Talk:Electronic cigarette/Archive 31

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Represent consensus on relative safety

While there is agreement on relative safety, there is an effort to muddle this in the lead. This (1) includes no indication of the magnitude of reduction in risk and (2) displays the level of confidence in the evidence for reduced risk.

A recent systematic review by Truth Initiative --America's largest anti-smoking NGO -- concludes

Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes.

The Framework Convention Alliance on Tobacco Control -- an international umbrella group including more than 500 tobacco control and public health organizations -- reports "widespread agreement" that

E-cigarettes are almost certainly considerably less hazardous for individuals than cigarettes.

FCA Policy briefing: Electronic Nicotine Delivery Systems (a consensus statement), October 2014 http://www.fctc.org/images/stories/policy_brief.pdf

Zvi Zig (talk • contribs 12:52, 9 July 2017 (UTC)

There is no agreement on relative safety. A 2015 review concluded "As e-cigarette manufacturing changes, the newer and “hotter” products may expose patients to higher levels of known carcinogens."[1] We can't dismiss this review even when there are newer reviews. A 2014 review found "Electronic cigarettes (e-cigarettes) are advertised as being safer than tobacco cigarettes products as the chemical compounds inhaled from e-cigarettes are believed to be fewer and less toxic than those from tobacco cigarettes."[2] But the same review found "the levels of formaldehyde in vapors from high-voltage devices were almost identical to those in traditional cigarette smoke (1.6–52 μg per cigarette) [18]. Ohta et al. further reported that increasing levels of carbonyl compounds, such as formaldehyde and acetaldehyde, were observed for a voltage over 3 V [13,14]."[3] Again, we can't dismiss this review per WP:MEDDATE. QuackGuru (talk) 13:23, 9 July 2017 (UTC)

QuackGuru - All the papers you cite aboverely on review evidence prior to findings reported in reviews like RCP, PHE and Glasser et al 2016 (PMID 27914771) which show that high levels of formaldehyde are produced under unrealistic conditions. It's not recentism to discredit research which has been shown to be irrelevant based on new studies.Zvi Zig (talk • contribs 20:52, 9 July 2017 (UTC)

Yes there is tentative evidence of short term safety. But overall safety is unclear per many sources. This is why we say "They are likely safer than tobacco cigarettes" follows Doc James (talk · contribs · email) 16:57, 9 July 2017 (UTC)

No, Doc -- not just short-term studies. You're ignoring the chemistry and the toxicology considered in so many reviews.Zvi Zig (talk • contribs 20:57, 9 July 2017 (UTC)

The situation for anything but short-term is not clear, even if there are some studies that support it — there are others that do not. Carl Fredrik ^talk 14:58, 14 July 2017 (UTC)

Refs that support

1. "Clear evidence about the safety of e-cigarettes is lacking, and laboratory experiments and case reports suggest these products may be associated with potential adverse health consequences."2015 Mayo Clin Proc
2. "The USPSTF concludes that the current evidence is insufficient to recommend electronic nicotine delivery systems for tobacco cessation in adults, including pregnant women. The USPSTF recommends that clinicians direct patients who smoke tobacco to other cessation interventions with established effectiveness and safety (previously stated)." USPSTF 2015
3. "These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking."2014 review

Doc James (talk · contribs · email) 17:26, 9 July 2017 (UTC)

These reviews, - and certainly the more recent ones like PMID 27914771 - do not support the overemphasized redundant uncertainty in the lead in relation to relative safety compared to combustible tobacco cigarettes.Zvi Zig (talk • contribs 21:06, 9 July 2017 (UTC)

It is citation overkill to continue to add more and more sources for the same claim. A 2017 review found "Electronic cigarettes (e-cigarettes) are a growing public health concern because of a dramatic increase in use by adolescents and the uncertainty of potential health impacts."[4] Reviews like this one do support it is "uncertain". QuackGuru (talk) 21:13, 9 July 2017 (UTC)

2016 Cochrane review states "People who do not wish to quit can be helped to cut down the number of cigarettes they smoke and to quit smoking in the long term, using NRT, despite original intentions not to do so. However, we rated the evidence contributing to the cessation outcome for NRT as 'low' by GRADE standards. There is a lack of evidence to support the use of other harm reduction aids to reduce the harm caused by continued tobacco smoking."2016 Cochrane review

So Cochrane is saying e cigs are unclear in reducing harm from continued tobacco use. This is aside from the population effect of continued nicotine addition for those not yet using tobacco. Doc James (talk · contribs · email) 17:29, 9 July 2017 (UTC)

Zvi Zig, which review says we know the health risks for certain? The sources indicate it is still uncertain. That's why the sources use words such as "may". For example, see "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[5] QuackGuru (talk) 17:35, 9 July 2017 (UTC)

And well almost certainly safer than cigarettes, this does not mean the health risks of e-cigs at either a individual or population level is known. Doc James (talk · contribs · email) 17:39, 9 July 2017 (UTC)

Doc James, the precise health effects of eating carrots remain uncertain. There are statistical envelopes of uncertainty around everything in epidemiology, and the etiology of diseases are complex. However, opening a page on bananas saying "the health effects of carrots are uncertain" would be highly misleading. There are people addicted to the world's most deadly legal product reading this page every day, we cannot afford this level of ambiguity when reviews assess the chemical, in vivo, in vitro and clinical toxicology in relation to smoking.Zvi Zig (talk • contribs 21:14, 9 July 2017 (UTC)

There are also people reading this page not currently addicted to nicotine. The last thing we want to say is that this is without risk when evidence does not say it is without risk. Doc James (talk · contribs · email) 22:48, 9 July 2017 (UTC)

There are virtually no never-smokers who become regular users of e-cigarettes, as the Royal College of Physicians' report notes. In any case, no one is saying that there's no risk.Zvi Zig (talk • contribs 01:05, 10 July 2017 (UTC)

A 2015 review found "e-cig use by nonsmokers and especially by youth may result in a new generation of nicotine addicts and may become a gateway to smoking."[6]

Another review found "E-cigs are used by some smokers as an aid for quitting or smoking reduction, and by never smokers (e.g., adolescents and young adults)."[7] QuackGuru (talk) 01:29, 10 July 2017 (UTC)

Do you read the reviews that you quote? Or are you simply harvesting them for words that you want to use? The first review (by Farsalinos&Le Houezec (2017)) does not "find" what you quoted - they cite this as one of 4 "arguments" used to support applying the precautionary principle towards e-cigarettes. In fact in the examination section for this argument (yes, there is a whole section of the paper dedicated to this argument), the conclusion is: Thus, although e-cig experimentation is increasing, there is no evidence of regular e-cig use by youth and never-smokers, while the gateway to smoking argument is largely hypothetical and not supported by current evidence. - in fact much the opposite of what you claim the paper said! --Kim D. Petersen 14:46, 14 July 2017 (UTC)

This seems to be more cherry-picking than the other way around, and isn't entirely truthful. None of the papers condemn ecigs, but QG and Doc James are closer to the money. Carl Fredrik ^talk 14:58, 14 July 2017 (UTC)

I hope that you aren't indicating that i cherry-picked the above - because your comment could be read that way. The reason i verified QG's quote, is because both Farsalinos and Le Houesec are known for a no nonsense approach towards the data, and thus it would be extremely surprising if they had supported a claim of non-smokers taking up e-cigarettes.

And when you say that QG is closer to the money, what sources are you using to support that stand? --Kim D. Petersen 11:18, 15 July 2017 (UTC)

A 2015 review found that there is an argument to apply the precautionary approach, stating that one of the arguments is that "e-cig use by nonsmokers and especially by youth may result in a new generation of nicotine addicts and may become a gateway to smoking."[8] The precautionary approach like NPOV policy can also be used with this article rather than push it is safer than smoking. Read below where it says "But there is also evidence...". QuackGuru (talk) 15:58, 15 July 2017 (UTC)

No QuackGuru. You are misrepresenting the source. They state that there is an argument in the debate about vaping ("by those supporting strict regulations and/or bans") that is getting used... but find that this argument, via a review of the scientific evidence, is unfounded. It would be helpful if you actually tried to read and understand the source. Using a paper to argue the exact opposite of its findings is unacceptable. --Kim D. Petersen 17:35, 15 July 2017 (UTC)

The source did say state that one of the arguments others are making is to apply the precautionary approach. That means others do apply this method. That is a statement of fact. They acknowledged what others are saying. What are other saying? For example, a review found "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."[9] QuackGuru (talk) 20:18, 15 July 2017 (UTC)

If the Farsalinos paper had said that the argument was common amongst scientific sources, then you may have had an argument - but they do not. What they say is that it is an argument used by "by those supporting strict regulations and/or bans", and people/debates that argue for policy is not usually in the scientific realm, but in the political one. The review you refer to in the above is in a non-MEDLINE journal and thus (according to precedence on this article) not usable. But if you wanted to argue for this - then you should use such a review, and not a paper that argues the exact opposite of what you are stating. The former is acceptable, the latter is not. --Kim D. Petersen 23:25, 15 July 2017 (UTC)

You say "If the Farsalinos paper had said that the argument was common amongst scientific sources, then you may have had an argument - but they do not." The Farsalinos paper made even a stronger argument than being common. The main arguments can be found here. The word "main" is much strong than just being "common". The main arguments are likely the most common arguments. QuackGuru (talk) 02:17, 16 July 2017 (UTC)

I'm sorry? Can you point me at the place in your particular dictionary, where "main" is a synonym for "scientific"? Also how do you interpret the evidence section of that table to be supportive of your claims? You are grasping for straws now, trying to get us to forget that, you in this case, as in others, have misused this source to support something that is diametrically opposite of the conclusions of the paper! Just as before: Not acceptable. --Kim D. Petersen 11:53, 16 July 2017 (UTC)

The word "main" is a different argument than being scientific. They acknowledged what are the primary arguments for using the precautionary approach. The main arguments are very clear. This means they are the most relevant. QuackGuru (talk) 15:18, 16 July 2017 (UTC)

It matters where the argument is used QG... is it in the scientific sphere (ie. in peer-review) or is it in the public policy debate. As you should know. (and from context it is strongly indicative that the paper is referring to the public policy debate) --Kim D. Petersen 18:02, 16 July 2017 (UTC)

The main arguments are sourced to a review. They did not indicate who made the main arguments. If they are not specific then we can't be specific. QuackGuru (talk) 18:06, 16 July 2017 (UTC)

So what you are saying that every sentence in a review can be quoted, no matter what the context, and no matter whether it completely contradicts the conclusions of the paper? Because the only place that those arguments are sourced, is to this particular review, which gives no indication as to whether these are medical or public health policy arguments. I find it interesting that you, as an experienced editor, can even contemplate such nonsense. --Kim D. Petersen 01:15, 17 July 2017 (UTC)

You say "Because the only place that those arguments are sourced, is to this particular review, which gives no indication as to whether these are medical or public health policy arguments." Do you actually think that review is the only place that those kind of arguments are sourced? One of the main arguments is Safer does not mean absolutely safe. A review found "However, they can hardly be considered harmless."[10] I have read all the reviews on this topic. Shall I continue? QuackGuru (talk) 02:13, 17 July 2017 (UTC)

When making an argument then you need to use reviews that actually argue what you state, and you didn't in the Farsalinos&Le Houesec case. I don't know why you suddenly argue the "safer does not mean absolutely safe", as if any of us disagree with this. All reviews state that there is a risk - the question is whether Risk(vaping)<Risk(smoking), and there the preponderence of reviews are in agreement - even the Pisinger & Døssing review that you cite now, is in agreement that vaping is probably less harmful than smoking (and Pisinger is anti-vaping, as i should know, since i regularly debate her). It is nice that you (also) have read all reviews on this topic - but that is quite obviously from this discussion, not a guard against you misusing sources. --Kim D. Petersen 04:36, 17 July 2017 (UTC)

The reviews found "Based on 76 studies, ECs cannot be regarded as safe, even though they probably are less harmful than CCs."[11] This confirms from review to review that vaping is not considered safer than smoking. They use words such as "may", "likely", or "probably" and so on. It is not pro versus anti. It is maintaining a Neutral Point Of View. This means vaping is not safe (according to Pisinger). QuackGuru (talk) 16:24, 17 July 2017 (UTC)

Of course we shouldn't say or indicate that vaping is without risk. No sources say that. What we must do, is state that the risk is lower than cigarettes - because that is what the preponderance of evidence states. How much lower is another controversy - but that is a bridge we must cross then. --Kim D. Petersen 12:59, 15 July 2017 (UTC)

You say "What we must do, is state that the risk is lower than cigarettes - because that is what the preponderance of evidence states." But there is also evidence that e-cigarettes "with higher voltages and can release carcinogens, such as formaldehyde, in levels similar to those of conventional tobacco smoke."[12] Asserting that the risk is lower when there are e-cigarettes that can produce carcinogens at levels similar to normal cigarettes appears to go against WP:NPOV. QuackGuru (talk) 15:58, 15 July 2017 (UTC)

Unless you have sources/evidence that claim that the entire risk of cigarettes lies in (for instance) formaldehyde emissions - then you are wrong (as simple as that). What the preponderence of sources say, is that there is less risk from vaping than from smoking - but not that there is no risk at all. One of the risks that still are there are things like formaldehyde levels and others - but that is only a small part of the risk-envelope for cigarettes. The major risk factor in smoking is from what is popularily called "tar", and that part is completely missing from vaping. Other smaller factors are aldehydes etc. but in most cases these are found at significantly lower levels in vaping. To repeat: the preponderence of sources state that there is less risk from vaping, but that it is not risk-free.

But show me wrong: Find reviews that state that e-cigarettes are just as (or more) harmfull than cigarettes. --Kim D. Petersen 17:47, 15 July 2017 (UTC)

A review stated "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[13] They don't assert it is safer. They are being neutral. There are many things we just don't know yet. For example, "The short- and long-term effects of e-cigarette use are still unclear, but their use is increasing."[14] QuackGuru (talk) 20:18, 15 July 2017 (UTC)

Do you understand what WP:WEIGHT means? One paper stating "may" does not change that the preponderence of sources state that vaping is less harmful than smoking. (nb. the paper that you quoted here, was in the context of surgery and not general, and it also states in the conclusion "Other than the vasoconstrictive effects of nicotine, e-cigarettes are likely safer than smoking traditional cigarettes before and after otologic surgery." - please stop cherry-picking!). --Kim D. Petersen 23:38, 15 July 2017 (UTC)

The part "likely safer" does not mean they are safer. See "The rapid acceptance of electronic cigarettes may be attributed in part to the perception created by marketing and the popular press that they are safer than combustible cigarettes."[15] What the popular press say and what is reality is very different. A Cochrane review found "The long-term safety of ECs is unknown."[16] This means we don't know if they are safer. QuackGuru (talk) 02:17, 16 July 2017 (UTC)

Context is key QG. Something can be dangerous in the specific situation of surgery, while being absolutely essential for living a healthy life. You cannot use a paper about vaping in the context of surgery, to determine anything about vaping in the general context. Stop it please. --Kim D. Petersen 11:56, 16 July 2017 (UTC)

A paper may be mainly about one thing, but there could be other things there are also relevant. QuackGuru (talk) 15:18, 16 July 2017 (UTC)

No. The Cochrane review you cite is very clear on the relative safety and found that:
"Expert consensus broadly holds that, based on all available evidence, ECs are considerably safer than traditional cigarettes (McNeill 2015; RCP 2016), but further studies are needed to establish their safety profile compared with established smoking cessation aids."[17]
Your shameful agenda is again duly noted.--TMCk (talk) 11:44, 16 July 2017 (UTC)

This is getting ridiculous. Can we please all get acquainted with the idea that "overall safety is uncertain" or "still needs further research" is not incompatible with "less harmful than cigarettes". --Kim D. Petersen 12:08, 16 July 2017 (UTC)

The Cochrane review did not "assert" they are safer. They said it was the "Expert consensus" expressing this view. The "Expert consensus" they are referring to is the UK-centric views. It was the opinion of McNeill 2015 and RCP 2016 to be precise. My ability to be accurate is now noted. QuackGuru (talk) 15:18, 16 July 2017 (UTC)

At a population level it is also unknown according to MEDRS compliant sources. See "Although there is increasing evidence of e-cigarette use among youth and adults, the population health impact of e-cigarettes is unknown."[18] Also see "At this time, data are not sufficient to confirm a long-term benefit for users or a public health benefit for the population at large."[19]. QuackGuru (talk) 17:59, 9 July 2017 (UTC)

it's redundant with (1) "likely to be safer than" and (2) "the long-term health effects are not known... ". What's not clear about in the above if not to overemphasize a viewpoint on this highly controversial topic?Zvi Zig (talk • contribs 20:52, 9 July 2017 (UTC)

One is dealing with overall safety (at the individual and population levels). What follows is looking at the individual level and with respect to one comparator. Doc James (talk · contribs · email) 22:49, 9 July 2017 (UTC)

In plain English, "The health risks of e-cigarettes... " does not refer to indirect population effectsZvi Zig (talk • contribs 00:57, 10 July 2017 (UTC)

Why would it not refer to population level risks? Yes I know the industry want to concentrate on only individual risk but that does not mean we should. Doc James (talk · contribs · email) 03:06, 10 July 2017 (UTC)

The average reader (quite rightly) doesn't understand the statement in relation to population level risks. Imagine the Paracetamol page opening, "The health risks of paracetamol are [adjective]" in relation to the adverse population level effects of suicidal overdose. It certainly would be highly misleading to the normal reader. Here too.

Conversely, "The public health effects of e-cigarettes... " would indeed relate what you mean.

Still, the statement would be go against WP:NPOV. The Royal College of Physicians concluded that "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".

