:45, 6 May 2017 (UTC)
According to a 2016 review, PHE's position was based in part on authors with "conflicts of interest". That is noteworthy. Sources have different opinions but PHE's position has been discredited. QuackGuru (talk) 03:39, 7 May 2017 (UTC)
Can you please cite your source? Zvi Zig (talkcontribs 06:36, 7 May 2017 (UTC)
It is a well known fact the PHE's position cited authors with "conflicts of interest". This is not up for debate. You want me to cite the review in the Electronic cigarette article? QuackGuru (talk) 11:48, 7 May 2017 (UTC)
You want to downgrade PHE report's WP:MEDRS status for citing a paper with a COI? Please find a single review which doesn't cite a source with a COI. Zvi Zig (talkcontribs 13:40, 7 May 2017 (UTC)
PHE report's has been criticizes by more than one review. Please find a review that criticizes another source in this article. If you can't find a review that criticizes another source in this article then that shows how rare it is for a MEDRS compliant source to direct criticize the PHE's questionable position. What about the PHE report's connection to the tobacco industry? We can't ignore that. Can we? It is absolutely noteworthy to include the repeated criticism. QuackGuru (talk) 17:34, 7 May 2017 (UTC)
It's science for one review to criticize another. Grana 2014 is criticized by Cochrane (McRobbie) 2014. Kalkhoran 2016 is criticized by Cochrane (Hartmann-Boyce) 2016. PHE's report has no connection to the tobacco industry whatsoever. That is baseless and slanderous. Zvi Zig (talkcontribs 17:42, 7 May 2017 (UTC)
Grana 2014 is not criticized as a farce by Cochrane 2014. Kalkhoran 2016 is not criticized as a joke by Cochrane (Hartmann-Boyce) 2016. Arriving at different conclusions is not a criticism. But the PHE's report has been repeated criticized in more than one way by more one than one MEDRS compliant review. QuackGuru (talk) 17:57, 7 May 2017 (UTC)
The Cochrane reviews on e-cigarettes criticize Grana 2014 & Kalkhoran 2016 in their Discussion sections. Please cite the review which criticizes the PHE review "as a farce". Zvi Zig (talkcontribs 18:08, 7 May 2017 (UTC)
If you think the Cochrane reviews directly criticizes other reviews then feel free to add it to the article. Others on this very talk page have tried to criticize Grana 2014 but came up empty.
I can cite more than one review that shows the PHE's position is wrong if you agree to include it in the article. QuackGuru (talk) 18:21, 7 May 2017 (UTC)
You wanted to exclude PHE's review for several reasons, all of which you fail to substantiate. Zvi Zig (talkcontribs 19:24, 7 May 2017 (UTC)
If I add a review to the article that says that the people who had a hand with the PHE's report are connected to the tobacco industry then it may be justification to exclude a bias source. QuackGuru (talk) 19:56, 7 May 2017 (UTC)
When you cite your source it will be possible to discuss it.Zvi Zig (talkcontribs 20:05, 7 May 2017 (UTC)
The full text from the review is not available to the public yet. As early as July 2017 it will be. QuackGuru (talk) 20:19, 7 May 2017 (UTC)

─────────────────────────So quack is arguing to remove the PHE report here while somewhere else they call a simple article written by a math & economics student a "high-quality source" for health claims.--TMCk (talk) 00:07, 13 May 2017 (UTC)

Passive smoking

It is not clear to me how this diff makes sense. The quantification of "how low" comes earlier in the sentence with the word "extremely"; the phrase in question, "and insufficient to justify prohibiting e-cigarettes" is purely a statement on policy recommendation, not a discussion of safety and is therefore out of place in the section on safety. Yobol (talk) 19:33, 7 May 2017 (UTC)