I have am not industry and have no conflicts of interests here. Wikipedia Talk is not a place for innuendo. I'm surprised, User:Doc James. Zvi Zig (talk • contribs 19:43, 10 July 2017 (UTC)

There was no innuendo. I disagree with efforts to downplay positions other than those of the UK. The PHE has even stated that their position is at odds with much of the rest of the world. We should present both which we currently do. Doc James (talk · contribs · email) 19:54, 10 July 2017 (UTC)

I absolutely agree that we must display both sides. Currently, the lead opens with overemphasized blanket uncertainty, which not only is contrary to WP:NPOV in relation to UK, but is an exagerated representation fo the US/WHO position.Zvi Zig (talk • contribs 20:04, 10 July 2017 (UTC)

As long as we are using neutral sources. For example, if one source was shown to be overtly bias such as have direct ties to the Big Tobacco things could rapidly change. See WP:MEDBIAS QuackGuru (talk) 20:11, 10 July 2017 (UTC)

When you have evidence that a source is biased or has ties to industry, then we can open a discussion. Meanwhile, let's stick to the issue: The opening blanket uncertainty in the lead doesn't represent the literature and certainly goes against WP:NPOV. Any valid point the opening statement relates is understood from the subsequent more nuanced statements. Zvi Zig (talk • contribs 20:30, 10 July 2017 (UTC)

See Talk:Electronic cigarette#Represents the literature without bias. QuackGuru (talk) 20:40, 10 July 2017 (UTC)

Again, you evidence that a source is biased or has ties to industry.Zvi Zig (talk • contribs 20:22, 12 July 2017 (UTC)

I continue to cite independent sources, including recent reviews. I do not rely on using mostly UK-centric sources. If there is any disagreement it is from the UK. This means they are most likely the tiny minority. QuackGuru (talk) 20:38, 12 July 2017 (UTC)

The citations I started this section with are not UK. As an aside, PHE and RCP are the only health organizations to have writen such broad comprehensive reports in relation to the public health effects of e-cigarettes (unlike the Surgeon General's Report which only relates to children).Zvi Zig (talk • contribs 22:26, 12 July 2017 (UTC)

The citations you started with are irrelevant to their uncertainty. Both PHE and RCP from the UK hold a minority view in aggressively promoting vaping. QuackGuru (talk) 00:21, 13 July 2017 (UTC)

A review found "Overall, e-cigarettes have the potential to significantly harm the public’s health, with particular concern for the health of adolescents and individuals from certain underserved populations."[20] The UK-centric view is a tiny minority position. QuackGuru (talk) 20:11, 10 July 2017 (UTC)

The same review states explicitely that "A full discussion of the potential for “harm reduction” with e-cigarettes and the balance of their harms versus benefits is beyond the scope of this review;" - and thus cannot be cused to make the dismissal that you are doing here, since it doesn't in any way or form address the issue. We've said this before: Please read reviews entirely, and do not use it to cherry-pick sentences that may or may not support your personal views. --Kim D. Petersen 08:01, 11 July 2017 (UTC)

It is irrelevant whether the "full discussion" of the potential for harm reduction was beyond the scope of the review because it does not dismiss or contradict that the review did find that "Overall, e-cigarettes have the potential to significantly harm the public’s health, with particular concern for the health of adolescents and individuals from certain underserved populations."[21] It may not be a "full discussion" or an "in depth discussion" but regarding its overall potential to greatly harm the public’s health is a fact according to this source. It definitely touched on the issue without having to go into extreme detail. QuackGuru (talk) 14:27, 11 July 2017 (UTC)

Why do you continue to harp on a paper that specifically states that: It doesn't discuss/examine this (at all) because it is outside of the scope of its examination/review. It is a paper about regulation and policy - not about harm. --Kim D. Petersen 14:58, 11 July 2017 (UTC)

It is still a fact according to the source. They did not say there were joking when they stated, that overall, vaping could have the potential for considerable harm to the public's health. QuackGuru (talk) 15:01, 11 July 2017 (UTC)

No, they did not need to say that they were joking - they stated that such an assessment was outside of the scope of the paper, and thus are just relaying whatever non-specialized/non-expert/non-review opinions they have on that topic. And since it is specified as outside of the scope of the paper, this view is not reliable. --Kim D. Petersen 17:42, 11 July 2017 (UTC)

They did not say that specific statement was outside of the scope of the paper. They did not say it for no reason. Not having a "full discussion" is different than having a brief mention. QuackGuru (talk) 19:32, 11 July 2017 (UTC)

Yes they did, QuackGuru. Kim quoted the exact sentence where they said that. Stop misrepresenting sources to support your POV.--Fahrenheit666 (talk) 04:47, 8 August 2017 (UTC)

No they did not. They did not say that exact statement was not within the scope of the paper. If it was outside the scope of the paper they would not have said it. No editor quoted anything to show that sentence was outside the scope of the paper. They mentioned they did not have a full discussion. But they still had a brief discussion. QuackGuru (talk) 13:30, 8 August 2017 (UTC)

How many times have you been told to stop obsessively analyzing the meaning of individual words? They said it's outside the scope of the paper.--Fahrenheit666 (talk) 09:13, 9 August 2017 (UTC)

Where did it say that particular statement is outside the scope of the paper? QuackGuru (talk) 10:26, 9 August 2017 (UTC)

See, this is exactly what I mean. You're not a lawyer, QuackGuru. Stop playing linguistic games to distort the sources.--Fahrenheit666 (talk) 20:21, 9 August 2017 (UTC)

What sources did I distort? I can improve the wording and add more content if that what it takes. QuackGuru (talk) 00:30, 10 August 2017 (UTC)

The part about its health effects being uncertain is different than comparing its safety to normal cigarettes. QuackGuru (talk) 01:29, 10 July 2017 (UTC)

Represents the literature without bias

See "Significant uncertainty exists about e-cigarette safety and efficacy, rendering patient discussions about these devices challenging."[22]

See "These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking." See "Although research has improved our understanding of e-cigarettes since these initial 2011 recommendations, safety and efficacy remains uncertain."[23]

See "The USPSTF concludes that the current evidence on the use of ENDS for conventional smoking cessation is insufficient. Evidence is lacking and conflicting, and the balance of benefits and harms cannot be determined."[24] It does represent the literature used using WP:MEDRS sources. QuackGuru (talk) 20:40, 10 July 2017 (UTC)

Those are all old papers. Stop searching for words you can cherry-pick to manufacture doubt.--Fahrenheit666 (talk) 06:04, 6 August 2017 (UTC)

Those are recent MEDRS compliant sources. I can't say the same thing about this source. QuackGuru (talk) 17:01, 6 August 2017 (UTC)

AGF

QuackGuru, can you maybe confine yourself to making constructive edits instead of leaving accusatory edit summaries like "WP:MEDRS violation used to argue against reviews?" You and a couple of others are making this article pretty damn unpleasant to work on. Stop it.--Fahrenheit666 (talk) 22:32, 6 August 2017 (UTC)

See WP:MEDRS. Why did you add a study (PMID 28778971) to the article? QuackGuru (talk) 13:30, 8 August 2017 (UTC)

I added a study because it's relevant. MEDRS says studies should not be used to contradict a review; it does NOT say studies can't be used at all. Stop twisting the rules to suit your POV.--Fahrenheit666 (talk) 09:14, 9 August 2017 (UTC)

See Safety of electronic cigarettes: "The IARC has categorized formaldehyde as a human carcinogen, and acetaldehyde is categorized as a potential carcinogenic to humans.[22]" and see "Later-generation e-cigarettes used with higher power may generate equal or higher levels of formaldehyde than compared to smoking.[14]" It appears you used a study that is arguing against reviews. It is also a violation of WP:SYNC. QuackGuru (talk) 10:26, 9 August 2017 (UTC)

But the formaldehyde claim has been debunked endlessly. It's based on complete ignorance of how the devices are used. It's ridiculous that you're still spouting it.--Fahrenheit666 (talk) 20:19, 9 August 2017 (UTC)

See "In addition, larger commercially available devices known as tanks can operate with higher voltages and can release carcinogens, such as formaldehyde, in levels similar to those of conventional tobacco smoke."[25] They did not mention anything about "debunked". It is far more than formaldehyde that is suspected of causing cancer. See "Known and suspected carcinogens, such as formaldehyde, acetaldehyde, and acrolein, are generated when carrier agents, such as propylene glycol or vegetable glycerin, are heated to high temperatures."[26] What about nicotine? "Although nicotine exposure by itself does not cause tumors, it has been shown to promote tumor growth and metastasis."[27] QuackGuru (talk) 00:30, 10 August 2017 (UTC)

Fahrenheit666, the original analysis of the data makes it a primary source. Also, did you read WP:SYNC? Synchronization is a good thing. QuackGuru (talk) 23:06, 17 August 2017 (UTC)

Cancer potential seems to be a meta-analysis

I noted that Jytdog removed this study with the statement that "we don't use primary sources from the biomedical literature"[28]. And that seems to be correct, except that from a read of the paper, it seems to be a Meta-analysis, which as far as i can read from WP:MEDRS is considered secondary source, and would be considered as highly regarded. Discussion? --Kim D. Petersen 22:14, 16 August 2017 (UTC)

See "This study aims to (1) derive a procedure that overcomes the problem of incompatible emissions data sets, (2) reduce the information on carcinogenic risk represented by multiple individual compounds to a single latent variable (potency) that reflects the cancer risk and (3) calculate cancer potencies from published emissions data and compare various nicotine product risks by factoring in exposure estimates."[29] Also read "The conclusions of this study refer only to the chemical risks of cancer and do not account for any other carcinogenic effects such as those attributable to small particle sizes."[30] QuackGuru (talk) 22:42, 16 August 2017 (UTC)

well no, this is nor your typical meta-analysis, where say you collect data from clinical trials to study the use of X to treat Y, lump it, and run numbers on it to find out how good X is at treating Y. A straight line.

In this paper they did start with data published by others (so similar as far as that goes) then they a) converted this data to "common units", and then they b) took data from yet elsewhere about risk of cancer, and then c) used both to calculate lifetime cancer risk. So they came up with a whole new thing, using published data from elsewhere. A primary source. Jytdog (talk) 23:24, 16 August 2017 (UTC)

In effect what you are saying is that the methodology is the primary issue, because it hasn't been used by others before. Had the method been used before, then this would be a classic meta-analysis - right? --Kim D. Petersen 01:24, 17 August 2017 (UTC)

No, that is not what i am saying. It is primary research, not a meta-analysis. Jytdog (talk) 03:51, 17 August 2017 (UTC)

Please reread what i wrote. I didn't dispute that it was primary research, i was trying to understand which part of the paper is considered primary, for future reference. Especially considering that the paper almost by definition follows what the Meta analysis article states. --Kim D. Petersen 17:57, 17 August 2017 (UTC)

I read what you wrote and have reread what you wrote. Jytdog (talk) 18:16, 17 August 2017 (UTC)

Then i fail to see anything other than the (apparently) novel methodoly that discards it from being a meta-analysis. They collate and analyse data from other papers, and normalize it, and present it with regards to a single factor. The conclusion is not novel, nor is there any original research being done (excepting the possible novel method). What exactly makes it a primary source, if it is not the methodology? Meta-analysis is more than collecting data from clinical trials and figuring out the best treatment. --Kim D. Petersen 21:55, 17 August 2017 (UTC)

I understand that you don't see the difference. No point repeating myself. Jytdog (talk) 00:29, 18 August 2017 (UTC)

Except that you haven't explained it. Could you please? It might be helpful, if you perhaps reworded your explanation? --Kim D. Petersen 02:39, 18 August 2017 (UTC)

It may be helpful, if you could explain how this study differs with regards to the description in our Meta analysis article, or this paper[31] --Kim D. Petersen 02:44, 18 August 2017 (UTC)

Because they lump datasets and analyze the lumped data, you think it is a meta-analysis. I don't agree. It is definitely data-crunching, sure. Not all data crunching is meta-analysis. People do this kind of stuff all the time. Jytdog (talk) 03:45, 18 August 2017 (UTC)

Ordering of sections

I feel that it makes much more sense putting the construction/design section early in the article. I moved the section up to improve readability, but it has been moved down again. It seems to me that the article is harder to understand if it starts detailing the use of an item before describing what it actually is.Cnbrb (talk) 21:34, 15 August 2017 (UTC)

I think the uses should be first and the health effects second. Construction and design can come after that. Doc James (talk · contribs · email) 21:25, 16 August 2017 (UTC)

Yes, definitely health effects should come after usage. It just seems to me to be an inverted way of describing something, to discuss its uses before actually describing what it is. Just an observation, but the article suffers dreadfully from readability issues; I really think any effort to sort the information into a more intuitive order would help the average reader considerably. There's probably a MOS guideline on this somewhere but I can't find anything relevant to illustrate the point. Cnbrb (talk) 23:56, 16 August 2017 (UTC)

See Talk:Electronic cigarette/Archive 22#Ordering of sections and see WP:MEDMOS. QuackGuru (talk) 00:25, 17 August 2017 (UTC)

Wow! Thanks for pointing that out. It never ceases to amaze me how the simplest things become incredibly contentious on Wikipedia! I'll not bother making any more contributions to this article because it looks like more trouble than it's worth. I will add the comment, though, that the bewildering discussion above seemed to give a lot of support to the Construction, Usage, Health effects order, which I completely agree with. But I guess we're stuck with a counter-intuitive taxonomy and awkward prose pockmarked by the bullet holes of ancient edit wars. :-( Cnbrb (talk) 10:59, 18 August 2017 (UTC)

It comes, unfortunately, from the absurd perception of Electronic cigarette as primarily a health article, which makes little more sense than treating (say) Sugar as a health article, but as you say it seems to be what we're stuck with... Barnabypage (talk) 13:27, 18 August 2017 (UTC)

Oh dear! All I can offer is my sympathies. Best of luck editing the article! Cnbrb (talk) 13:29, 18 August 2017 (UTC)

New paper concerning "Gatewaytheory"

To whom it may concern: Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015–2017 by L. Bauld et al.

An analysis of 5 studies provides evidence that e-cigarettes are not a "Gatewaydrug". Across the 5 surveys, regular use by young people who had never smoked was <0.5%. On account of the edit war of multiple editors of "Electronic Cigarette" in the distant and in particular over the recent past, I'm not going to insert this study. Sombody with some good background in editing (and a better knowledge of the English language than me) should take care of this.--90.187.11.237 (talk) 10:17, 30 August 2017 (UTC)

Tar and carbon monoxide

Why isn't mentioned in the article that by vaping you don't get tar and carbon monoxide in your lungs (which is widely known and easy to prove)? – Wayfarer (talk) 08:27, 13 September 2017 (UTC)

Here, I have immediately found a source when I searched: Let's Not Make The Same Mistake Twice" – Wayfarer (talk) 01:51, 15 September 2017 (UTC)

Unfortunately that source is not sufficiently reliable to be used on Wikipedia. The information is correct though, but we need to find a reliable source that can verify it. Something like this would be more reliable. --Kim D. Petersen 02:33, 15 September 2017 (UTC)

Aha, okay thanks much for reviewing it. – Wayfarer (talk) 13:17, 15 September 2017 (UTC)

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Typo

In:

===Positions of medical organizations===

Others medical organizations, primarily in the US, feel...

—109.145.91.249 (talk) 11:46, 11 September 2017 (UTC)

 Not done - introduction of a grammatical error. DrStrauss talk 14:54, 12 September 2017 (UTC)

 Done - See here. QuackGuru (talk) 17:31, 24 September 2017 (UTC)

Re: Link to full paper of "Overview of Electronic Nicotine Delivery Systems: A Systematic Review"

Jytdog reverted here, with the comment "WP:ELNEVER. NEVER DO THAT." - but it seems that Jytdog hasn't read WP:ELNEVER, since that link is specifically excluded from ELNEVER, by:

• ... External links to websites that display copyrighted works are acceptable as long as the website is manifestly run, maintained or owned by the copyright owner; ...

To verify this go to https://trsknowledge.com/theme/tcorslms/components/headlines/view.php, and find the newsrelease for the paper under the link line ""Overview of Electronic Nicotine Delivery Systems: A Systematic Review" - American Journal of Preventative Medicine", which is where the paperlink came from. And since the copyright is held by the "Tobacco Regulatory Science (TRS) Knowledge Center", thus it is an acceptable link. Further, the copyright notice that Jytdog is referring to, is to the user/reader of the document, not for the link.

Silly thing to get into an editwar over. Instead of discussing it here. May i suggest that Jytdog reinstate the link, so that we provide a service to our readers? --Kim D. Petersen 18:28, 24 September 2017 (UTC)

The link to the journal does not provide the full text. See here. The full text will be available by February. There is no rush. I added the PMC for the full text. QuackGuru (talk) 19:01, 24 September 2017 (UTC)

user:KimDabelsteinPetersen If you want to bet your editing privileges on your analysis of COPYVIO in this instance please feel free to restore the link yourself. Jytdog (talk) 19:14, 24 September 2017 (UTC)

Since i'm not allowed to edit the page, then its not even a possibility. But on further research, the copyright is and the funding was held by the Truth initiative, while TRS knowledge is a part of Westat. I thought TRS was part of TI, but it seems not. On the other hand, all TI's materials are linkable for educational usage. --Kim D. Petersen 20:04, 24 September 2017 (UTC)

But no matter what. WP:ELNEVER is not applicable here, since a site run by Westat is not one that we can have reason to suspect of being copyright enfringers - right? --Kim D. Petersen 21:13, 24 September 2017 (UTC)

Travel and importation question

If anyone happens to know anything about traveling with electronic cigarettes, then please see the question at voy:Wikivoyage:Travellers' pub#Liquid Nicotine. Wikivoyage is a separate WP:SISTER project with some different rules; see voy:Wikivoyage:Welcome, Wikipedians and then please voy:Wikivoyage:Plunge forward to help out! WhatamIdoing (talk) 20:15, 13 November 2017 (UTC)

Semi-protected edit request on 21 January 2018

I am not here to edit, but to suggest that this article be allowed to be updated, or appended to, in order to provide information more closely reflecting current knowledge, rather than current opinion- preconceived or otherwise. Mitcorb (talk) 18:32, 21 January 2018 (UTC) Mitcorb (talk) 18:32, 21 January 2018 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Not done: requests for decreases to the page protection level should be directed to the protecting admin or to Wikipedia:Requests for page protection if the protecting admin is not active or has declined the request. Eggishorn (talk) (contrib) 18:39, 21 January 2018 (UTC)

Citation 11

In the lead it says "The health risks of e-cigarettes are uncertain.[8][9][10]" Citation 10 says "Despite their popularity, little is known about the health effects of e-cigarettes."[32], but it does not explicitly verify the claim. But the previous citation does explicitly verify the claim. Citation "Harrell2014" says "Although research has improved our understanding of e-cigarettes since these initial 2011 recommendations, safety and efficacy remains uncertain." This was previously discussed on the talk page. See Talk:Electronic cigarette/Archive 31#Represents the literature without bias. QuackGuru (talk) 14:02, 18 February 2018 (UTC)

Okay restored the prior one. Doc James (talk · contribs · email) 07:59, 19 February 2018 (UTC)

Quote does not verify the claim

The quote does not verify the claim. It does not verify "When used by non-smokers, e-cigarettes can lead to nicotine addiction, and there is concern that children could start smoking after using e-cigarettes." Could 'start' smoking is different than 'ever use' smoking. See "It is not the same to equate 'ever use' with use, as ever use can mean that someone had just tried an e-cigarette once."[33] QuackGuru (talk) 14:16, 3 February 2018 (UTC)

Source says "For youth and young adults, there is substantial evidence that e-cigarette use increases the risk of ever using combustible tobacco cigarettes."

This definitely supports "there is concern that children could start smoking after using e-cigarettes"

Doc James (talk · contribs · email) 06:15, 18 February 2018 (UTC)

The source does indeed state "For youth and young adults, there is substantial evidence that e-cigarette use increases the risk of ever using combustible tobacco cigarettes."[34]

This definitely does not support "there is concern that children could start smoking after using e-cigarettes" because "substantial evidence" has a very different meaning than "concern"[35] and could 'start' smoking also has a very different meaning than 'ever use' smoking. The other part of the sentence in the lead is "When used by non-smokers, e-cigarettes can lead to nicotine addiction, and...". The same source also does not support this. QuackGuru (talk) 14:02, 18 February 2018 (UTC)

Substantial evidence is close enough to concern

And starting smoking is similar to ever use. So no I disagree.

What "same source"

Source also says "Overall, the evidence suggests that while e-cigarettes might cause youth who use them to transition to use of combustible tobacco products," Which very clearly supports the current wording.

This also supports it "However, young people who begin with e-cigarettes are more likely to transition to combustible cigarette use and become smokers who are at risk to suffer the known health burdens of combustible tobacco cigarettes. " Doc James (talk · contribs · email) 07:48, 19 February 2018 (UTC)

A "concern" has a completely different meaning than "evidence". They are not close in meaning. Also it is not "youth" in general. The WHO source states "children". The other source does not mention children. What the "same source"[36] also states does not support the current wording. There is no need to add another source that fails verification when there is another source that verifies the current entire sentence. Only the WHO 2014 source verifies the following: "...there is concern that children could start smoking after using e-cigarettes." QuackGuru (talk) 14:49, 19 February 2018 (UTC)

You can try a RfC. I disagree. We are to paraphrase which means rewriting in our own words. This means we do more than simple take words and replace them by close synonyms. Doc James (talk · contribs · email) 00:53, 20 February 2018 (UTC)

The issue is not about "We are to paraphrase which means rewriting in our own words." It is about the additional citation failed verification.

I wrote the current claim "....there is concern that children could start smoking after using e-cigarettes.[22]" I am not claiming that part fails verification using the WHO source. Page 6 from WHO July 2014 verifies the claim. The new source[37] added does not verify there is a "concern". See definition of concern. Then see the definition of evidence. They have different meanings and are not close synonyms. QuackGuru (talk) 01:22, 20 February 2018 (UTC)

Yes "evidence" of X, means that there is "concern" of X.

You appear to be insisting that each and every word needs to be a close synonym. We are to write sentences that have similar meaning. That is paraphrasing, not just adjusting single words. Doc James (talk · contribs · email) 02:00, 20 February 2018 (UTC)

Source does not verify claim

See "They are likely safer than tobacco cigarettes but are of unclear effect in relation to other methods of stopping smoking." The source used to verify the claim does not verify "...unclear effect in relation to other methods of stopping smoking."[38] The source is clear with regard to the extent of the evidence. For example, "There is insufficient evidence from randomized controlled trials about the effectiveness of e-cigarettes as cessation aids compared to no treatment or to FDA- approved smoking cessation treatments."[39] There is "insufficient evidence" from RCTs regarding their effectiveness of quitting compared to no treatment or to FDA medicine, according to the source.[40] The part "unclear effect" fails verification and the part "other methods of stopping smoking" is ambiguous and too vague. QuackGuru (talk) 14:02, 18 February 2018 (UTC)

This verifies it beautifully "There is "insufficient evidence" from RCTs regarding their effectiveness of quitting compared to no treatment or to FDA medicine" Doc James (talk · contribs · email) 07:54, 19 February 2018 (UTC)

I stated above "are of unclear effect in relation to other methods of stopping smoking." fails verification and I explained why it fails verification.

The source does not state "There is "insufficient evidence" from RCTs regarding their effectiveness of quitting compared to no treatment or to FDA medicine." But the source verifies this claim.

I wrote "There is insufficient evidence from RCTs regarding their effectiveness of quitting compared to no treatment or to FDA medicine." The part "insufficient evidence" does not mean the evidence is "unclear". It does not verify the current wording. It is not close enough and the current wording is too unclear. QuackGuru (talk) 14:49, 19 February 2018 (UTC)

The source says "There is insufficient evidence from randomized controlled trials about the effectiveness of e-cigarettes as cessation aids compared to no treatment or to FDA approved smoking cessation treatments."

This supports "are of unclear effect in relation to other methods of stopping smoking"

"insufficient evidence" = "unclear effect" Doc James (talk · contribs · email) 02:41, 20 February 2018 (UTC)

That source ALSO verifies the first part of that sentence "They are likely safer than tobacco cigarettes" by saying

"Across a range of studies and outcomes, e-cigarettes appear to pose less risk to an individual than combustible tobacco cigarettes." Doc James (talk · contribs · email) 02:46, 20 February 2018 (UTC)

increase of calls to U.S. poison centers from children drinking liquid, 2014 CDC press release

https://www.cdc.gov/media/releases/2014/p0403-e-cigarette-poison.html

'The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, . . . '

' . . . More than half (51.1 percent) of the calls to poison centers due to e-cigarettes involved young children under age 5, . . . '

' . . . by ingestion, inhalation or absorption through the skin or eyes. . . '

---

then Director of CDC Dr. Tom Frieden basically said, yeah, the nicotine liquid comes in colorful packages and appealing flavors. It's an issue. We touch on this in our article, probably should have more info with more references. Cool Nerd (talk) 20:22, 21 February 2018 (UTC)

Not unreasonable. Doc James (talk · contribs · email) 05:45, 22 February 2018 (UTC)

Like most other aspects of the subject, the 2018 PHE update gives up to date coverage - see above. Johnbod (talk) 11:48, 22 February 2018 (UTC)

Toward the end of our lead, we do say, "A European directive of 2016 set standards for liquids, vaporizers, ingredients and child-proof liquid containers." Cool Nerd (talk) 17:37, 27 February 2018 (UTC)

FWIW - although perhaps not entirely ok for the main Electronic cigarette article - the following recent references may be worth noting here - hope this helps in some way - in any case - Enjoy! :) Drbogdan (talk) 15:57, 7 March 2018 (UTC)

References

References - new PHE 243 page evidence update

A nice fat 243 page evidence update published by Public Health England - executive summary of of the executive summary is that the 2016 findings are reaffirmed with stronger evidence. Not mentioned in the article yet. Many of the refs here now fail MEDRS on age, and can very often be updated using this very strong source, and/or the new American National Academy one, also only used once at present. Johnbod (talk) 14:22, 19 February 2018 (UTC)

We have been discussing the NAP review above. Here is the summary[41] Doc James (talk · contribs · email) 02:42, 20 February 2018 (UTC)

I have inserted a portion from this report with regard to observed youth access and use as well as added the American Cancer Society's new position statement in support of adult use as a means of tobacco harm reduction. PhilEdits (talk) 20:38, 30 March 2018 (UTC)

The lead is a summary of the body and 4 paragraphs is usually the limit. It is recommended that the content is supported by the source presented. The American Cancer Society statement was rewritten and moved to another page. Cutting and pasting content directly from the source is a copyright violation if added to the article or talk page. See WP:COPYVIO. QuackGuru (talk) 04:39, 31 March 2018 (UTC)

increase of calls to U.S. poison centers from children drinking liquid, 2014 CDC press release

https://www.cdc.gov/media/releases/2014/p0403-e-cigarette-poison.html

'The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, . . . '

' . . . More than half (51.1 percent) of the calls to poison centers due to e-cigarettes involved young children under age 5, . . . '

' . . . by ingestion, inhalation or absorption through the skin or eyes. . . '

---

then Director of CDC Dr. Tom Frieden basically said, yeah, the nicotine liquid comes in colorful packages and appealing flavors. It's an issue. We touch on this in our article, probably should have more info with more references. Cool Nerd (talk) 20:22, 21 February 2018 (UTC)

Not unreasonable. Doc James (talk · contribs · email) 05:45, 22 February 2018 (UTC)

Like most other aspects of the subject, the 2018 PHE update gives up to date coverage - see above. Johnbod (talk) 11:48, 22 February 2018 (UTC)

Toward the end of our lead, we do say, "A European directive of 2016 set standards for liquids, vaporizers, ingredients and child-proof liquid containers." Cool Nerd (talk) 17:37, 27 February 2018 (UTC)

FWIW - although perhaps not entirely ok for the main Electronic cigarette article - the following recent references may be worth noting here - hope this helps in some way - in any case - Enjoy! :) Drbogdan (talk) 15:57, 7 March 2018 (UTC)

References

References - new PHE 243 page evidence update

A nice fat 243 page evidence update published by Public Health England - executive summary of of the executive summary is that the 2016 findings are reaffirmed with stronger evidence. Not mentioned in the article yet. Many of the refs here now fail MEDRS on age, and can very often be updated using this very strong source, and/or the new American National Academy one, also only used once at present. Johnbod (talk) 14:22, 19 February 2018 (UTC)

We have been discussing the NAP review above. Here is the summary[42] Doc James (talk · contribs · email) 02:42, 20 February 2018 (UTC)

I have inserted a portion from this report with regard to observed youth access and use as well as added the American Cancer Society's new position statement in support of adult use as a means of tobacco harm reduction. PhilEdits (talk) 20:38, 30 March 2018 (UTC)

The lead is a summary of the body and 4 paragraphs is usually the limit. It is recommended that the content is supported by the source presented. The American Cancer Society statement was rewritten and moved to another page. Cutting and pasting content directly from the source is a copyright violation if added to the article or talk page. See WP:COPYVIO. QuackGuru (talk) 04:39, 31 March 2018 (UTC)

Why does "vaping" redirect to this page?

When I search for vaping I get to this article. Why? — Preceding unsigned comment added by B0ef (talk • contribs) 16:33, 5 April 2018 (UTC)

What were you looking for if it wasn't this? Johnbod (talk) 16:36, 5 April 2018 (UTC)

SYN violation

Combining two sources together is a SYN violation. There are other issues with the wording when it was originally added. QuackGuru (talk) 17:19, 5 April 2018 (UTC)

• Utter rubbish. This is disruptive editing on your part and any more of it will see an Arbcom Enforcement against you.

There is no SYNTH violation here, it is taken directly from the Pharmaceutical Journal source, which is itself based on the PHE source (whether that is linked directly here or not).

Nor is it, as you have falsely claimed, either a verification failure or a copyvio. Andy Dingley (talk) 20:58, 5 April 2018 (UTC)

I have rephrased it - really the ref would be better as the original PHE report, already used. Johnbod (talk) 21:07, 5 April 2018 (UTC)

vocabulary of current ecig/pods/mods/vape gear terms

Advice on vocabulary not included regarding electronic cigarettes/vaping. Is is useful for wiki to offer descriptions of what a Rebuildable Drip Atomizer (RDA) is compared to a Rebuildable Tank Atomizer (RTA), Rebuildable Atomizer (RBA) Rebuildable Drip & Tank Atomizer and as well as what an Atomizer is in general. What about open and closed pod systems?

Would you use a source like Spinfuel, Vaping360 or Vaping.com? ECF is a great resource, but forums are forums. Still new here and seek oversight before oversteeping (pun intended). What depth are you looking for? I may be able to help some.

In a first search I couldn't find anything except for a RED highlighted lack of definition for RTA. Where do you want to place these things category wise within wiki pages of this industry's components? RDA's and refillable pods saw a large increase in sales in 2017. Squonk box mods too, regulated and unregulated. These trends will continue.

I do not know the extent wiki wants to be the resource for this knowledge. One obvious problem is this page does not appear to have been updated at all in 2017 or 2018 except for a few sections. Your direction would be appreciated. Thank you in advance. PhilEdits (talk) 08:48, 6 April 2018 (UTC)

This is mostly true - we prefer to use published sources rather than trade/consumer websites, and there aren't many on this fast-moving field. The kind of medical papers we prefer are often manifestly ignorant or out of date in their brief coverage of the delivery mechanisms (ie the actual ecigs). We don't really aspire to be "the resource for this knowledge", but our coverage should be rather better than it is, but probably mostly in subsidiary articles. Johnbod (talk) 10:30, 6 April 2018 (UTC)

Quack clarification needed

Quack you need to spell out, using English, what your concerns are with these paras you have removed:

The concern that children could start smoking after using e-cigarettes has been shown in England to be less critical, but worth continued observation. The sale of these products to people under age 18 is illegal and should be more closely monitored. What has been found for youth is that some experimentation with these devices among never smokers occurs, but e-cigarettes are attracting very few young people who have never smoked into regular use. E-cigarettes do not appear to be undermining the long-term decline in cigarette smoking in the UK among young people.

The American Cancer Society supports all efforts to stop smoking and in 2018 stated that individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.

Johnbod (talk) 18:15, 5 April 2018 (UTC)

Johnbod where do we put information like this? https://www.nyu.edu/about/news-publications/news/2018/january/do-less-harm--e-cigarettes-a-safer-option-than-smoking.html

PhilEdits (talk) 08:01, 25 April 2018 (UTC)

The first bit is nothing new, really just confirming the British PHE reports. Adding anything at all to this article is extremely difficult while it is in the grip of QuackGuru, who takes the RCT-only position, and is unfriendly to the public health perspective. Unless you are prepared to devote hours a day trying to get him to explain his cryptic edit summaries, and engage in discussion in plain English. He is pretty unresponsive (see section above), and hard to follow when he does respond. At the moment he has essentially driven off other editors from the page, as he has with other pages in the past; there has been very little activity on the article since last September. Eventually he either moves off to edit something else, or gets a topic ban. You might try Tobacco harm reduction for some of it (from the paper when it is published, & other sources for the stuff at the end). That article seems not to have been updated much since 2016, though QG is also active there. Johnbod (talk) 15:15, 25 April 2018 (UTC)

Johnbod I am prepared to continue on this topic and would hope Quack is open to discussions about potential edits perhaps even as my Coach. I'm retired and only have one extremely large volunteer project other than this to devote my 'serious work' efforts. My corporate training should not go to waste, I am confident that if we approach this with an open mind and the mutual goal to update this section to the neutral point of view needed (as it currently reads like a one sided opinion to anyone well informed on the topic). This topic in general is very new, and a cautious approach was wise as we waited for more data to come in. Now that it has started to arrive, the trepidations from the last few years, 2011-2016/7,are proving to be merited in some ways, and prudish/prejudiced in many others. I do recognize the need to further examine the use of certain flavorings in electronic cigarettes, not for their appeal to youth, but for the diacetyl, acetoin and acetyl propionyl harm which are of unknown safe levels. There is one standard for the workplace and another for individuals. DAAP is already present in foods and cigarettes, how do the levels compare. The case of popcorn lung was the only known extreme example that has raised all caution levels, and is far above any known eliquid on the market today. Flavoring companies have gone out of their way to formulate new concentrates that remove (or reduce) these DAAP issues but an industry standard has yet to be established. There is a difference in a diacetyl ingested vs inhaled and more study is needed. I think it is very interesting that even WedMD has a 2015 article which includes a section 'Are E-cigerettes Safe?' and it points out that the dangers are much less hazardous than smoking. The article also clearly states that second hand smoke is less dangerous than cigarettes, for the vaper exhales very little and the device emits none when not being inhales vs 75% of the second hand smoke from a cigarette stemming from the lit cigarette just being held between puffs. WedMD reminded us in 2015 that this is a product for adult smokers, and is not a product for people who do not smoke. More information as you have already pointed out now exists to answer some of the questions raised in this ancient article. They don't even broach youth, for this is not a youth product... the CDC and other agencies have raised this issue and stressed it over the potential health benefits to the millions of people still smoking. What we have failed to address is the lobbying that is being done by the pharmaceutical and tobacco industries to curb vaping- which is eroding their income. Perhaps if they had found more effective methods of putting an end to the cancerous problem of 'analog' cigarettes by offering effective NRT's and stricter laws we would not be here today. Chalk one up for the consumer marketplace. https://www.webmd.com/smoking-cessation/news/20150218/e-cigarette-ingredients#3 . If only WP gave such a balanced overview of the topic. Mrphilip (talk) 09:31, 29 April 2018 (UTC)

You should probably spend some time reading the archives for this talk page (which are archived rather too quickly) to see the previous laps round this track. Johnbod (talk) 13:22, 29 April 2018 (UTC)

References

I see the need for that, issues include warnings going back a number of years and bans from certain topics. I shall try not to be one of those authors.Mrphilip (talk) 09:58, 2 May 2018 (UTC)

Recent changes

Maintenance tags were added to the citations that are not MEDRS compliant. For example, the Mailman School of Public Health source is written by people from the Columbia University. Citing a university for medical content is generally unreliable. Sciencedirect publishes numerous studies. Citing a study for medical content is generally unreliable.

See WP:MEDRS: "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies. Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials."[43]

The WP:LEDE is usually 4 paragraphs for an article of this length. The current 7 paragraphs is way too long. See MOS:LEADLENGTH. The See also section has duplicate links. See WP:OVERLINK.

Sourced content was replaced with failed verification content. For example, The wording was "...and as of 2015 most e-cigarettes are made in China." The date was changed to 2018, but the source is from 2015. There is failed verification content recently added. For example, "The vaping community refers to a traditional cigarette as an analog cigarette.[13]" fails verification. There are other problems with the content recently added. For example, the lede states "Since known carcinogens have been removed from the equation when vaping, scientists are currently examining the amount of heavy metal that might be exhaled." It is unsourced and also incorrect. See "E-liquids and aerosols tested so far contain some toxicants in concentrations much lower than in tobacco smoke and negligible concentrations of carcinogens."[44] The quickest way to fix the recent changes would probably be to apply WP:TNT. QuackGuru (talk) 01:11, 7 May 2018 (UTC)

The Columbia University citation is about a Professor's work and she is a respected academic professional in this field. She is one of the authors of the recent NASM Public Health Consequences of Electronic Cigarettes from January 2018. Dare I call her an expert? She is. The Sciencedirect study is another analysis she has done of other's data from 2010-2015. That makes it a useful secondary look at the original data, cited in the work, you are claiming not to meet WP Medical source standards. I believe you are again over-reaching QuackGuru and if this behavior continues I will report it to WP and seek more than just another warning for you. Mrphilip (talk) 05:26, 7 May 2018 (UTC)

I have:

1) Returned the lead to 4 paragraphs.

2) Trimmed a bunch of primary sources.

3) Moved some stuff to the body

4) This bit is concerning "Whateffects the amount of visible vapor a person exhales depends on the ratio of PG to VG in the e-liquid as well as the amount of airflow provided by the atomizer used. A large cloud does not necessarily have any more harmful properties than a small or imperceivable exhalation from a low wattage e-cigarette. The actual amount of nicotine in the smaller devices can actually exceed that used by most cloud chasers. What is exhaled from the smoker is called mainstream smoke. What is in the mainstream vapor exhaled by the electronic cigarette user is still being studied and varies by device, settings and choice of liquid vaped. " This article is about electronic cigarettes, the source is NOT about the topic in question?

References

5) Than a bunch of stuff was added without any refs at all such as "E-cigaretteswere developed as an alternative for current adult smokers to remove the carcinogenic risks and mortality rates associated with smoking."

6) Were does the source say "E-cigarettes are designed to be used by adults. Laws are in place to prevent youth access and need to be enforced as studies show adolescent use of these products does occur. "

7) What is this "Vapeshops and online vaping dedicated forums are good resources for the current smoker to access."?

8) This source is not suitable https://spinfuel.com/vapers-glossary/ while this source did not support the content it was next to https://hints.cancer.gov/view-questions-topics/question-details.aspx?red=1&qid=1282&PK_Cycle=8

9) This was added without any evidence "This is important to know to ensure the health of others from passive vaping. Since known carcinogens have been removed from the equation when vaping, scientists are currently examining the amount of heavy metal that might be exhaled. Environmental vapor studies need to factor for the real world situation of pollution from traffic and winter heating systems that also contain these heavy metals to properly assess the true public health consequence of vaping"

References

Doc James (talk · contribs · email) 10:39, 8 May 2018 (UTC)

Failed verification

Were does the ref support this

"As of 2018 no one has died from vaping e-liquid."

References

Doc James (talk · contribs · email) 10:47, 8 May 2018 (UTC)

A man did die in May 2018 from vaping e-liquid.[45][46] We should not add content that contradicts reality. QuackGuru (talk) 23:44, 10 May 2018 (UTC)

Then don't claim that he died of vaping. He died of an exploding battery. Andy Dingley (talk) 23:52, 10 May 2018 (UTC)

A man did die in May 2018 from vaping e-liquid after an exploding battery.[47][48] Later this year or early next year there will be a review. For now we should not include content that is known to be patently false. QuackGuru (talk) 23:55, 10 May 2018 (UTC)

Quack: People are dying all the time from eating toast - by that logic. Because a well known cause of fires are electric toasters[49][50]. Please get a sense of reality. --Kim D. Petersen 00:41, 11 May 2018 (UTC)

Are you claiming the sources are incorrect and "As of 2018 no one has died from vaping e-liquid." is correct? This edit added "As of 2018 no one has died from vaping e-liquid." to the article. The editor thinks it is reasonable to include information about vaping and death to this article. The source states, "Shes talking about 38-year-old Tallmadge Wakeman DElia, a long-time neighbor. She was the one to identify him after almost 45% of his body was burned. Lt. Steven Lawrence, a deputy fire marshal for St. Pete Fire & Rescue, believes DElias vape pen exploded and led to his death."[51] The source also states, "An autopsy will determine if the explosion killed D’Elia or if it knocked him unconscious, trapping him inside the fiery room. Investigators are also trying to determine the brand of vape pen he was using."[52] It seems pretty clear a man died after the vaping device exploded. I'm sure a review will eventually mention it. Of course, I will wait for a review. People don't use electric toasters to obtain nicotine, but Wikipedia's Toaster article has specific information about death and fires.[53] People are vaping as an alternative to conventional cigarettes. I never heard of a conventional cigarette exploding while being used. This means there is a risk to vaping that is not present while smoking. Again, the details can be summarised when there is a review. QuackGuru (talk) 02:34, 11 May 2018 (UTC)

I expect that you would claim that someone who was in a traffic accident while being a vapor would be the same as "dead from vaping e-liquid" --Kim D. Petersen 16:27, 11 May 2018 (UTC)Nb: Can you give a comparison between the number of deaths from fires caused by vaping vs. smoking - preferrably normalized in comparison with their percentage in the general population. --Kim D. Petersen 16:31, 11 May 2018 (UTC)

More serious: A noted in the article about Toasters - the death is caused by the toaster, not by the toast. And that is where your mistake is buried. --Kim D. Petersen 16:33, 11 May 2018 (UTC)

The exact cause of death is uncertain at this time. The man could of died from the initial e-cigarette explosion or it could of rendered him unconscious and he was burned alive. See "An autopsy will be conducted to determine the official cause of death."[54] A 2018 or 2019 review or MEDRS compliant source will likely discuss what is or is not important when it becomes available. If a review or MEDRS compliant source compares vaping vs. smoking regarding death we can also make that comparison. QuackGuru (talk) 18:18, 11 May 2018 (UTC)

Cloud chasing characterized as dangerous

In the section discussing cloud chasing, the practice of using low-ohm coils is described as dangerous and stressful to batteries. The article does not mention that this is only true for mechanical ("mech") mods. The majority of users now use regulated mods, which have circuits to specifically protect against these hazards. Failing to make this distinction is unfairly disparaging to vaping users and implies that the practice is inherently dangerous, when, in fact, the majority of modern mods are free from this hazard.