"Extremely low" is a very relative term. "Extremely low and insufficient to... " gives you more understanding of how extremely low.Zvi Zig (talkcontribs 19:47, 7 May 2017 (UTC)
That text including the other text is a severe violation of undue per WP:SYNC. We don't have five paragraphs in the lede for the subpage. Is there a benefit for have five paragraphs? QuackGuru (talk) 19:58, 7 May 2017 (UTC)
I agree the qualifier of "insufficient..." quantifies the risk assessment. That it also may have policy implications doesn't affect this quantification. And in addition, i find it rather problematic that we cherry pick the parts of sentences in material, that we (as editors) find pertinent. --Kim D. Petersen 01:26, 15 May 2017 (UTC)
Please read my comment above. Is there a reason to violate WP:SYNC? QuackGuru (talk) 01:40, 15 May 2017 (UTC)
SYNC is a guideline not a policy QG. And i don't really find it a good argument here - no. If anything it argues that this particular tidbit should go into the articles that we summarize (if not already there) --Kim D. Petersen 01:49, 15 May 2017 (UTC)
I assume you have read my original comment above in this thread. Why 5? QuackGuru (talk) 01:52, 15 May 2017 (UTC)
I don't see why not. If this is the level of detail in summary that matches the need of the reader, then everything is fine. And there is no hard limit set out in guidelines for this. Would be more adequate to discuss this if the article was bloated. --Kim D. Petersen 05:10, 16 May 2017 (UTC)
It is random content because it does not appear to summarize any particular content. That's exactly what we don't do with creating a WP:SUMMARY of the daughter article. QuackGuru (talk) 00:47, 19 May 2017 (UTC)

Tobacco Taxes

This is just a loose thought.

I think that the effect of E-cigarettes on Tobacco Taxation should be covered here, as these effects are perhaps behind most media opinions and even purportedly neutral positions, like the WHO.

Tobacco is a State business, more than a manufacturer's business (most Western States and Governments have a return from tobacco 4 or 5 times larger than the manufacturer).

I'm not against tobacco taxation nor for smoking. I just think that this is a most relevant aspect of E-cigarette business and marketing.

(My opinion is that States should forget about the tobacco revenue and take a measure like Russia, that will forbid people born after 2014 to smoke. This is the fair end of cigarettes, and tobacco revenue, saving smokers from hypocritical social prosecution as the States did nothing for them not to start smoking) — Preceding unsigned comment added by 78.137.202.86 (talk) 23:28, 19 May 2017 (UTC)

Strange comparison between the PHE and RCP report?

Yobol removed a summary of the Royal Collage of Physicians report with the statement that "RCP report is basically a rehash of the PHE report; undue weight here as they both cite the same single study"[35]. This seems to be a wrong assessment, since the reports[36][37] are quite different, and focus on different aspects of tobacco harm reduction. A comparison of the two reports, show that they are not written by the same authors, nor are the two organizations linked. That reviews/reports are citing the same papers are/should not be a qualifier for removal either - since that would mean that quite a lot of reviews should be removed.

Thus I would like for Yobol to explain what he means with this statement, and give a more adequate explanation for hir removal of this material. --Kim D. Petersen 01:19, 15 May 2017 (UTC)