At the very least, it should be clarified that this only applies to mechanical mods, lacking safeguards. — Preceding unsigned comment added by 119.175.142.252 (talk) 17:51, 29 May 2018 (UTC)

Do you have a source that states "this only applies to mechanical mods, lacking safeguards"? QuackGuru (talk) 18:00, 29 May 2018 (UTC)

Reference 97 mentions that regulated devices incorporate protection against over-amperage conditions. Numerous other references can be found on the Net, as this is the whole purpose of regulated mods in general.

It does not mention cloud-chasing. It is better to use sources that pertain to cloud-chasing and regulated mods. QuackGuru (talk) 19:26, 17 June 2018 (UTC)

No mention of NAS report?

The National Academy of Sciences of the US recently (this January) released a report on e-cigarettes that should definitely be incorporated into this article. PubMed Page on NAS website Really, I'm quite surprised it was not cited in the article at all already AFAICT. Everymorning talk to me 16:26, 24 June 2018 (UTC)

Indeed - the report is on the whole favourable to e-cigs, which rather explains why it has not been added after 6 months! If it had been critical it would have appeared in a shot. To me, it also highlights the difference that has been increasingly evident for some years in terms of usage by youth - apparently relatively high in the US but low in the UK (and I suspect other parts of Europe). It would be good to find MEDRS that address this difference directly. Johnbod (talk) 16:48, 24 June 2018 (UTC)

No mention of NAS report? The citation was added to the article. See Talk:Electronic cigarette/Archive 31#Quote does not verify the claim and see Talk:Electronic cigarette/Archive 31#Source does not verify claim. The citation is being used twice in the lead. It is not used in the body. That suggests the content added to the lead is violating a summary of the body because it is not used in the body. QuackGuru (talk) 21:32, 24 June 2018 (UTC)

Update tag

It is correct this article needs updating. I counted well over a 100 MEDRS-compliant sources missing from the article. Even recent sources such as National Academy of Sciences are not discussed in detail in the body. QuackGuru (talk) 14:54, 25 July 2018 (UTC)

Supported by lots of sources from the last 5 years...

Sure some of it can be updated. But we could tag every article on Wikipedia if this were the criteria. Have things significantly changed? Doc James (talk · contribs · email) 09:46, 26 July 2018 (UTC)

Image

Adverse effects of vaping.

This image is supported by a bunch of references. Doc James (talk · contribs · email) 09:46, 26 July 2018 (UTC)

I agree the image is supported by references. BUT there is a larger problem with it, and that is that it basically is WP:OR, since it is a synthesis of sources, that is not weighted by severity, prevalence or any other measure that i can determine.

Some of the adverse effects are not even coming from vaping, but are instead from the device, and coincidentally in the <1:1,000,000 scale.

So there is significant problems with the image, and it really shouldn't be here. --Kim D. Petersen 10:27, 26 July 2018 (UTC)

You can improve the imagine by adding prevalence were it is know. Doc James (talk · contribs · email) 17:11, 26 July 2018 (UTC)

So, let me get this straight. You are saying that adding more WP:OR makes it more acceptable???? --Kim D. Petersen 09:38, 27 July 2018 (UTC)

References

Claims are sourced

Entries

• Brain:

• Addiction

• Eyes:

• Eye irritation and blurry vision
• Corneoscleral lacerations or ocular burns after e-cigarette explosion

• Airways:

• Irritation and cough
• Increased airway resistance
• Irritation of the pharynx

• Stomach:

• Nausea and vomiting
• Abdominal pain

• Heart and circulation:

• Chest pain
• Increased blood pressure
• Increased heart rate

Mortality:

• Death after e-cigarette explosion (small risk)

References

Each claim for the adverse effects diagram which links to here is sourced using only MEDRS-compliant sources. There are multiple sources that verify each claim. QuackGuru (talk) 14:54, 25 July 2018 (UTC)

Since you seem not to understand why this is a WP:SYN, let me quote: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources". The picture is a stand-alone entry, as opposed to articles, and thus there is no possibility of explanation, and presenting a neutral discussion on the things it presents. And thus it is even more important that it presents a clear (pun unintended) picture of what it presents, and this one doesn't.

For original pictures, to wikipedia, such as this one. There is an out in WP:OI: Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments. But this image fails this, by presenting an overview that has not been published! --Kim D. Petersen 15:00, 27 July 2018 (UTC)

It even cites case-reports - which even fails WP:MEDRS, despite your claims to the opposite - not all sources are created equal! The Death claim is not even supported by its reference (which is a collection of case-reports), the mortality it was referring to was from a fire caused by oxygen equipment close by. -- Kim D. Petersen 15:23, 27 July 2018 (UTC)

Sources are not being combined to reach a new conclusion. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

See WP:OI: "Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments, the core reason behind the NOR policy." This image passed OR because there is no original research. The image would have too much detail if every detail was explained in the image. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

You are aware that synthesis is WP:OR right? Thus there is OR there. Where is that list of adverse effects published? --Kim D. Petersen 21:56, 27 July 2018 (UTC)

The specific detailed list of the adverse effects are at Safety of electronic cigarettes#Adverse effects. The list itself does not need to be published in a source because each entry is supported by each source. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image? --Kim D. Petersen 23:46, 27 July 2018 (UTC)

See "The media have reported a number of EC explosions where individuals suffered burns, lost teeth and/or palate trauma, neck fractures, and battery acid exposure to the face, mouth, and eyes6,7; moreover, one user died when his charging EC exploded and ignited adjacent oxygen equipment.8"[55] Also see "Although the number of serious adverse events is small compared with the number of EC users worldwide, the consequences may be devastating to those involved in an EC-related blast."[56] The content in the image is supported by the source presented. When the image was being created there was a discussion. It was decided to include general information. The image states "- Wounds and burns in case of e-cigarette explosion". There are newer sources that verify the content in the image.[57][58] Again, the details go in an article instead of overcrowding an image. If anyone wants more detailed information in the body of the Safety of electronic cigarettes article I can add more detailed information. Just leave a note on the talk page of that article and let me know what you want summarised. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

Write about it in an article, where it can be described in a WP:NPOV way, where it is possible to explain that this is an extremely rare event, and not something that you even can expect from e-cigarettes in general. --Kim D. Petersen 22:04, 27 July 2018 (UTC)

It not something that a user would expect from vaping. That's what makes it relevant to add to an image. Editors can start working on a dedicated image for e-cig blasts and death when more sources are available. A new image may or may not include the rarity part. It depends on what the sources say and what editors decide at that time. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Who choses what is relevant for the image? You? Can you spell WP:POV. Wikipedia uses WP:WEIGHT, not POV to determine whether something should go in or not. Does the prevalence of WP:MEDRS sources on adverse effects have death as a credible adverse effect? --Kim D. Petersen 23:42, 27 July 2018 (UTC)

There is no issue with it, and there is no WP:OR, since there is no synthesis by editors. The image is a basic overview. It is not meant to go into extreme detail. There are adverse effects that are also coming from the device itself. That means the image is covering a variety of adverse affects. Therefore, there is no real problems with the image, and it really should remain in the article. QuackGuru (talk) 14:10, 26 July 2018 (UTC)

Of course there is an issue - you cannot just dump sources together and get a comprehensive picture. That is the essence of WP:SYN. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

Sources are not being dumped together. Each claim is supported by each source. Therefore, there is no SYN. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

Each claim is supported - yes. But the compilation and the choises of what to add and not to add is done by an editor - and it is not copied or found in any other source - thus it is WP:OR: An original list of adverse effects not published as such elsewhere. --Kim D. Petersen 22:01, 27 July 2018 (UTC)

It is not a list that is coming to a new conclusion - thus it can't be construed as OR. There is a compilation of entries but it was determined that this image can't include too much detail. If there are other entries about the adverse effects that are missing then please share that with me. I don't think an entry was intentionally excluded from the list except for the part about death. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Even assuming that i bought your argument... you would still have to fight with WP:NPOV, since it is quite obvious that the adverse effects were picked not for their prevalence in the literature, but instead by some editors personal opinion on what should be there. Still not good. Now we are even more into WP:POV territory. --Kim D. Petersen 23:38, 27 July 2018 (UTC)

Adding low level details where prevalence is known would not improve the image. That kind of detail belongs in the body of the Safety of electronic cigarettes article with a 4 paragraph summary here in accordance with WP:SYNC. QuackGuru (talk) 19:33, 26 July 2018 (UTC)

A picture needs to follow our WP:POLICIES as well - and this is pure WP:SYN. The picture conflates the extremely rare with the rare, it conflates serious with non-serious adverse effects. It even adds issues that have only been mentioned in an individual source. Basically it is a WP:POV collection someone created by cherry-picking sources => WP:SYN. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

The image follows policies and it uses quality sources rather than individual articles. If there is an issue with a particular source then it can be replaced with a newer source that verifies the same content. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

No. The image fails WP:SYN - since it describes a original list of adverse effects, not published in any sources before. --Kim D. Petersen 22:06, 27 July 2018 (UTC)

The image passes WP:Verifiability - since it describes a general list of adverse effects, where each claim is published in a source. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

WP:V is not the only policy that needs to be adhered to. WP:SYN also needs to be followed, and it isn't. --Kim D. Petersen 23:34, 27 July 2018 (UTC)

No editor is suggesting to add more WP:OR to the image to make it more acceptable and no editor has shown there is WP:OR in the image. KimDabelsteinPetersen, what is the OR? Please keep in mind the image is meant to be a very basic overview. The Safety of electronic cigarettes article contains the details. QuackGuru (talk) 14:02, 27 July 2018 (UTC)

Why are you writing this here? The discussion is below. And Yes, someone is suggesting that: Adding more cherry-picks to an already WP:OR collection, doesn't make it less WP:OR. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

I started this thread first and the discussion was here first. Using MEDRS compliant sources is not cherry-picking and no evidence of WP:OR has been presented. If a better source is found then we can use a better source. There are other sources that can verify each claim. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

You may have started this thread first - but the discussion was in another thread. As for the rest: The adverse effects are cherry-picked, since it did not include everything from all sources, and included some from sources that aren't even WP:MEDRS compliant. To summarize: Some adverse effects glanced from a variety of sources, not supported by all sources and no source contains a similar list => WP:SYN. --Kim D. Petersen 22:10, 27 July 2018 (UTC)

Another of the adverse effects (blurry vision) is taken from a review where it is even stated that it is from a single paper, where "the extent to which these effects were attributable to ECIG use was unclear" ... And some of the more common (and better supported) adverse effects (in this review) aren't in the image..... So basically a very clear cherry-pick. --Kim D. Petersen 22:22, 27 July 2018 (UTC)

You said "some of the more common (and better supported) adverse effects (in this review) aren't in the image..... So basically a very clear cherry-pick." Please share what was the more common adverse effects that are missing from the image from the review. More information can be added to the image as long as it is basic information. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

The adverse effects are not cherry-picked. It is impossible to include everything from all sources in an image. It is possible to include almost everything in the Safety of electronic cigarettes article. The image is a general list that includes an overview of the adverse effects. If you want a better source for any entry then you can update the list or ask me which one you want updated. In summary: The list is a basic overview of the adverse effects from various sources, which are supported by each source presented. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Which is basically the same as saying: Yes! it is WP:SYN. Cherry-picked from various sources, as the list that the image-creater wanted to present WP:POV. --Kim D. Petersen 23:29, 27 July 2018 (UTC)

I previously said "Please share what was the more common adverse effects that are missing from the image from the review."

You recently said "Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image?" What is missing? QuackGuru (talk) 00:02, 28 July 2018 (UTC)

How would that solve the WP:SYN issue? Or any of the many other issues with this image? --Kim D. Petersen 02:25, 31 July 2018 (UTC)

Each entry is sourced using at least one source. There is no combining of sources or statements. Therefore, there is no SYN issue. It would help solve the accusation it is a cherry picked list. If you don't tell me what is missing from the list then I don't know what is missing or maybe nothing important is missing from the NPOV collection. We can't turn the image into a detailed paragraph and explain almost everything. But I will explain almost everything in the Safety of electronic cigarettes article.

You previously said "Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image?" Please tell me what is missing from the image. QuackGuru (talk) 02:49, 31 July 2018 (UTC)

You are just repeating what makes this WP:SYN. From your argument anyone can create an image that presents a synthesis of sources to present a unique combination, without having to present them according to WP:WEIGHT. Purely according to the image creator's WP:POV. Something that he/she wouldn't be able to do in article text. And of course they can't. Which is why this image is WP:SYN. --Kim D. Petersen 03:18, 31 July 2018 (UTC)

See WP:SYN: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources." Each entry is explicitly sourced to each source. For example, see "Less serious adverse events include throat and mouth irritation, cough, nausea, and vomiting."[59] That supports 4 entries (irritation, cough, nausea, and vomiting) in the image. Presenting a unique combination of entries is not a SYN violation. I repeatedly asked you what is missing from the image. QuackGuru (talk) 16:15, 31 July 2018 (UTC)

I think you need to become more familiar with other areas of wikipedia. Since you do not seem to understand what WP:SYN is. The picture is doing exactly that: presenting a conclusion that is not explicitly stated by any of the sources. - that individual items can be referenced to individual sources and that these individual items are combined into a single conclusion is the WP:SYN. No source has this particular conclusion! --Kim D. Petersen 00:28, 1 August 2018 (UTC)

Each source has its own specific conclusion. The individual entries are not combined into a single conclusion. Each entry is its own conclusion and each entry is supported by each source presented. For example, a 2014 review found "Less severe adverse events included sore throat, abdominal pain, headache, blurry vision, cough, and nausea/vomiting."[60] That review is being used to verify under Stomach the word "- Pain". That is a single conclusion and is not being combined with other entries to come to a new single conclusion. QuackGuru (talk) 01:07, 1 August 2018 (UTC)

Semi-protected edit request on 17 August 2018

Addition of paragraph to the 'Health Effects > Safety' heading of the article:

Existing: A 2014 review recommended that e-cigarettes should be regulated for consumer safety.[133] There is limited information available on the environmental issues around production, use, and disposal of e-cigarettes that use cartridges.[155]

Add following in new paragraph: A report published in 2018 in the journal Thorax highlighted important concerns regarding the impacts to human health caused by e-cigarettes. The report highlighted how macrophages, a white blood cell, were negatively impacted by e-cigarette vapor in a similar way to that caused by regular tobacco smoke. E-cigarette vapor caused the release of chemicals from the cells that cause inflammation and potential damage to surrounding tissues, and increased the amount of cell death in a dose-dependent manner. The study also showed how nicotine-containing e-cigarette fluid is more damaging than nicotine-free fluid.

Reference: Scott A, Lugg ST, Aldridge K, et al Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages Thorax Published Online First: 13 August 2018. doi: 10.1136/thoraxjnl-2018-211663 Lesadmick (talk) 08:39, 17 August 2018 (UTC)

The source is a primary source. See WP:MEDRS. QuackGuru (talk) 15:57, 17 August 2018 (UTC)

There is no ban on using primary sources, just that the information may later change - feel free to highlight the preliminary nature of the result, but it is still relevant to the safety discussion. Lesadmick (talk) 08:43, 20 August 2018 (UTC)

 Not done: If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.  spintendo  05:37, 31 August 2018 (UTC)

Spinfuel

Wondering peoples thoughts on this source?

http://spinfuel.com/all-about-temperature-control/

Doc James (talk · contribs · email) 10:02, 15 October 2018 (UTC)

this source has already been used in this article see reference number 91

We should be asking the same question about a page like this with is fairly cut and dry but filled with information the average person will find in few other places. https://vaping360.com/vaping-101/

Few mass media outlets, reference books and non-academic sources exist for all things electronic cigarette related regarding the technical information an average person interested in the topic might have. https://spinfuel.com/about/ is an established website to look to for vaping basics and more advanced information as well as original editorial reviewing products as they are released in addition to news related to the industry. Mrphilip (talk) 11:36, 15 October 2018 (UTC)

There's a discussion at Wikipedia:Reliable sources/Noticeboard#Spinfuel. I'll comment there; that seems a more centralized location for a discussion of the quality of spinfuel.com. Huon (talk) 17:38, 15 October 2018 (UTC)

Can EC article be improved with this 2017 book?

Request for other editors input and suggestions as how and where it may be of use as information resource.

Analytical Assessment of e-Cigarettes From Contents to Chemical and Particle Exposure Profiles Published • 2017 Mrphilip (talk) 06:20, 27 October 2018 (UTC)

Poison Control Concerns, Pediatric and Adult

I do not want to mishandle the information available and ask others to review these two sources of pertinent data.

I believe this article should note the 2016 Poison Control Center numbers (next update comes out in a month so if not these numbers, we can use 2017's) on tobacco/nicotine/e-cigarette products as a single poison category and in comparison to the issue of poison control calls as a whole (transparent perspective, not alarmist editing).

There where 2,159,032 calls about human exposures in 2016. 46.4% where kids 5 and under. Changes in the number of calls between 2000 and 2016 have put this category on the list of 25 most significantly relevant substances. Of the 1,045,339 reported pediatric exposures 1.17% fall under this category representing 11,358 single substance exposures. Serious exposures have been increasing at the rate of about 11 calls a year.

We should note that after breaking this category down and only looking at electronic cigarettes and liquid nicotine the numbers are significantly lower. Such calls started to come in the 2011 and are available through September 30, 2018. In 2013 there were 1,543 calls, 2014 a spike to 4,023 then dropping to 2,478 in 2017 and so far this year 2,226.

Given this information, I think it is clear that tobacco cigarettes comprise the bulk of poison center calls.

How should we present this properly? If 46% of poison calls were pediatric in 2016 and we know those 11,358 were categorized as tobacco/nicotine/e-cigarette are we misrepresenting the issue if we fail to include that specifically 2,907 calls identified e-cigarette and liquid nicotine as the substance exposure... or an estimated 1,337 pediatric exposures. What percent of the 2,159,032 total calls does this articles topic prove to be. Would that number be significant enough to include on the top 25 reported serious concerns. The larger category did not make the list of top 25 concern for those 20 and above.

References

Mrphilip (talk) 07:25, 27 October 2018 (UTC)

From the nicotine article

This content was in the toxicity section of the nicotine article. It's undue weight to cover nicotine toxicity from ecigs at length and concerns about it in that article, so I figured I'd merge it into this one. However, there's no readily apparent place where this material is apt, so I'm putting it here. If anyone can find a home for it in this article, great. If not, it's no big deal.

Ecig-related content exported from nicotine

The rise in the use of electronic cigarettes, many forms of which are designed to be refilled with nicotine-containing e-liquid supplied in small plastic bottles, has raised concerns over nicotine overdoses, especially in the possibility of young children ingesting the liquids. A 2015 Public Health England report noted an "unconfirmed newspaper report of a fatal poisoning of a two-year old child" and two published case reports of children of similar age who had recovered after ingesting e-liquid and vomiting. They also noted case reports of suicides by nicotine. Where adults drank liquid containing up to 1,500 mg of nicotine they recovered (helped by vomiting), but an ingestion apparently of about 10,000 mg was fatal, as was an injection. They commented that "Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake." The FDA recommends that e-cigarettes and e-liquids be kept in a safe place, where children and pets do not have access to them.

Seppi333 (Insert 2¢) 17:28, 23 January 2019 (UTC)

• Thanks for posting this here! I inserted most of it into the Nicotine subsection of the Health effects section. --Chumash11 (talk) 16:47, 25 January 2019 (UTC)
  • There article at least two sections in this article that are undue weight. Both the nicotine section and passive vaping section should be removed. There is an article for nicotine and the content about passive vaping is duplication from the safety article. QuackGuru (talk) 17:55, 25 January 2019 (UTC)

References

Nomenclature of the word "internet"

In the article, the word "internet" is spelled "Internet", which is wrong. The word "internet" is not a brand name or any other kind of proper noun and actually gets a lower case first letter, not a capital letter. What a shame that articles with poor spelling and grammar are blocked for editing to correct their poor spelling and grammar. This foregoing unsigned comment was by Liambot. — Preceding unsigned comment added by 2407:7000:9C3D:4800:5DD8:9967:1F85:A998 (talk) 04:51, 4 March 2019 (UTC)

Long term health effects

These are uncertain and this is a major point. What effects they will have on long term rates of smoking tobacco is unclear with concerns that they will result in nicotine addiction persisting. Doc James (talk · contribs · email) 20:59, 3 April 2019 (UTC)

The sentence "Their long-term health effects are not known." is quite redundant in relation to "The health risks of e-cigarettes are uncertain." and many other reflections of uncertainty in the paragraph.

E-cigarette effects on tobacco smoking and nicotine addiction are already addressed in the paragraph.

Zvi Zig (talk • contribs 21:16, 3 April 2019 (UTC)

Seizures

Content about seizures was not added. Only a citation was added.[61] Now there is two citations after a claim. Both citations verify very different content. Content about seizures is not a part of a summary of any subpage.

For content about seizures that is verifiable see the subpages.[62][63] The Electronic cigarette#Nicotine content on this page is not a summary of any subpage. The Electronic cigarette#Passive vaping is also not a summary of any subpage. QuackGuru (talk) 18:25, 6 April 2019 (UTC)

Suggest

The "...short-term human studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes"[64] does not mean they are likely substantially safer.[65] The content fails verification because it does not follow the source. The part about "suggest was left out and the other sources do not support it was a suggestion and different sources verify different content. There are five sources for one claim.[13][14][15][16][17] This is not necessary and looks strange. QuackGuru (talk) 20:08, 16 April 2019 (UTC)

"Likely safer"

Is fine. Doc James (talk · contribs · email) 20:22, 16 April 2019 (UTC)

It's not fine at all. It leaves readers in the dark!

1. The National Academies of Sciences report on e-cigarettes says:

Laboratory tests of e-cigarette ingredients, in-vitro toxicological tests, and short-term human studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.

https://www.ncbi.nlm.nih.gov/books/NBK507163/

2. The Cochrane Review says:

Expert consensus broadly holds that, based on all available evidence, ECs are considerably safer than traditional cigarettes

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub3/full

3. The American Cancer Society says in a published public health statement:

Along the spectrum — and closer to nicotine-replacement therapies than to combustible tobacco products — are current-generation ENDS, which are likely to be much less harmful than combustible tobacco products.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21455

5. A consensus statement of major UK public health organizations:

We all agree that e-cigarettes are significantly less harmful than smoking

https://www.gov.uk/government/news/e-cigarettes-an-emerging-public-health-consensus

Zvi Zig (talk • contribs 21:34, 16 April 2019 (UTC)

Selecting specific sources that support a certain view is not going to help. We could delete all sources and start over. We should stick to a more neutral statement using only reviews rather that pile up multiples sources after one sentence. Using five sources shows there is a problem. QuackGuru (talk) 01:10, 17 April 2019 (UTC)

I do not mean to select sources. The National Health Service (England) and National Academies of Sciences, Engineering, and Medicine agree that e-cigarettes likely pose a substantially reduced health risk compared to traditional cigarettes. No equal or more authoritative WP:MEDRS source contradicts this, to my knowledge. Shouldn't this be somehow conveyed to the reader. I'm afraid that "likely safer" etc. may give the impression that e-cigarettes may be only slightly reduced risk.Zvi Zig (talk • contribs 02:42, 17 April 2019 (UTC)

See "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[66]

Please select from reviews only. The part "likely safer" is POV and not neutral. I found sources that come to a different conclusion than "likely". The part likely is what is causing confusion. The next step is to delete all the sources that are not reviews rather than select from organizations. QuackGuru (talk) 03:25, 17 April 2019 (UTC)

According to NICE, "the evidence suggests that e‑cigarettes are substantially less harmful to health than smoking but are not risk free".

According to the National Academies of Sciences, "... studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes".

How are we to communicate the fact that e-cigarettes are likely more than minimally less harmful than cigarettes?

Zvi Zig (talk • contribs 15:54, 17 April 2019 (UTC)

We should not communicate the statements from organizations when reviews provide more neutral statements. We should use reviews instead that review the overall evidence. When sources disagree we should summarize the more neutral statements. QuackGuru (talk) 16:34, 17 April 2019 (UTC)

1. Reviews are a lesser WP:MEDRS source than major medical and scientific organizations.
2. Stating "the evidence suggests that" is not merely an opinion.
3. The National Academies of Sciences conclusion is in the summary of its comprehensive review.

Zvi Zig (talk • contribs 20:38, 17 April 2019 (UTC)

1. See WP:MEDORG: "Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance with WP:WEIGHT."
2. See WP:MEDORG: "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."
3. The opinion from organizations clashes with the statements in the medical literature from reviews. Since there is disagreement we should write a more neutral statement using reviews.

QuackGuru (talk) 21:58, 17 April 2019 (UTC)

1. Scientific reports by the National Academy of Sciences and NICE clinical guidelines comprise the highest levels of evidence according to WP:MEDASSESS and [[WP:MEDORG.
2. No high level source contradicts the NAS and NICE conclusions that evidence suggests that e‑cigarettes are substantially less harmful to health than smoking.

Zvi Zig (talk • contribs 23:21, 17 April 2019 (UTC)

There are MEDRS compliant reviews that come to a different conclusion than they are substantially less dangerous. I recommend we don't ignore reviews that provide more neutral conclusions. QuackGuru (talk) 01:13, 18 April 2019 (UTC)

1. NICE clinical practice guidelines and NAS reports are of higher credibility than mere reviews.
2. To my knowledge, no credible reviews contradict the notion that e-cigs are likely to be substantially less harmful.

Zvi Zig (talk • contribs 04:29, 18 April 2019 (UTC)

1. See again "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[67] This creditable review contradicts the believe that vaping is likely to be substantially less dangerous. We can also take into account vaping products can explode and can cause serious immediate injury such as burns.
2. See WP:MEDORG: "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." They may be less authoritative than the underlying medical literature.

QuackGuru (talk) 16:54, 18 April 2019 (UTC)

That source is specifically about tobacco/NRT and e-cigarettes in otologic and neurotologic surgery situations - there is nothing in the review about what is discussed here, which is how e-cigarettes compare to tobacco in general. And aside from that - the review actually based on the little information available on e-cigs in surgery, considers the risk to be comparable to NRT. --Kim D. Petersen 00:03, 19 April 2019 (UTC)

That source is MEDRS compliant and the content I quoted is specifically about safety.[68] There is more sources. See "E-cigarettes may be safer than tobacco products, but repeated prolonged exposure to their aerosols has its own considerable potential risk."[69] QuackGuru (talk) 00:46, 19 April 2019 (UTC)

A random review certainly carries far less WP:WEIGHT than a 775 page review by the National Academies of Science and NICE clinical practice guidelines. See WP:UCS. This, I believe, is undoubtedly the spirit of WP:WEIGHT and WP:MEDASSESS.

We can invite a wider WikiMED discussion if we don't agree on this.

Zvi Zig (talk • contribs 18:34, 19 April 2019 (UTC)

Continuing to revert[70][71] when there is disagreement among editors is not helpful. Common sense tells me we can write a more neutral statement when sources disagree. QuackGuru (talk) 21:15, 19 April 2019 (UTC)

How about a compromise based on a recent IARC publication[72] statement:

"Electronic nicotine delivery systems show promise in being substantially less harmful than combustible tobacco, although the long-term risk has not yet been established"?

Zvi Zig (talk • contribs 17:38, 24 April 2019 (UTC)

That's not a compromise. Try writing a proposal without the word "substantially" and "Likely". The word "promise" is also problematic. I prefer to use the word "safer" instead of "less harmful". QuackGuru (talk) 18:11, 24 April 2019 (UTC)

You want the current text to ignore an agreement between NICE, the National Academy of Sciences, and the IARC?

Zvi Zig (talk • contribs 17:22, 29 April 2019 (UTC)

I prefer the lede to reflex a more neutral statement using other sources since different sources come to different conclusions.

See "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[73]

See "E-cigarettes may be safer than tobacco products, but repeated prolonged exposure to their aerosols has its own considerable potential risk."[74]

Here are two reviews. Please try Wikipedia:Writing for the opponent. QuackGuru (talk) 20:27, 29 April 2019 (UTC)

These sources

1. do not carry the same WP:WEIGHT as NICE, National Academy of Sciences and IARC publications.
2. are not a contradiction to the statement that e-cigarettes are likely substantially safer than true cigarettes.

Zvi Zig (talk • contribs 21:50, 29 April 2019 (UTC)

Organisations typically have a POV. For example, one such organisation claims they are 95% safer. Different organisations come to different conclusions. I'm afraid I would not select the ones that support a certain POV. I would choose reviews that come to a more neutral stance. QuackGuru (talk) 01:14, 30 April 2019 (UTC)

Edit request

Please add a hatnote to handle the incoming redirect ENDS

"ENDS" redirects here. For other uses, see End (disambiguation).

{{redirect|ENDS|other uses|End (disambiguation)}}

-- 70.51.201.106 (talk) 05:38, 4 May 2019 (UTC)

I'm not seeing any other articles on the disambiguation page which use "ENDS" in all caps. Is this something that needs a hatnote since nothing else would link to that redirect? – Þjarkur (talk) 11:17, 4 May 2019 (UTC)

I'm considering it as a capslock error, and there are several "Ends" at the destination, so it would be a good destination.

Alternately, the hatnote can be formulated as

"ENDS" redirects here. Not to be confused with Ends.

{{redirect-distinguish|ENDS|End (disambiguation){{!}}Ends}}

-- 70.51.201.106 (talk) 05:07, 5 May 2019 (UTC)

ENDS no longer redirects here. QuackGuru (talk) 16:05, 5 May 2019 (UTC)

Not done: ENDS now redirects to End. Hatnote not required. NiciVampireHeart 05:55, 7 May 2019 (UTC)

Discussion on the talk page

See Talk:Marketing of electronic cigarettes#Issues have not been resolved. Is the page a POV Fork? QuackGuru (talk) 01:25, 4 April 2019 (UTC)

Electric cigarettes potential association with fog machine studies with controversial findings

I believe this to have some relevance depending on carrier fluid and other compounds used in some products. — Preceding unsigned comment added by 176.93.183.193 (talk) 10:40, 1 July 2019 (UTC)

Fog machine - Wikipedia Electric cigarettes potential association with fog machine studies with controversial findings

"In May 2005, a study published in the American Journal of Industrial Medicine,[7] conducted by the School of Environment and Health at the University of British Columbia, looked at adverse respiratory effects in crew members on a wide variety of entertainment venues ranging from live theaters, concerts, television and film productions to a video arcade. This study determined that cumulative exposure to mineral oil and glycol-based fogs were associated with acute and chronic adverse effects on respiratory health. This study found that short-term exposure to glycol fog was associated with coughing, dry throat, headaches, dizziness, drowsiness, and tiredness. This study also found long-term exposure to smoke and fog was associated with both short-term and long-term respiratory problems such as chest tightness and wheezing. Personnel working closest to the fog machines had reduced lung function results." — Preceding unsigned comment added by 176.93.183.193 (talk) 10:38, 1 July 2019 (UTC)

See https://en.wikipedia.org/wiki/Safety_of_electronic_cigarettes for detailed information on safety content. QuackGuru (talk) 14:51, 1 July 2019 (UTC)

Fruit flavor marketing to youth

I added the following to the marketing section: One common claim is that the inclusion of sweet and fruity flavors in e-liquids is primarily for marketing E-cigarettes to children, but studies show that fruit and other candy flavored e-liquids are by-far the most popular flavors among adults.

References

Just looking for consensus or opinions. I believe it's pertinent because this claim is made very often, but with 9 million american adults vaping on a regular basis, and most of them preferring something, it only makes sense that companies would produce that product for them. It seems to be a huge example of correlation doesn't equal causation to say that since children like fruity flavors, and e-juice has fruity flavors, then they make e-juice because of children. I believe it's useful information, but will happily remove it if consensus is that it's not useful. SpoonLuv (talk) 18:13, 10 July 2019 (UTC)

I have removed the paragraph until consensus is reached SpoonLuv (talk) 18:17, 10 July 2019 (UTC)

The first source is low quality. The second is a study. The second part of the sentence is a SYN violation. QuackGuru (talk) 19:03, 10 July 2019 (UTC)

Heavy metals

A recent edit was reverted saying that heavy metals are from the devices and not from the liquid. Is there any source that metals are in the liquid? It is well documented that there is heavy metals released. It doesn't appear as though it's been determined whether it's a chemical exchange inside the chamber between the coils and the liquid, or whether it's a vapor being emitted when the coils are heated. Either way, there's little argument that it's not coming from the device itself. SpoonLuv (talk) 18:56, 10 July 2019 (UTC) — Preceding unsigned comment added by SpoonLuv (talk • contribs) 18:33, 10 July 2019 (UTC)

There is not an article for that. This article is meant to be a summary of the subarticle. I just added content to anther article using a 2019 review. QuackGuru (talk) 18:59, 10 July 2019 (UTC)

Which states the metals are because of "degradation from the metal coil used to heat the solution", not the solution itself. I'll make a further edit that I think you'll be happy with. That will clarify that the metals are in the resulting vapor that's being consumed. SpoonLuv (talk) 19:12, 10 July 2019 (UTC)

Adding more off-topic content makes it more off-topic. QuackGuru (talk) 19:15, 10 July 2019 (UTC)

The original way it was written made it sound like the e-liquid contained the heavy metals, which they don't. Sources (including ones provided by you) have clearly shown that the metals come from the devices (notably the coils). This isn't off topic, it's clarification. Please explain to me how that's off topic? SpoonLuv (talk) 19:19, 10 July 2019 (UTC)

It illustrates the point that although the marketing says that it only contains those things, what you're inhaling is different. — Preceding unsigned comment added by SpoonLuv (talk • contribs) 19:22, 10 July 2019 (UTC)

It is not clarification and the marketing section is not about general content about the emissions. The liquids do contain metals. A 2017 review states, "One study found traces of chromium, manganese, nickel, and lead in the e-liquids of five brands of cig-a-like devices (59)."[75] See "...researchers have found differing amounts of heavy metals in the vapor." That's not the liquid. That's the vapor. When adding a source to the 'Marketing' section it should be about marketing. Random sources that do not discuss claims or marketing are off-topic. QuackGuru (talk) 19:25, 10 July 2019 (UTC)

You wrote "The linked sources say nothing about marketing cigarettes to youth, nor any involvement by "big tobacco"[76] The source does verify the claim. You are clicking on a deadlink. You have to read the original source from 2015 to verify the claim. See "The tobacco industry aggressively markets e-cigarettes to youth, glamorizing e-cigarette use in advertisements and offering e-cigarettes in candy flavors such as bubble gum and gummy bears."[77] QuackGuru (talk) 22:42, 10 July 2019 (UTC)

The source has updated their information to more current information. You are cherry picking old information, that they themselves have changed. The source that you cited does not contain that information, I've looked. If you are unable to cite a current and accurate source, then the information isn't current and accurate and should be removed. SpoonLuv (talk) 11:51, 11 July 2019 (UTC)

And again, and this is getting exhausting, manufacturers don't put heavy metals in e-liquids. The liquid "In the device" contained the heavy metals. If I pour water into a glass with red food coloring in it, I can't make the claim that the water contained red food coloring. I do agree with the edits you made though and accept that part of the section in its current form. SpoonLuv (talk) 12:00, 11 July 2019 (UTC)

I still disagree with your assertion that sweet flavors are specifically for marketing to children. Your source has changed their information about there, therefore I don't really think it's accurate anymore. Nor that tobacco companies are the ones agressively marketing, as by a number of sources on this same page, there is many different companies manufacturing devices, the biggest of which (juul) is unrelated to the cigarette industry. I think this is another attempt at equating e-cigarettes with tobacco products, which is an outdated theory. SpoonLuv (talk) 12:00, 11 July 2019 (UTC)

It is not my claim. It is the sourced claim of the citation. It does contain that information. Many times there are deadlinks. I fixed the issue. Metals are found in e-liquids. But that is not relevant to this discussion. Please don't try to replace on-topic content with off-topic content. QuackGuru (talk) 12:21, 11 July 2019 (UTC)

How is metals not being in e-liquid not relevant in a discussion about whether or not e-liquid contains metals? Just because a fact doesn't agree with your personal view, doesn't make it off topic or irrelevant. Also, if you need to use the wayback machine to cite something that the authors chose to remove and update with more current information, maybe the first question should be whether you should use that information, or update it to the more current information. You're reaching, and it's becoming patently obvious. — Preceding unsigned comment added by SpoonLuv (talk • contribs) 13:26, 15 July 2019 (UTC)

What does metals in the e-liquid have to do with a claim? It is off-topic. A discussion about whether or not e-liquid contains metals is not relevant to this specific claim. In any event, they do contain metals. See "Another study found detectable levels of arsenic, nickel, and other metals in e-liquids, with additional traces of lead in the devices themselves (96)."[78] QuackGuru (talk) 14:29, 15 July 2019 (UTC)

And when you read the study it's cites, it only speaks of metals found in the aerosols, and specifically talks about how those metals are transferred from the coils. The quote says that it's in the e-liquid, but it does not say whether those metals come from the manufacturing of the e-liquid, or leaching from the device. To avoid taking that out of context, it would be appropriate to look at the subject of the article that the claim cites, where you would find that the cited work never made the claim that the liquids contained metals from the manufacturer, but in it's conclusion, specifically stated that the metals were transferred to the aerosol. This is either MEDRS, or you taking something out of context. Either way the claim is that e-liquids contain metals, of course whether or not e-liquids contain metals are relevant to the claim. SpoonLuv (talk) 14:49, 15 July 2019 (UTC)

For the metals being in the e-liquid, I cited a review rather that a study. This content is off-topic for this article. QuackGuru (talk) 14:56, 15 July 2019 (UTC)

Also, it's not off topic to mention that it is the most popular flavor among adults. The claim is that the use of sweet flavors is specifically targeting to youth. The fact that the majority of their biggest demographic also prefers that is a counterpoint and important information to know when making that type of claim. It would be like saying that racist people like strawberries, therefore grocery stores mainly target racist people. The context that the majority of other people like strawberries would be important information to include in order to keep with a neutral point of view. SpoonLuv (talk) 15:00, 15 July 2019 (UTC)

It is off-topic to state what are the most popular flavor among adults for the marketing section. See Construction of electronic cigarettes under contents: "Adults in general also preferred sweet flavors (though smokers like tobacco flavor the most) and disliked flavors that elicit bitterness or harshness.[134] Young adults overall preferred sweet, menthol, and cherry flavors, while non-smokers in particular preferred coffee and menthol flavors.[134]" That is cited to a review.