The part "they are unlikely to exceed 5% of those associated with smoked tobacco products"[38] is tantamount to "e-cigarettes are estimated to be 95% less harmful than smoking".[39] Is there a reason to add duplication? I highly doubt it. QuackGuru (talk) 01:36, 15 May 2017 (UTC)
Since the two reports apparently reach this conclusion from different approaches, then yes, it is most certainly something that argues for it to be "duplicated". We have lots of similar duplication of conclusions in this article. (such as the rather similar conclusions from FDA, AHA, AAP etc). --Kim D. Petersen 01:54, 15 May 2017 (UTC)
I disagree with including duplication from a UK-centric minority position per WP:UNDUE. QuackGuru (talk) 01:57, 15 May 2017 (UTC)
What on Earth is making you claim that this is a "minority position"? Can you mention other similar comprehensive review material that comes to a different conclusion, as opposed to position statements? Or are you opposing it due to the US-centric position? --Kim D. Petersen 03:13, 15 May 2017 (UTC)
A handful of UK medical organizations are more optimistic regarding vaping, but there is no evidence that this optimism is widely shared outside the UK. See Positions of medical organizations on electronic cigarettes, where most or if not all major international organizations are cautious, and the referenced positions that are optimistic stem from the UK. We should reflect the weight of the major organizations, not the UK's minority view. QuackGuru (talk) 04:53, 15 May 2017 (UTC)
Bad argument Quack. You basically ran into the US-centric view. Most organizations on the Positions article, either have rather old positions, are rather obscure, or are US ones. And heres the clincher:
None of those organizations have made comprehensive reviews to evaluate and support their positions. (ie. they haven't actually researched e-cigs in depth).
Outside of the PHE, RCP and the FCTC (WHO) - no comprehensive reports on this topic has been made. Which means that it most certainly isn't a minority position. --Kim D. Petersen 14:45, 15 May 2017 (UTC)
There seems to be a bit of confusion over the 95% safer claim. Don't worry. The MEDRS compliant reviews are coming. QuackGuru (talk) 00:47, 19 May 2017 (UTC)
Excuse me? You are citing an editorial to dismiss two WP:MEDRS compliant systematic reviews? Really? Can i do the same for the WHO report? --Kim D. Petersen 20:06, 20 May 2017 (UTC)
I said "Don't worry. The MEDRS compliant reviews are coming." I will cite more than one review that will directly contradict the claim or will criticize the claim. I will use inline citations in accordance with WP:INTEGRITY. QuackGuru (talk) 20:16, 20 May 2017 (UTC)
Do you have a COI with regards to the paper? I ask this since you apparently know what the paper will say before it is published.... And your comment was no response at all - because you ignored what i said, and answered with a strawman (paper in the future).
This really is telling with regards to your bias here, that you aren't going with what secondary sources are saying - but instead related to your personal view. --Kim D. Petersen 22:56, 20 May 2017 (UTC)
I meant exactly what I said. That particular statistic is cited by both reports to the same single study (Nutt, et al). It is already in there once, there is no need to mention it again as if it is different information. Duplicate information is undue. Yobol (talk) 02:26, 19 May 2017 (UTC)
Yobol We are not referring to the primary source, but instead to independent systematic reviews, that aggregate and review the literature as a whole. Thus the conclusions are not the same, nor are they duplicates of each other. One way to see this is to consider the PHE (Nutt& Hayek (2015)) response to the criticism of the 95% figure[40], which explains how they reach this conclusion and how it interlocks with all the other harm/risk evidence.
But if we take your stance, then what should we do with the rather staggering amount of prose in our article(s) that is based upon the same primary sources/evidence? Because that is what we have to do, if we go down the road of not taking secondary sources for what they say, but instead rely on our own interpretation of what the evidence quality and primary sources say, or are duplicates of. --Kim D. Petersen 15:27, 21 May 2017 (UTC)
Let's be clear, the mention of 5% risk is in the article. It just does not need to be repeated (and in a form that makes it appear as if it is new information), as it is based on one single study. Yobol (talk) 15:30, 21 May 2017 (UTC)
So it is your claim that the evaluation and thought processes of the PHE authors, and the RCP authors were identical, when reviewing the harm potential of e-cigarettes - and thus that we can dismiss it? Are we really allowed to do that as Wikipedia editors? Really? --Kim D. Petersen 15:37, 21 May 2017 (UTC)
No, I'm saying the information that is being presented (5% risk) is already covered in the previous sentence. Repeating it again in the very next sentence, rephrased as if it is new information is undue, especially since it comes from one single study. Yobol (talk) 15:40, 21 May 2017 (UTC)
Another interesting tidbit is that 50% of the authors of the PHE report appear to have also contributed to the RCP report. The notion that these are two completely independent reports seems a bit dubious. Yobol (talk) 16:09, 21 May 2017 (UTC)
(edit conflict)Additionally: You forgot to comment on your claim that the "RCP report is basically a rehash of the PHE report" - which as said is rather strange, since the reports are written from different perspectives and with rather different focuses. (PHE is about e-cigarettes, while the RCP report is about harm-reduction). That they have citations that are duplicates is rather curious as an argument, since i'll bet you that the WHO report cites some of the same sources, as both the PHE and RCP report. --Kim D. Petersen 15:34, 21 May 2017 (UTC)
Let me be clearer then: the cited sentence which I removed, regarding the 5% risk or 95% risk reduction, is a rehash of the same material already covered in the previous sentence. Both statistics from both PHE and RCP come from the same single study. There is no need to repeat information like that as if it is new information when it is not. That is misleading to the reader and WP:UNDUE. Yobol (talk) 15:38, 21 May 2017 (UTC)

Cannot verify one specific use of the NHE reference

The Nicotine yield section says: "The concentration of nicotine in e-liquid ranges up to 36 mg/mL.<ref name=NHE2014/>"... I would add a {{nicg}} myself, if the page wouldn't be semi-protected. Or have i completely missed the page of the pdf where this value is mentioned?! -- 5.2.203.71 (talk) 19:12, 27 May 2017 (UTC)

That is not the only text in that section that fails verification. QuackGuru (talk) 19:24, 27 May 2017 (UTC)

Potential concerns regarding use among non smokers

WHO states on page 6 "the possibility that once addicted to nicotine through ENDS children will switch to cigarette smoking"[41] Doc James (talk · contribs · email) 17:00, 30 May 2017 (UTC)

The WHO report is referring to a "concern" which it itself admits is unsubstantiated.