There are problems with the content you restored. The WHO claim was moved to the subarticle. This article is meant to be a summary. Same problem with the other sentence added. But it is also a WP:MEDRS violation. It is a study rather than a review. See WP:MEDRS. The part about the "candy and other sweet flavors are also the most popular among adult smokers" is off-topic to a marketing claim and it is a primary source. Stating "American Lung Association has removed this information from their website" is unencyclopedic. QuackGuru (talk) 15:55, 15 July 2019 (UTC)

You moved the content. That content was added to that section because it pertains to THAT section. Trying to hide it by moving it to a sub-article does nothing to add to the article that I was editing. Please stop edit warring. This is well sourced and cited information that pertains directly to the article at hand, and it's importance of maintaining a neutral point of view. Please review the 5 pillars of Wikipedia, and please stop editing to push your narrative. SpoonLuv (talk) 16:58, 15 July 2019 (UTC)

The section is getting to long. See WP:SUMMARY. Also see WP:MEDRS. You restored a primary source again. QuackGuru (talk) 17:04, 15 July 2019 (UTC)

If the section is getting too long, I will work to remove some of the other repetitive information. The first thing should go is information that's already been made clear, not information that's new and different from the information already there. Also, I don't know what you're saying is a primary source, but one is a review published in a journal, and another is finding from a collaboration of doctors at a convention based on multiple medical studies. Neither of those are considered primary. SpoonLuv (talk) 17:12, 15 July 2019 (UTC)

The content you added made it too long. There was no problem before with the section. You removed the tag but PubMed does not indicate it is a review. QuackGuru (talk) 17:18, 15 July 2019 (UTC)

Both the fact that it's getting too long, and that it was fine before is your opinion. There are multiple other sections under the same heading that are considerably longer. It wasn't fine before, as clearly it was incomplete. SpoonLuv (talk) 17:32, 15 July 2019 (UTC)

You have not shown the source you restored is MEDRS compliant. Please remove it. Also please remove the dated content.

You restored content about "the absence of longitudinal data" from 2014, but there is content about the longitudinal data in 2016 cited to a 2016 review on the longitudinal data and gateway. See Chatterjee, Kshitij; Alzghoul, Bashar; Innabi, Ayoub; Meena, Nikhil (2016). "Is vaping a gateway to smoking: a review of the longitudinal studies". International Journal of Adolescent Medicine and Health. 0 (3). doi:10.1515/ijamh-2016-0033. ISSN 2191-0278. PMID 27505084. Therefore, I removed the dated content from the subarticle. QuackGuru (talk) 17:39, 15 July 2019 (UTC)

And here's a review from 2017 pointing out the flaws and limitations of those reviews.

This article is referring to a gateway to smoking, which is actively becoming a smoker, but the metrics they used in the review was whether or not they tried a puff of tobacco smoke, and even then the review itself says the effect is limited at best. That is not relevant information to the context of this section. SpoonLuv (talk) 18:09, 15 July 2019 (UTC)

This subject is clearly divisive among both researchers, and health professionals. As removing the whole section would likely be a mistake, I don't see what's wrong with having both sides of the debate represented. This is necessary in order to ensure a neutral point of view is maintained. SpoonLuv (talk) 18:13, 15 July 2019 (UTC)

You still have not shown the source is a review.

Science Daily is not MEDRS compliant.

The claim is there is an "absence of longitudinal data", but that was from 2014. In 2016, there is data on longitudinal studies from a review. QuackGuru (talk) 18:27, 15 July 2019 (UTC)

Check the source. Read the article. SpoonLuv (talk) 18:31, 15 July 2019 (UTC)

Why is it not MEDRS compliant? SpoonLuv (talk) 18:32, 15 July 2019 (UTC)

This is also the talk page, MEDRS compliance doesn't apply. It refered to a lack of longitudinal data about whether e-cigarette use would lead to smoking. The review that you referenced only looked at whether the subjects ever had a puff on a cigarette, and had "no indication of current use, frequency, or intensity", which would be needed in order to assert that e-cigarettes led to them becoming a tobacco smoker. An unrelated review doesn't make the original information wrong. SpoonLuv (talk) 18:38, 15 July 2019 (UTC)

The information remains correct as there still is no longitudinal review that I can find showing that e-cigarettes lead to becoming a smoker. SpoonLuv (talk) 18:41, 15 July 2019 (UTC)

Why is it not MEDRS compliant? Because pubmed did not indicate it is a review.[79] We don't use poor sources to argue against reviews.

It refers to "the absence of longitudinal data". That is not a "lack" of longitudinal data. The review I cited is about the longitudinal data and gateway. We don't use content that claims there is no longitudinal data when there is a related review that shows there is content about the longitudinal data.

See Is vaping a gateway to smoking: a review of the longitudinal studies. "This review highlights the strong evidence that not only are ECs are not an effective tool for smoking cessation among adolescents, they actually are associated with higher incidence of combustible cigarette smoking. Policy makers need to recognize of the insidious nature of this campaign by the tobacco industry and design policies to regulate it."[80] QuackGuru (talk) 18:50, 15 July 2019 (UTC)

You are so clearly trying to eliminate any information that doesn't follow your personal frame of reference. These articles are supposed to be written in a neutral point of view, but you remove anything that doesn't follow your personal narrative. You found a review that talks about a study that says that it leads to higher incidences of cigarette smoking (which does not mean that the subjects actually became smokers), and I provided a newer article describing why that review is flawed and should not be considered representative of whether e-cigarettes are a gateway to active smoking. Your reasoning for it being old information, is bad information. The use of the word "insidious" also doesn't speak much to the impartiality of this particular review. SpoonLuv (talk) 19:14, 15 July 2019 (UTC)

We don't base editing decisions on reviews that are biased and documented as flawed. SpoonLuv (talk) 19:20, 15 July 2019 (UTC)

Your link stating that it's not a review with the search also shows the work I cited as the first result. SpoonLuv (talk) 19:31, 15 July 2019 (UTC)

And if you don't like science daily as a source, here's a link to the original article [81]

My reasoning for removing it is not that old information, is bad information. The reviews cites longitudinal data in relation to the gateway effect. It does not talk about "a study". It was more than a few longitudinal studies.[82] Science Daily is not relevant to improving this article. It is not MEDRS and it should not be used for this article for MEDRs claims. These articles supposed to be written in accordance with MEDRS as well as being neutral. It is not neutral to use information that has been shown to be dated. The MEDRS tag was removed but so far there is no indication it is a review.[83] Same with the other article. QuackGuru (talk) 19:35, 15 July 2019 (UTC)

You haven't shown it to be dated. It refers to whether there's longitudinal data that shows that cigarettes lead to smoking. I included the article to which science daily was referring to here. MEDRS requires the use of valid and accurate secondary sources, which I've supplied. You're using sources that have been refuted in order to say that my sources are somehow not MEDRS compliant, and arguably those sources are off-topic anyway. Just because you disagree with it doesn't mean it's not MEDRS compliant. Just accept this and allow a little impartiality and neutral information on this page. SpoonLuv (talk) 19:49, 15 July 2019 (UTC)

I have demonstrated it to be dated because there is a recent review that does overview the longitudinal data. The WHO source claims there is no longitudinal data. There was true in 2014. That is longer true because there is a review that shows there is longitudinal data related to the gateway effect. The recent 2016 review is MEDRS compliant and it not been withdrawn from pubmed. You have ]not shown the source you restored is a review. See pubmed. It is not listed as a review. QuackGuru (talk) 20:15, 15 July 2019 (UTC)

By your own review search linked above in this post this is indeed a review right on top of your search result.--TMCk (talk) 21:20, 15 July 2019 (UTC)

https://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed_reviews&from_uid=28786147 It is at the top of the search result because I clicked on it to check if it was a review.

Gateway effects and electronic cigarettes. is not a review according to pubmed. QuackGuru (talk) 21:31, 15 July 2019 (UTC)

Also see "A longitudinal study of electronic cigarette users." It is listed at the top.[84] but a longitudinal study is not a review. QuackGuru (talk) 22:08, 15 July 2019 (UTC)

References

Gateway

How are you disputing the neutrality? The source itself says that this is a limitation, and this section is specifically about it being a gateway to regular tobacco smoking. SpoonLuv (talk) 12:51, 16 July 2019 (UTC)

Therefore it is important to understand that when you've presented evidence that a review found a link to smoking, it didn't actually review studies that found a link to regular smoking, IE, the gateway effect, IE the title of this section. SpoonLuv (talk) 12:53, 16 July 2019 (UTC)

Also, are we really going to start adding NPOV tags? Almost every review and study that you've referenced has listed selection bias as a "significant" issue in the studies reviewed. SpoonLuv (talk) 12:54, 16 July 2019 (UTC)

You stated "Almost every review and study that you've referenced has listed selection bias as a "significant" issue in the studies reviewed." That's correct but for other reviews we don't state things link that. We usually stick to the evidence rather than explain about the studies they reviewed.

See "1) it was referring to "among adolescents and young adults" but there was no mention of that; the source does not mention gateway; although none of the studies reviewed... is not encyclopedic; it better to stick to the evidence rather than explain about the raw data 2) this content was moved to the subarticle 3) there is a youth section that has similar content 4) "Some argue" fails verification 5) no evidence the source is a review has been presented on the talk page"[85] QuackGuru (talk) 13:28, 16 July 2019 (UTC)

Yes, and they didn't provide evidence about how many became regular smokers, which is the gateway effect. That is about the evidence. If a review lists a significant issue with the material as it pertains to the subject that you are talking about, then it is important to include it to maintain NPOV. — Preceding unsigned comment added by SpoonLuv (talk • contribs) 13:58, 16 July 2019 (UTC)

"Gateway effects and electronic cigarettes." is a WP:MEDRS violation. See here. It does not indicate it is a review. Other sources state "Review". This one does not state it is a "Review".

"Adolescents and e-cigarettes: Objects of concern may appear larger than they are." is a MEDRS violation. See here. It does not indicate it is a review. Other sources state "Review". This one does not state it is a "Review". I added maintenance tags to address the issues. QuackGuru (talk) 14:27, 16 July 2019 (UTC)

Does not have to be a revue to be MEDRS. Also doesn't have to agree with you to be MEDRS. SpoonLuv (talk) 14:36, 16 July 2019 (UTC)

Using non-MEDRS sources to argue against MEDRS sources is not neutral content. The wording is not fixed. QuackGuru (talk) 14:39, 16 July 2019 (UTC)

Maybe instead of always just throwing MEDRS around, you should explain, using proper Wikipedia policies, how that information isn't MEDRS compliant. — Preceding unsigned comment added by SpoonLuv (talk • contribs) 14:40, 16 July 2019 (UTC)

There is MEDRS compliant content explaining about the "common liability" and the concerns but the non-MEDRS content that was restored is being using to argue against the "common liability" and those concerns. QuackGuru (talk) 14:53, 16 July 2019 (UTC)

SpoonLuv: please stop adding non MEDRS content. Please learn what qualifies as MEDRS. Thanks. Cloudjpk (talk) 15:15, 16 July 2019 (UTC)

Yet again, please kindly explain, using proper Wikipedia policies, how that information isn't MEDRS compliant. So far the only argument given that it's not MEDRS compliant is that you don't agree. SpoonLuv (talk) 15:47, 16 July 2019 (UTC)

They are not reviews. It's that simple. Have you shown they are MEDRS compliant? QuackGuru (talk) 15:52, 16 July 2019 (UTC)

Yes they are and no it's not. Please please read the page on what determines MEDRS compliance. And yet again, using proper Wikipedia policies, describe how they are not. SpoonLuv (talk) 16:00, 16 July 2019 (UTC)

Your edit summary was "Not MEDRS, fixed issue with wording." According to you, they are "Not MEDRS".[86] We don't reach down to use poor sources to argue against reviews. QuackGuru (talk) 16:08, 16 July 2019 (UTC)

My apologies, I meant "Not MEDRS violation". My mistake. SpoonLuv (talk) 16:43, 16 July 2019 (UTC)

We don't ignore valuable information just because we disagree with it. SpoonLuv (talk) 16:43, 16 July 2019 (UTC)\

One more time.... please explain why you feel that this is not MEDRS compliant regarding Wikipedia policies. If you keep arguing semantics, I'm just going to assume you're stonewalling the discussion, and engaged in disruptive editing. SpoonLuv (talk) 16:47, 16 July 2019 (UTC)

I told you before they not reviews. We don't use MEDRS violations to argue against reviews. QuackGuru (talk) 16:50, 16 July 2019 (UTC)

Nowhere on the MEDRS page does it say it HAS to be a review. Please read the MEDRS page and describe why the content doesn't meet MEDRS compliance USING WIKIPEDIA POLICIES. Also, I believe the sources are reviews, but that's neither here nor there. SpoonLuv (talk) 16:53, 16 July 2019 (UTC)

None of the sources are listed as reviews at pubmed. If you believe they are reviews then please show how they are reviews. QuackGuru (talk) 17:00, 16 July 2019 (UTC)

It is now clear that you are engaged in disruptive editing. I have asked you to explain why you believe it is not MEDRS compliant with Wikipedia policies, and you have dodged around the issue. Please cease. If you insist that something is not MEDRS compliant, then please explain why it isn't with regards to Wikipedia policies. SpoonLuv (talk) 17:31, 16 July 2019 (UTC)

Also, whether or not it's a review is not what's being discussed. What is being discussed is whether or not it complies with Wikipedia's MEDRS policy. — Preceding unsigned comment added by SpoonLuv (talk • contribs) 17:34, 16 July 2019 (UTC)

SpoonLuv: the burden isn't on everyone else to show it's not MEDRS. If you believe the source is MEDRS, please explain how it qualifies. In the meantime please stop restoring MEDRS violations. Thank you. Cloudjpk (talk) 18:24, 16 July 2019 (UTC)

It is an independant secondary source written by somebody in the field and published by a respected publisher. This is the definition of an MEDRS. Please stop claiming something isn't MEDRS without bothering to say why it's not according to Wikipedia policies. SpoonLuv (talk) 19:12, 16 July 2019 (UTC)

I used a source that meets MEDRS compliance according to Wikipedia policy. I made sure it did before posting. You are now saying it's not, but aren't saying why it's not. You're claiming it's not, so the burden is on you to explain why. If you truly believe that it is not, then why are you both so hesitant to explain why using Wikipedia's guidelines? SpoonLuv (talk) 19:16, 16 July 2019 (UTC)

So in the meantime, please stop removing MEDRS compliant material.SpoonLuv (talk) 19:17, 16 July 2019 (UTC)

An independent secondary source does not mean it is a review. There is a difference. According to your argument anyone can add independent secondary sources. That is not the case. We have far better sources available such as reviews. We don't normally use lower quality sources to argue against better sources.

See Wikipedia:Identifying_reliable_sources_(medicine)#Biomedical_journals: "Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Wikipedia articles. Journal articles come in many different types, and are a mixture of primary and secondary sources. It is normally best to use reviews and meta-analyses where possible. Reviews in particular give a balanced and general perspective of a topic, and are usually easier to understand." QuackGuru (talk) 19:33, 16 July 2019 (UTC)

Etter: It's not a review. It's not a general narrative review. It's not a systematic review. It presents the author's original analysis which refers to studies merely to illustrate his views on research possibilities. It's not a secondary source. It's hardly a balanced and general perspective. It's not MEDRS. Please stop adding content that fails MEDRS. Cloudjpk (talk) 00:22, 17 July 2019 (UTC)

Kozlowski and Warner: that's probably MEDRS; but it fails verification. They do not report "evidence" supporting the model; they report claims of a model, which model they then explicitly note is difficult to confirm or disconfirm because of the complexity of the evidence in the real world. Cloudjpk (talk) 00:28, 17 July 2019 (UTC)

May I suggest: "some researchers see the gateway effect as part of a common liability model of risky behavior" (followed by a proper citation to Kozlowski and Warner). Cloudjpk (talk) 00:30, 17 July 2019 (UTC)

It was not is not peer-reviewed by the Journal. It is a low quality source. QuackGuru (talk) 02:52, 17 July 2019 (UTC)

Cloudjpk I would agree to that. I also agree to remove any reference to Etter. I finally managed to find the original article in a library and agree that it's consideration from MEDRS is shaky at best. SpoonLuv (talk) 13:33, 17 July 2019 (UTC)

QuackGuru If you truly believe that this represents a low quality source, I think it should be important that you go through the rest of the page and check for this. I quickly checked 6 sources, and 3 of them specifically noted that either the work was not reviewed by the journal, or that the work was the responsibility of the authors, and the journal accepted no responsibility for it's accuracy. The other 3 didn't specifically say either way. Please stop nitpicking, you're showing way too much of your hand. SpoonLuv (talk) 13:51, 17 July 2019 (UTC)

For this content about gateway we have much better sources available. There is no consensus for the content, especially when it fails verification. Please provide verification for the content and gain consensus before restoring the consensus. QuackGuru (talk) 14:32, 17 July 2019 (UTC)

We don't have better sources available. Those sources themselves report multiple biases that will skew the data. This link identifies the many issues in these studies in a much more explicit way. If the reviews themselves are reporting biases and other issues with the studies they're reporting, then a source that is MEDRS and discusses these issues is important information to have, if NPOV is important. SpoonLuv (talk) 20:25, 17 July 2019 (UTC)

Quackguru, you are clearly stonewalling here, and are making it impossible to achieve consensus through discussion. There was consensus achieved between the two people on here that are open to productive discussion and are interested in moving forward with a solution that makes all parties happy. What you are doing is the very definition of disruptive editing. I beg you to please stop. SpoonLuv (talk) 20:28, 17 July 2019 (UTC)

We do have better sources available such as Public Health Consequences of E-Cigarettes that overviews the source you restored and others. The disputed content was restored, but no verification was provided and no consensus was reached. Please provide verification and gain consensus for the content rather than violating consensus. There must be a reason verification has not been provided. Is it because the content fails verification? QuackGuru (talk) 20:32, 17 July 2019 (UTC)

What verification? How does it not meet verification. It is a valid MEDRS source offering valuable information important to the subject matter. If you want to know specifically why it meets verification then you need to specifically describe how it doesn't meet verification. The information provided is complementary to topics discussed in the review. No consensus was reached that it should be removed. No reasonable effort has been made to prove that it doesn't meet verification. Only parties willing to reach consensus have reached consensus. Please stop removing valid MEDRS verified material. SpoonLuv (talk) 20:50, 17 July 2019 (UTC)

A far better source is a systematic review and meta-analysis: Soneji et. al. "Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults". JAMA Pediatrics. It's more recent, more definitive, more general; it's exactly the kind of secondary source that MEDRS is looking for. It also answers whether the common liability model explains the evidence, something that Kozlowski and Warner could not deliver. Cloudjpk (talk)

If for some reason you still think it fails verification, you are more then welcome to take it to the reliable sources noticeboard. I don't think you'll be happy with what they say though. SpoonLuv (talk) 20:53, 17 July 2019 (UTC)

"Verification" means accurate to the source, not whether the source is MEDRS. E.g. it's not accurate to say Kozlowski and Warner provide "evidence that supports" the model; it's accurate to say they report there is this model and some researchers like it. Cloudjpk (talk) 20:58, 17 July 2019 (UTC)

Excellent source. Well written explanation of how it exceeds liability model. Will update. SpoonLuv (talk) 21:01, 17 July 2019 (UTC)

So it would be fine to source Kozlowski and Warner for "some researchers see the gateway effect as part of a common liability model of risky behavior"; can we get consensus for that much? Cloudjpk (talk)

Do you mean only adding back that one part of the section? SpoonLuv (talk) 21:04, 17 July 2019 (UTC)

The article that you referenced also notes that the risk of biases in the studies used was moderate. There is still doubt. My main concern with all of the reviews presented is that they all point out that long term smoking >30 days, wasn't considered in any of the studies, which is kind of necessary to show that there is a gateway effect into active smoking and tobacco dependence (some do point out a rather tenuous link between one time tobacco exposure and long term smoking, but this fails verification as the articles themselves say that ecigarettes are different and have different effects and outcomes). SpoonLuv (talk) 21:11, 17 July 2019 (UTC)

Past 30 day use is an accepted metric in the field. As WP editors it's not our job to judge whether the field of study is proceeding in the way we think right; we just accurately summarize what reliable sources say. Cloudjpk (talk) 21:17, 17 July 2019 (UTC)

And that reliable source said that it was a significant issue with the studies they reviewed. Kozlowski and Warner pointed that out in their review, but you judged whether that information was presented the way you think is right. SpoonLuv (talk) 21:20, 17 July 2019 (UTC)

This section is not NPOV, as it fails to mention the multitude of issues with this theory, both pointed out be the sources I provided, and the sources you provided. SpoonLuv (talk) 21:22, 17 July 2019 (UTC)

No, I judged whether the source verified. It did not. Can we move on? Cloudjpk (talk) 21:26, 17 July 2019 (UTC)

How about: cite Kozlowski and Warner for "there is this model to account for the gateway effect and it has gained currency among some researchers" and cite Soneji. et. al for "a recent review finds the model does not explain all the effect". (To verify: Soneji finds the effect persists even after "adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking"). Can we get consensus on this? Cloudjpk (talk) 21:31, 17 July 2019 (UTC)

Perhaps better: cite Kozlowski and Warner for "there is this common liability model that some researchers apply: it says common risk factors lead to common behaviors", then cite Soneji. et. al for "a recent review finds the gateway effect persists even after adjusting for risk factors". I think that accurately summarizes both sources. Does this work? Cloudjpk (talk) 21:38, 17 July 2019 (UTC)

See "Under the common liability model, some have suggested that any favorable relation between vaping and starting smoking is a result of common risk factors.[134] This includes impulsive and sensation seeking personality types or exposure to people who are sympathetic with smoking and relatives.[134]" That is similar to your proposal using the book. The next sentence states: "A 2014 review using animal models found that nicotine exposure may increase the likelihood to using other drugs, independent of factors associated with a common liability.[notes 3][136]" I think that explains it well. QuackGuru (talk) 14:50, 18 July 2019 (UTC)

Stratton, Kathleen; Kwan, Leslie Y.; Eaton, David L. (January 2018). Public Health Consequences of E-Cigarettes (PDF). National Academies of Sciences, Engineering, and Medicine. pp. 1–774. doi:10.17226/24952. ISBN 978-0-309-46834-3. PMID 29894118. {{cite book}}: Unknown parameter |agency= ignored (help)

This book has details about the gateway model and the "catalyst model". It cites the sources that were removed. It is a better source. QuackGuru (talk) 21:51, 17 July 2019 (UTC)

See "Some see the gateway model as a way to illustrate the potential risk-heightening effect of vaping and going on to use combusted tobacco products.[141]" This is sourced to the book and I also added content about the "catalyst model". QuackGuru (talk) 01:50, 18 July 2019 (UTC)

Cloudjpk, I appreciate your attempts to reach consensus. As I've said before, I feel the source you provided did an excellent job of explaining why the common liability model does not sufficiently explain the gateway theory, nor would it necessarily improve the content of the page the way it was phrased. I am still troubled by the POV nature of this section, and after extensive reading, I feel some clarification is needed in regards to the gateway theory above what is represented here. I will do some more reading and see if I can't figure something out that we can agree on. I will not repost the disputed content, and I will post the material I decide on here before the main page, but I do ask that you approach it with a neutral mind. SpoonLuv (talk) 19:12, 18 July 2019 (UTC)

Thank you! And I salute you; this is not easy. Let's keep engaging in a civil way and following the facts! Cloudjpk (talk) 00:10, 20 July 2019 (UTC)

NPOV

This article is kind of ridiculous when it comes to NPOV, and desperately needs to be fixed. There are multiple people that remove anything that doesn't go along with their personal views on the matter. It seems as though when new information is added that might conflict, they find every reason possible to remove it. Is NPOV actually important to Wikipedia? Is there any way to deal with bullying editors? I'm somewhat new here, is this just par for the course on Wikipedia? This is a health issue, and could literally lead to people dying, but it seems to be treated like a game by the editors. SpoonLuv (talk) 14:39, 16 July 2019 (UTC)

The article contains numerous MEDRS compliant sources. The only issue I noticed is the non-MEDRS content is being restored to the article. That can be fixed. QuackGuru (talk) 14:29, 16 July 2019 (UTC)

I don't think you understand what MEDRS means. It doesn't mean that anything you disagree with is an MEDRS violation. If you cared about keeping an NPOV, and honestly believe that these sources aren't MEDRS, then you would seek an MEDRS compliant (in your mind) source to back up the information. If you are purposely attempting to remove NPOV compliance, you would find a way to remove anything that disagrees with your point of view with no attempt to find out the information yourself, which is clear to all what's happening here. SpoonLuv (talk) 14:39, 16 July 2019 (UTC)

See "...numerous longitudinal studies have confirmed their role as a gateway to more conventional tobacco products [88–91]."[87] I found evidence to settle the matter. QuackGuru (talk) 14:59, 16 July 2019 (UTC)

Again, the fact that you found something that agrees with your personal views doesn't make it NPOV. I've provided many sources that question the legitimacy (or even ability to perform) those studies, as well as information that's counterpoint. There's even some evidence that there's a reverse causal gateway effect, but that information is incredibly incomplete, so not included. Finding something that agrees with you doesn't settle a matter. Providing readers with all of the pertinent information, and references to those sources is what's important. It should include all of the information, and be neutral. Not just agree with you if it means including part of the story. SpoonLuv (talk) 15:44, 16 July 2019 (UTC)

You restored content claiming there was an absence of longitudinal data. That is incorrect because "longitudinal studies have confirmed their role as a gateway to more conventional tobacco products."[88]

The MEDRS violation was removed but you restored the content against consensus. QuackGuru (talk) 15:52, 16 July 2019 (UTC)

Consensus wasn't reached, but nice try. And I reverted that edit because you also removed other unrelated information. You did a blanket revert to remove 1 section, that removed a different one, with your reasoning being the removal of the one section. SpoonLuv (talk) 16:03, 16 July 2019 (UTC)

You wrote "Consensus wasn't reached, but nice try." Consensus has not been established for the new content, according to your comment. Please remove it and gain consensus for the disputed content. QuackGuru (talk) 16:08, 16 July 2019 (UTC)

Consensus has not been gained for removing the new content. SpoonLuv (talk) 16:31, 16 July 2019 (UTC)

Either way, the subject of this is NPOV, please discuss that instead of other issues. If you want to discuss different issues then the subject of the section, please create a new section. SpoonLuv (talk) 16:35, 16 July 2019 (UTC)

On the contrary, there is consensus to remove the MEDRS violations. QuackGuru (talk) 17:04, 16 July 2019 (UTC)

Consensus has not been reached, discussion is still ongoing. Please explain to me using Wikipedia policies how consensus was reached? SpoonLuv (talk) 17:28, 16 July 2019 (UTC)

See WP:EDITCONSENSUS. QuackGuru (talk) 17:31, 16 July 2019 (UTC)

See WP:EDITCONSENSUS. Discussion is still ongoing, consensus not reached. SpoonLuv (talk) 17:40, 16 July 2019 (UTC)

And again, please respect the talk page. You are not discussing things related to the title of the section. SpoonLuv (talk) 17:49, 16 July 2019 (UTC)

@Spoonluv, I saw this on the AN board and took a look. You initially asked for an explanation as to why what you wanted to add in wasn't MEDRS and you got that explanation. You still tried to add this information back in stating your version was a consensus version. Now you're asking why your version wouldn't be consensus, that was also explained to you.

You're really starting to look like you're hear to right great wrongs. This isn't the right place for it. Find a different article to edit instead. For example, I don't edit this article because I'm an ex-smoker and am biased against any form of smoking or tobacco use, so I steer clear of editing any article dealing with tobacco or nicotine usage in any form! Wekeepwhatwekill (talk) 13:18, 18 July 2019 (UTC)

@Wekeepwhatwekill, while my initial impression of SpoonLuv was similar to yours, after reading back through several days of discussion, I do think that QuackGuru is the one who has not and either cannot or will not engage in honest editing practices when it comes to this subject. He does so under the guise of being an enforcer of Wikipedia policies, but an editor whose agenda is to *bend the viewpoints of public policy makers so that they are in line with his own viewpoints* will inevitably cherry pick which policies to enforce, and will stretch the scope of the policies accordingly so that the "policy" being enforced is truly just a reflection of his own agenda.

The basis on which I make this charge against the editor QuackGuru: in one particular heated comment, several days ag (in the 'Heavy Metals' thread, during a tangent dispute regarding whether or not flavoured vape liquid is part of an evil scheme to get children hooked on cigarettes), he exposed his true purpose as an editor of this article: something along the lines of how policy makers must be made aware of all the various wicked intentions of tobacco companies so that they can implement policies accordingly. Firejuggler86 (talk) 18:40, 1 August 2019 (UTC)

@Wekeepwhatwekill I asked why the article wasn't MEDRS according to Wikipedia policies, which was never answered. He just kept saying "because they're not reviews". The MEDRS policy does not state that something has to be a review to be considered MEDRS. When I pointed this out, his response was to just keep repeating that it's not MEDRS as it's not a review, without providing any Wikipedia policies that support this argument. Don't worry though, I really don't have time to constantly fight against somebody that appears to have unlimited time, and is also completely unwilling to discuss or reach consensus according to Wikipedia policies. He's been accused of disruptive editing multiple times. It's incredibly clear what's really going on here with only a cursory look at the page itself and the abundance of other peoples valid work that's been removed en mass. All information that disagrees with his viewpoint is instantly removed. I honestly find it sad that Wikipedia is clearly a game where those with the most time on their hands will get to push their own personal narrative by wearing down anyone that disagrees with them. It's also sad that yet another editor who wants to help improve the quality of information on Wikipedia, is leaving after discovering that NPOV, one of the FIVE PILLARS of Wikipedia, appears to be of little to no importance to its editors. 18:46, 7 August 2019 (UTC)

Copyright violation

I tagged and deleted the problematic content. There is similar content that is not a copyright violation. See "The revised EU Tobacco Products Directive came into effect May 2016, providing regulation for e-cigarettes.[105]" QuackGuru (talk) 02:07, 18 July 2019 (UTC)

Renormalization

Renormalization of smoking appears to be speculative. Either the section should be removed, or information pointing to the fact that it's unproven needs to be provided.

See "Even if an e-cigarette contains no nicotine, the user mimics the actions of smoking.[143] This may renormalize tobacco use in the general public.[143]" That is about specifically about no nicotine e-cigarette use. Therefore, I removed the SYN violation that did not explicitly address the no nicotine e-cigarette use. QuackGuru (talk) 19:13, 8 August 2019 (UTC)

Your quote of a source stating that it "may re normalize tobacco use" doesn't argue with the cited sources assertion that this effect hasn't actually been observed. It's important to show this fact in the summary if you're going to include re normalizing at all. 19:42, 8 August 2019 (UTC)

It did not verify this effect is specifically about e-cigarettes contains no nicotine. This may renormalize tobacco use in the general public.[143]" This is about e-cigarettes contains no nicotine. Therefore, it is a SYN violation to suggest that. QuackGuru (talk) 19:47, 8 August 2019 (UTC)

There are newer sources that indicate a gateway effect or vaping encourages tobacco use. This article states, "Studies indicate vaping serves as a gateway to traditional cigarettes and cannabis use.[134]" That is a 2019 review.

Also see "While some publications from Great Britain have downplayed the use of electronic cigarettes and their link to combustible cigarette use in adolescents, numerous longitudinal studies have confirmed their role as a gateway to more conventional tobacco products."[89] The source for this content is from Great Britain. It has been directly disputed.

Also see "e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking."[90] Please remove the SYN violation. It was not contradicting that content about no nicotine e-cigarette use. It is undue weight to include this while not including the positions statements from others. However, the details about the positions statements are in the subarticle. See the 4th paragraph under "Gateway theory" in the subarticle. QuackGuru (talk) 20:41, 8 August 2019 (UTC)

The full quote was added to the appropriate place. QuackGuru (talk) 01:11, 9 August 2019 (UTC)

Verification provided

See "These studies indicate that emissions from e-cigarettes do contain potential toxic compounds such as nicotine, carbonyls, metals, and organic volatile compounds, besides particulate matter. While usually these compounds are generally at lower concentrations than those found in secondhand tobacco smoke, these findings made false the popular statement that e-cigarette emissions are “only water vapor,...".[91] I did provide verification in my edit summary. QuackGuru (talk) 21:21, 8 August 2019 (UTC)

Nicotine and Passive vaping sections

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

---

Should we delete both the nicotine section and passive vaping section? QuackGuru (talk) 17:50, 2 June 2019 (UTC)

• Yes. The Electronic cigarette#Nicotine content on this page is not a summary of any subpage. The Electronic cigarette#Passive vaping is also not a summary of any subpage. There is more than 10 paragraphs about nicotine content in the Safety of electronic cigarettes page. All content from the main e-cig page on nicotine was rewritten and moved to the safety and adverse effects subpages. This article is getting a bit long. We don't need additional content about nicotine and passive vaping. The summary of the Safety of electronic cigarettes page does contain content about nicotine and passive vaping. The nicotine section and passive vaping section are a violation of WP:WEIGHT, especially when they are not a summary of any subpage. See Safety_of_electronic_cigarettes#Nicotine and Safety_of_electronic_cigarettes#Carcinogenicity for content about nicotine. See Adverse_effects_of_electronic_cigarettes#Risks_related_to_e-liquid for content about nicotine e-liquid. See Safety_of_electronic_cigarettes#Exposure for content about passive vaping. The subpages are for the additional content. QuackGuru (talk) 18:00, 2 June 2019 (UTC)
• yes agree w/ QuackGuru--Ozzie10aaaa (talk) 10:35, 6 June 2019 (UTC)
• yes agree, better organization Cloudjpk (talk) 16:51, 7 June 2019 (UTC)
• yes JonRichfield (talk) 06:46, 14 June 2019 (UTC)
• No (summoned by bot) The sections need a bit of work, many unreliable sources are tagged, and they could be trimmed. But the material, or a good summary of it, needs to stay at the main page, not (re)moved and sent to a subpage or related page, which results in hiding information (albeit unintentionally to be sure). This article is by no means "too long". petrarchan47คุก 22:40, 16 June 2019 (UTC)
• Yes acknowledging unnecessary overlapping content. --NikkeKatski [Elite] (talk) 18:53, 17 June 2019 (UTC)

• Remove Nicotine altogether but Reduce/Rewrite Passive Vaping per WP:SYNC/SUMMARY as brought up by the quack. --NikkeKatski [Elite] (talk) 15:11, 23 June 2019 (UTC)

• OR also strongly supporting the sections concerned be replaced by An Informing Image as proposed by the quack. --NikkeKatski [Elite] (talk) 13:32, 24 June 2019 (UTC)

• No, this would be an extreme response; consider reducing content instead: To begin with, WP:WEIGHT is not established as a function of what our other articles say about a topic, even as an indirect matter: it's is determined exclusively by the coverage given by WP:reliable sources to a given aspect of the article's subject matter. Now, clearly the topic of this article receives so much coverage that WP:DUE weight paid to particular aspects is a relative matter and hard to nail down without reviewing very large numbers of sources (which, given they opened this RfC, I will give QuackGuru the benefit of the doubt and assume they've spent a fair amount of time doing just that. However, insofar as the Nicotine section utilizes dozens of sources, including a number of WP:MEDRS, I think it is clear that the issue of accidental exposure is not a non-issue to health and safety experts. Therefore I think that options presented by this RfC (remove the section entirely or leave it in a bloated state) are clearly a false choice; there is at least one other (and I believe probably the appropriate) option: simply reduce the profile of the section some. It's worth noting that while this isn't the shortest article on the project, neither is it near the length of some of our other articles on topics that are large in scope and high on controversy. Furthermore, fully 50% of the page length is occupied by the massive notes and reflist sections, a result of the large amount of sources needed to resolve verification disputes and annotations. All factors considered, I'm seeing more than enough evidence of WP:WEIGHT to cover the topic of nicotine exposure in this article, but believe this summary could probably be achieved in half the space. Snow ^{let's rap} 07:16, 22 June 2019 (UTC)

On a side note, QuackGuru, you might want to consider re-working your !vote above, insofar as it immediately follows the prompt and thus serves as strong advocacy for one side of the dispute: you have somewhat conflated/misused the terms "subpage", "page", "subsection" and "subarticle" repeatedly in that post (made all the more confusing by the fact that you piped a link to a subsection of this article and labelled it as it if it was a different "page" altogether). For clarity: a "subpage" (as the term is used on this project) is when someone hosts a page within the namespace of another page. It is almost never used in article space. What you apparently meant to say is "subarticle": that is when one article represents coverage of one aspect of a topic covered by another article. A "subsection" is a section within a section (in any article or workspace page) and a "page" is any distinct namespace on the project (an article or work/project space). I don't mention all of this just to be pedantic: it actually took me several minutes to figure out the nature of your argument due to the mis-usages here (and one of them could also be considered outright misleading, though I'm quite certain it was just an error); I think new users probably would have any even more difficult time parsing the meaning. Snow ^{let's rap} 07:16, 22 June 2019 (UTC)

I added extra details to the Safety section in this article about nicotine and passive vaping. There is content about nicotine exposure as well as second-hand exposure to vaping in the safety section. The safety section in this article is a summary of Safety of electronic cigarettes, Adverse effects of electronic cigarettes, and Composition of electronic cigarette aerosol. See Electronic_cigarette#Safety. Those other sections are not a summary of any subarticle. Random content is a violation of WP:SYNC. If more coverage of nicotine and passive vaping is required then the safety section would be expanded rather than have other sections. I was careful to avoiding turning this article into an anti-e-cig article. I meant to say subarticle. QuackGuru (talk) 14:36, 22 June 2019 (UTC)

QuackGuru Reviewing the sections again with your most recent comments in mind, I understand your argument better. However, if you do ultimately end up removing the section, can I suggest that a very small amount of the content removed probably should be rolled into the 'Safety' section as well? I think it's probably reasonable to address the accidental exposure to nicotine issues with just the one statement and reference currently in the main 'Safety' section; while such exposure can of course be toxic at very low thresholds, I imagine these events are relatively rare and that the sources reflect as much (but you'd know better than me, being much more familiar with the sourcing). However, I do think the possible developmental effects of nicotine are a salient subject in their own right and it maybe makes sense to add a sentence or two on that subject to the 'Safety' section if the 'Nicotine' section is removed. Similarly, a small amount of discussion of the second-hand exposure risks (that is, a vastly reduced version of the content currently in the 'Passive vaping' subsection) could be reasonably included in the 'Safety' section, since that topic is almost completely absent from the rest of the article, as best I can determine. In other words, if you do end up deleting the 'Nicotine' and 'Passive vaping' sections, I think 5-10% of the content currently in those sections is probably ripe for minor re-wording and insertion into the 'Safety' section. That's jsut my quick assessment on the situation--I appreciate that you are eager to avoid this article becoming a cache-all for every negative consequence of using these devices, since there is another article reserved for the purpose. Snow ^{let's rap} 20:45, 22 June 2019 (UTC)

Sometimes editors will add details to a summary section without adding those facts to the more detailed article. To keep articles synchronized, editors should first add any new material to the appropriate places in the detailed article, and, if appropriate, summarize the material in the summary section. If the detailed article changes considerably without updating the parent article, the summary section will need to be rewritten to do it justice. See Wikipedia:Summary style#Synchronization.

The effects of nicotine and e-cigs are not a salient subject in their own right. There is no dedicated article on that specific topic. The composition of electronic cigarette aerosol is a salient subject in their own right, yet the 'Safety' section has only sentence for a summary for all of this content.

How is this specific content in 'Nicotine' and 'Passive' vaping better than using other content from the subarticles? Do you think the 'Nicotine' section and 'Passive' vaping section is a summary of any subarticle? If it is not a summary of the 'Nicotine' risks and 'Passive' vaping risks then what justification would there for keeping content that is not a summary of any subarticle? How could it be ripe for minor re-wording and insertion into the 'Safety' section when I do believe it is not a summary of the subarticles? The 'Passive' vaping section are all quotes. Quotes do not have an encyclopedic feel. I was thinking the 'Passive' vaping section could be replaced with an image about the second-hand aerosol and e-cig blasts.