The likelihood and significance of these two effects occurring will be the result of a complex interplay of individual, market and regulatory factors and is difficult to predict. They can only be assessed with empirical data, which at present are virtually non-existent."

Zvi Zig (talkcontribs 13:47, 8 June 2017 (UTC)
For the WHO to voice it, it is still very notable. Carl Fredrik talk 13:55, 8 June 2017 (UTC)
I realize it had been removed, and have restored it, it is very notable and definately belongs in our article. Carl Fredrik talk 13:56, 8 June 2017 (UTC)
It definitely belongs in the article presented for what it is - an unsubstantiated hypothesis - and presented side-by-side with the conclusions of PHE[42] and UVIC[43] that evidence suggests e-cigaretes divert youth away from smoking. Zvi Zig (talkcontribs 14:09, 8 June 2017 (UTC)
Also next to the substantiated and high-profile criticism directed at the PHE-report. Carl Fredrik talk 15:17, 8 June 2017 (UTC)
Those criticisms are published at a lower MEDRS level and are unsubstantiated1.
However, the WHO should certainly be cited together with the high-profile refutation of their unprofessional report [44].Zvi Zig (talkcontribs 15:23, 8 June 2017 (UTC)
You misinterpret MEDRS, and the Lancet and BME are certainly highly enough regarded that joint statements from their editorial board merit inclusion. That is unrelated to whether other criticism exists of other reports. You can't cherry-pick which criticism to include. Carl Fredrik talk 15:55, 8 June 2017 (UTC)
Editorials and commentary articles are lower on the MEDRS hierarchy than reviews - certainly government reports.Zvi Zig (talkcontribs 16:10, 8 June 2017 (UTC)
They are two different things. Nicotine addiction is not about frequency. It is a WP:SYN violation and misplaced content for both content. This change is duplication. See the 4th paragraph. It says "while use among never-smokers is "negligible".[35]" The content about leading to other tobacco products is about frequency. QuackGuru (talk) 16:28, 8 June 2017 (UTC)
Good first point, Quack. I'm not sure what you mean in the 2nd 1/2 of what you wrote.Zvi Zig (talkcontribs 20:47, 8 June 2017 (UTC)
The content failed verification. That is about children. That does not verify this claim not about children. The part "Minors who use e-cigarettes are more likely to later use other tobacco products such as cigarettes" is misplaced. It is about frequency not addiction. It does not follow the body. QuackGuru (talk) 20:59, 8 June 2017 (UTC)

─────────────────────────WHO was not originally used to support the claim. It was generalised for non-smokers here. The source does not verify not just young people. Different sources were added at the end of the sentence. None of the sources verify the last part of the sentence. At least WHO verifies the first part of the claim. QuackGuru (talk) 16:49, 9 June 2017 (UTC)

The Gateway Effect

There have been several references to the gateway effect in the article. While there's no doubt teens who tried e-cigarettes are more likely to smoke compared to teens who have abstained from nicotine altogether, both US and UK authorities agree that the evidence does not demonstrate that e-cigarette use causes smoking.

The 2016 US Surgeon General's Report states

The available evidence suggests that e-cigarette use is associated not only with the use of other tobacco products, but also with alcohol and other substance use, such as marijuana. This is consistent with the common liability model for substance use and other risky behaviors (Vanyukov et al. 2012)

The Royal College of Physicians' report states:

...it appears that, to date, concerns over gateway progression into smoking are unfounded. The association between e-cigarette and tobacco cigarette use is therefore more likely to arise from common liability to use of these products, and to use of e-cigarettes as a gateway from, rather than to, smoking.

Zvi Zig (talkcontribs 19:01, 3 July 2017 (UTC)

Sure. Doc James (talk · contribs · email) 02:20, 5 July 2017 (UTC)