There is another problem with the content in the 'Nicotine' section in this article. A lot it is bias and misleading like this date of 1991. It took me a lot of time to rewrite all of it. You can read both 'Nicotine' and 'Passive vaping' sections and determine what could be useful for the safety section and then I can find the similar content in the subarticles. You could also copy the 'Nicotine' and 'Passive vaping' sections to your sandbox and work on it and check if anything is worth keeping. I did do that before. I don't think I missed anything essential. The content in those other sections was re-written and merged into the subarticles and parts were inserted into the lede of Safety of electronic cigarette as well as the 'Safety' section. What you are telling me to do I already did. Before content is added here I would have to add content to the lede of the safety article per WP:SYNC. See Safety of electronic cigarettes and other subarticles. What content on those articles do you want in the lede of Safety of electronic cigarette. 4 paragraphs is the limit. There is 8 paragraphs on safety in this article. No editor suggests there should be 8 paragraphs in the lede for the Safety of electronic cigarette article. This is a serious violation of WP:SYNC. It looks like you support keeping the content in this article and as an afterthought consider reducing content instead. I can't support reducing it instead when there has not been a specific proposal for specific sentences. The topic of nicotine exposure in this article is covered in the 'Safety' section. The topic of second-hand exposure risks is covered in the 'Safety' section. The 'Passive vaping' section is essentially duplication. It is unreasonable to add duplication to the 'Safety' section. If you don't support 8 paragraphs in the lede of the Safety of electronic cigarette article then there is no justification for continuing to violate WP:SYNC. This is not about a compromise. This is about following WP:SYNC. Additional content added to the lede of the Safety of electronic cigarette article is supposed to be a summary of that article. The 'Nicotine' and 'Passive vaping' sections are not a summary of any subarticle. Therefore, this content should not be incorporated into the lede of the Safety of electronic cigarette article. If you want additional content in this 'Safety' section it would first be added to the safety article that summarizes the body. The 4 extra paragraphs in this article don't summarize any subarticle. Therefore, the 4 extra paragraphs in this article about safety is violating Wikipedia:Summary style#Synchronization. Should we delete both the 'Nicotine' section and 'Passive' vaping section in accordance with WP:SYNC? QuackGuru (talk) 20:53, 22 June 2019 (UTC)

Well, before looking at the particular issues here, I will say this as to WP:SYNC concerns. It's a fine principle and something that should reasonably be striven for at all times, but as a matter of policy and pragmatism, it yields to WP:LOCALCONSENSUS. What I mean by this is that, if there is a consensus to include content in a main article and for a topic, and yet, for whatever reason, you could not secure support for inclusion in the relevant sub-article, then the two articles would each still default to their own consensus as to whether or not to include said information. But I'm going to guess in this case that this is not going to be a huge issue, because I'm figuring that there's going to be significant overlap between the editors working at both pages? If that's so, there should be no trouble squaring the two consensuses. Which is good, because wherever you can have SYNC, you should have it.

And look, if you feel that the content should be removed wholesale, I'm not going to argue the point into the ground--that's pretty much why I was clear to format my commentary as a suggestion, rather than an !vote or similarly oppositional language. I stand by that suggestion, by the way: retaining two or three sentences from those deleted paragraphs about the increased risks of nicotine poisoning and second hand exposure does make sense to me. I'm not looking to dictate exact content to you though, because you're in a far better position to make the call, and you clearly have strong opinions about some of the content with regard to bias--apparently even after you've edited the section once, if I read you correctly. I just can't imagine that there's not a single source or statement there that you don't find to be biased as to the issues of nicotine poisoning (rare as it may be) and second hand exposure. But if I'm blunt, I don't want to keep rehashing the issue of the wording in increasingly minute detail. I'd much rather defer to your familiarity with the content. If you absolutely feel you are put between a rock and a hard place by my !vote and genuinely want me to look further into the sources and draft specific statements myself, I suppose the communal thing to do would be to do so, but, are you very certain you can't see anything in particular in those sections pertaining to those two topics that you don't think is worth saving, that is supported by the balance of the sources, as you understand them? Snow ^{let's rap} 10:25, 3 July 2019 (UTC)

See "Aside from toxicity exposure in normal use, there are also risks from misuse or accidents[234] such as nicotine poisoning (especially among small children[96]),[148] contact with liquid nicotine,[239] fires caused by vaporizer malfunction,[1] and explosions resulting from extended charging, unsuitable chargers, or design flaws.[234]"

See "E-cigarettes create vapor that consists of fine and ultrafine particles of particulate matter, with the majority of particles in the ultrafine range.[1] The vapor have been found to contain propylene glycol, glycerin, nicotine, flavors, tiny amounts of toxicants,[1] carcinogens,[96] heavy metals, and metal nanoparticles, and other substances.[1]"

See "But workplace safety standards do not recognize exposure to certain vulnerable groups such as people with medical ailments, children, and infants who may be exposed to second-hand vapor.[1] Concern exists that some of the mainstream vapor exhaled by e-cigarette users may be inhaled by bystanders, particularly indoors.[98] E-cigarette use by a parent might lead to inadvertent health risks to offspring.[77]"

The summary section contains content on nicotine poisoning as well as second hand exposure. It has been given its due weight. I do not want to overemphasize nicotine poisoning or second hand exposure. QuackGuru (talk) 10:39, 3 July 2019 (UTC)

Well, let me ask this then: you're happy to dump all of the first paragraph of the 'Nicotine' section? Because it comes sourced by work published in two fairly well respected journals within the top few percent of journals and ranked by impact factor. They are primary, but given the quality of the publications and the MEDRS context, that's not necessarily a negative. I don't know that it need four sentences to convey the gist when probably one would suffice, but doesn't some mention of the neurological impacts bear at least brief mention. Similarly, what about the first sentence in last paragraph of the 'Nicotine' section, noting a fourteen-fold increase in cases of accidental nicotine poisoning? I'm not sure how that source got tagged with a MEDRS tag, but it's the official publication of the American Academy of Pediatrics--it's a reliable source for medical topics lol. I wouldn't be surprised if its the biggest journal in its field after JAMA Pediatrics in most bibliometric indexes. And the underlying fact seems pretty relevant. And the source itself makes the connection between the rise of the product and the cases, so there's no issue with synthesis. Of course a large percentage increase doesn't necessarily equate to a huge number of individual cases, but that's why we cite source (and we can always add the raw figures if we feel that extra dimension is necessary for the average reader to appreciate the scale of the issue). Thoughts? Snow ^{let's rap} 11:47, 3 July 2019 (UTC)

I don't think any quality content was lost when it was rewritten and moved to the subarticles. The first paragraph of the 'Nicotine' section *is* covered in Safety_of_electronic_cigarettes#Nicotine and Safety_of_electronic_cigarettes#Carcinogenicity. It is not about the publication. It is about the content. What you have cited about nicotine are not a good overall summary. The Adverse effects of electronic cigarettes subarticle has content about the nicotine poisoning increases and decreases. A summary would be more general content.

Do you agree any content in the 'Passive vaping' is essentially duplication and already discussed in the 'Safety' section? I copied some of the content from the 'Safety' section and posted it above. I don't think I missed anything essential. I also added an image that covers second hand exposure. QuackGuru (talk) 16:33, 3 July 2019 (UTC)

• Yes cut out I am here through general WikiProject Medicine alerts. This article is already long and should either be focused on the e-cigarette devices or summarize related subjects which have their own articles. This top-level e-cigarette article is not the place to centralize the complicated subjects of either "nicotine" or "passive smoking". I can support either minimal coverage of those topics here linking to other articles or outright deletion on the assumption that mentions and wikilinks elsewhere in the article will help users navigate to the main articles. English Wikipedia is not currently differentiating between e-cigarette nicotine and conventional nicotine, or e-cigarette passive consumption and conventional passive consumption. If those articles ever got established then that could make a case for linking them from here, but right now the weight of the publication seems to be that should be only one term for nicotine. Blue Rasberry (talk) 21:34, 24 June 2019 (UTC)

Oh no its the legendary blueraspberry --NikkeKatski [Elite] (talk) 22:08, 24 June 2019 (UTC)

Discussions on Nicotine and Passive vaping sections

The article is currently at 267,427 bytes. It is longer than any e-cig-related page. The Nicotine and Passive vaping sections are not a summary of any subpage. It is random content. I rewrote it to fix the problems in my sandbox and moved it to the subpages. See this discussion on the Safety of electronic cigarettes talk page. QuackGuru (talk) 01:41, 17 June 2019 (UTC)

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

Safer than tobacco claim

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

---

See lede and body: "... e-cigarettes are generally seen as safer than combusted tobacco products.[90][91]" Is this wording neutral? QuackGuru (talk) 00:44, 26 June 2019 (UTC)

Please note. For the body I updated it to "e-cigarettes are generally seen as safer than combusted tobacco products[90][91] such as cigarettes and cigars.[90]" I provided two examples of combusted tobacco products in the 'Safety' section. QuackGuru (talk) 01:34, 18 July 2019 (UTC)

• Yes. The wording is neutral, according to the WP:MEDRS-compliant reviews. See discussion below for verification. QuackGuru (talk) 00:44, 26 June 2019 (UTC)
• Yes. It is as neutral as physically possible as it is just a statement of fact. It does not claim that they are safer. Neutrality is not censorship. --NikkeKatski [Elite] (talk) 16:14, 13 July 2019 (UTC)
• Yes, as above. Bondegezou (talk) 18:48, 14 July 2019 (UTC)
• Yes,the statement is unexceptionable. It is past time to stop fussing. JonRichfield (talk) 05:46, 20 July 2019 (UTC)
• Yes agree Cloudjpk (talk) 19:20, 26 July 2019 (UTC)

Discussion on safer than tobacco claim

See Electronic cigarette#cite ref-KnorstBenedetto2014 91-0

See "Given that ECs do not generate the smoke that is associated with the combustion of tobacco, EC use is generally considered safer than tobacco use."[92]

References

See Electronic cigarette#cite ref-Burstyn2014 92-0

Also see "Electronic cigarettes (e-cigarettes) are generally recognized as a safer alternative to combusted tobacco products, but there are conflicting claims about the degree to which these products warrant concern for the health of the vapers (e-cigarette users)."[93]

References

Both sources are making a broad claim that e-cigarettes are generally considered/recognized safer than tobacco. If it were changed to tobacco cigarettes rather than tobacco in general that would be a more narrow claim. In this case, both citations verify the same claim. Another source states "Importantly, they are often viewed as safer than tobacco cigarettes, meaning that at-risk populations, including pregnant women, might be more inclined to use them."[94] This is a more narrow claim because it was only tobacco cigarettes rather than tobacco in general.

Both are MEDRS-compliant reviews. J BRAS PNEUMOL[90] has an impact factor of 1.496, as of 2016.[95] BMC PUBLIC HEALTH[91] has an impact factor of 2.42, as of 2017/2018.[96] QuackGuru (talk) 00:44, 26 June 2019 (UTC)

The narrower claim seems particularly uncontroversial. Benjamin (talk) 13:48, 13 July 2019 (UTC)

Both reviews are making a broader claim it was tobacco products in general rather than only cigarettes. It would be inaccurate to claim it was just cigarettes. The other source was just used to show it was making more narrow claim for only cigarettes. It is not a review.[97] QuackGuru (talk) 14:01, 13 July 2019 (UTC)

They mention "combusted tobacco products". I'm not too familiar with all the different types of tobacco products, but I assume that's things like cigarettes and cigars, and not things like chewing tobacco? Benjamin (talk) 14:37, 13 July 2019 (UTC)

You are correct. I added the word "combusted'. QuackGuru (talk) 14:50, 13 July 2019 (UTC)

What is this all about? I have only skimmed a couple of articles and talk pages relating to this topic and am not aware whether there was a dispute over the wording in question. The article includes the following relating to "safer" (and more, not listed):

e-cigarettes are generally seen as safer than combusted tobacco products

misbelief that e-cigarettes are safer than traditional cigarettes

no evidence that ECIGs are safer than tobacco in the long term

appear to be safer than traditional cigarettes

These statements appear to conflict with each other. Is that the issue in the RfC? Johnuniq (talk) 04:07, 15 July 2019 (UTC)

What is this all about? The dispute over the wording goes back over 5 years. Almost all editors have moved on or have left Wikipedia. I think I finally found the wording that is most neutral for the "safer claim".

"appear to be safer than traditional cigarettes" has been shortened to "E-cigarettes cannot be considered safe because there is no safe level for carcinogens."

"misbelief that e-cigarettes are safer than traditional cigarettes" is according to a 2016 review. There is in-text attribution and it says misbelief that e-cigarettes "are safer". That is not in conflict with they are "generally seen as safer".

no evidence that ECIGs are safer is a quote from a medical organization. It says no evidence that ECIGs "are safer". That is not in conflict with stating it in WP's voice that e-cigarettes are "generally seen" as safer. These other statements are not part of the RfC. QuackGuru (talk) 06:39, 15 July 2019 (UTC)

I have a problem in general with the words "no evidence" being used anywhere in encyclopedia articles, except in such exceptional cases that it is widely known and unanimously accepted that there is indeed "no evidence" of such and such. And I do not care WHAT the source is, any claim of "no evidence" (which is an absolute) regarding a contentious subject matter is probably not true (or the conditions for there to possibly be evidence do not exist, e.g., "no evidence that e-cigarettes are safer than cigarettes over the span of 50 years of use" would be a ridiculous statement considering that e-cigarettes have not existed long enough for there to BE any such evidence). Firejuggler86 (talk) 19:06, 1 August 2019 (UTC)

One of them is citied to a quote from 2019. The other one is no longer accurate. The last one is still accurate. See "There is no evidence that the cigarette companies are acquiring or producing e-cigarettes as part of a strategy to phase out regular cigarettes, even though some claim to want to participate in “harm reduction."[98] QuackGuru (talk) 19:18, 1 August 2019 (UTC)

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

Association between ecigs and THC

The ref says:

"This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes. These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population."

This supports that ecigs are potentially a gateway to cannabis. The exact words in our text are not needed in the source just the same meaning. One can know the definition of "gateway" which is what the ref is defining in more direct language. Doc James (talk · contribs · email) 06:04, 29 August 2019 (UTC)

"This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes."[99]

That does not support that e-cigarettes are potentially a gateway to cannabis in general. The source is specifically about adolescents and young adults. It is not about the potential as a gateway to cannabis in general for e-cigarettes. QuackGuru (talk) 09:59, 29 August 2019 (UTC)

Please read the subarticle under 'Youth'. See "There is a greater likelihood of past or present and later cannabis use among youth who have vaped.[133]" That is a very different claim than the current claim for e-cigarettes in general. The additional source is making only a narrow claim among youth and therefore does not have the same meaning. The other source that does verify the content does make a broader claim. See "Studies have suggested a "gateway" effect for combustible cigarettes and cannabis use."[100] QuackGuru (talk) 10:23, 29 August 2019 (UTC)

It supports that it is a gateway in adolescents and young adults. The authors state "These findings highlight the importance of addressing the rapid increases in e-cigarette use among youths as a means to help limit marijuana use in this population" makes that clear.

The section on "youth" does not mention cannabis and that section does not have a sub-article. Plus this is not just about youth but also young adults. Doc James (talk · contribs · email) 10:37, 29 August 2019 (UTC)

The section on "youth" does have a section in the sub-article and it now mentions young adults.

It does not support that it *is* a gateway in adolescents and young adults and it does not support the broader claim for e-cigarettes in general. See "There is a greater likelihood of past or present and later cannabis use among youth and young adults[101] who have vaped.[133]" A greater likelihood or potential does not mean it *is* a getaway. QuackGuru (talk) 10:57, 29 August 2019 (UTC)

I removed another ref spam. QuackGuru (talk) 21:16, 3 September 2019 (UTC)

Recent reports of lung disease and deaths related to vaping

I assume this article is written under MEDRS rules, rather than newspaper reports. So I'm not going to add this myself, I'll leave it to those of you who are familiar with the rules for content here. But after the recent rash of lung disease and death associated with vaping (CDC reports 450 confirmed or suspected cases in 33 states, and three deaths with a fourth under investigation), the CDC has issued a warning: "While this investigation is ongoing, people should consider not using e-cigarette products. People who do use e-cigarette products should monitor themselves for symptoms."[102] Surely that deserves to be reported here? -- MelanieN (talk) 17:51, 6 September 2019 (UTC)

See https://en.wikipedia.org/w/index.php?title=Safety_of_electronic_cigarettes&type=revision&diff=910209406&oldid=909858441

See https://en.wikipedia.org/w/index.php?title=Adverse_effects_of_electronic_cigarettes&type=revision&diff=912805910&oldid=912393563

The CDC website has some initial findings. There is more probably more information on the CDC website. QuackGuru (talk) 19:25, 6 September 2019 (UTC)

Umm, thanks. That's it? The “safety” article still says prominently, in both the lead and the text, “The risk from serious adverse events, including death, is low.[19]” The CDC report, mentioning several hundred cases of severe pulmonary disease (but not death), is buried in the middle of a paragraph about “effects on breathing and lung function,” and is followed immediately by an earlier report of "11 cases of severe lung disease.”

This article, Electronic cigarette, uses the same “risk is low” sentence in the lead and in the “Safety” section, and AFAICS there is nothing at all about the recent reports. The CDC is quoted as saying that vaping is "likely less harmful" than smoking traditional cigarettes.

Excuse me, but doesn’t it seem as if the new information requires rethinking some things - like whether to keep saying in Wikipedia’s voice that “the risk from serious adverse events, including death, is low”? This article gets thousands of views a day. How many of those people are going away saying “OK, never mind, don’t worry about it, Wikipedia says the risk is low”? -- MelanieN (talk) 01:26, 7 September 2019 (UTC)

See …e-cigarettes are generally seen as safer than combusted tobacco products.[97][98] That's well written.

None of the new sources indicate the risk is moderate, high, or low. I have to follow the sources. You can search the CDC website for more content. It usually takes about 6 months for a review to cover the recent events. QuackGuru (talk) 01:37, 7 September 2019 (UTC)

@DocJames: Are you in agreement with this philosophy? Keep the old and possibly obsolete reports in our article as gospel, and wait 6 months before mentioning that there is new information on the subject of risk? [103]

@QuackGuru: RE None of the new sources indicate the risk is moderate, high, or low. I have to follow the sources. Would you consider the CDC announcement - "While this investigation is ongoing, people should consider not using e-cigarette products" - to be Reliably Sourced new information about risk? Or at least worth mentioning/quoting? We do report/quote other CDC announcements. See …e-cigarettes are generally seen as safer than combusted tobacco products.[97][98] That's well written. Yes, it's well written - and both sources are five years old. Should that trump the more recent evidence? -- MelanieN (talk) 02:47, 7 September 2019 (UTC)

There is no recent information about their safety in general. The subarticles cover the recent information. It is now at 5 confirmed deaths. QuackGuru (talk) 03:37, 7 September 2019 (UTC)

So somebody added this to this article - Following five confirmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products. - important, well written and well sourced information. And you removed it and buried it deep in the text of the most obscure of the multiple spinoffs on the subject. With apparently NO mention of this important development to be allowed anywhere else, not even in the lead of that article, much less in the "safety" or "adverse effects" articles, and perish the thought of even hinting at it here in the main article. Well, I strongly disagree with this approach, and I await the opinions of other people on the subject. -- MelanieN (talk) 04:33, 7 September 2019 (UTC)

@Doc James: Sorry, mis-ping above; that appears to be a troll account. I would like to hear what you think on this subject. -- MelanieN (talk) 04:40, 7 September 2019 (UTC)

That wording and that source was not added to this article. I removed the MEDRS violation and lede violation. I added new content to the subarticle where it belongs. It is a bit too soon to put it in the lede of the subarticle. QuackGuru (talk) 04:47, 7 September 2019 (UTC)

I added it to the summary section. I would of preferred to wait until the investigation was over. QuackGuru (talk) 05:25, 7 September 2019 (UTC)

Looks like QG is just wanting you to use the CDC as a source. The version they removed uses PBS. Will add it back with the CDC. Doc James (talk · contribs · email) 10:24, 7 September 2019 (UTC)

Hum yes QG would do well to stop. Doc James (talk · contribs · email) 10:41, 7 September 2019 (UTC)

Sources

You would do well to stop. I did add it to the body. QuackGuru (talk) 10:50, 7 September 2019 (UTC)

User:QuackGuru you are at 3 reverts. Next revert you may get blocked.

This is a new significant safety concern by a major medical organization. It belongs in the lead. Doc James (talk · contribs · email) 11:09, 7 September 2019 (UTC)

I am not at 3 reverts. I am at five reverts if you also include this revert and this revert.

See "In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe lung disease.[104]" That is a recommendation by an organisation. The problem with that is that there are other organizations that recommend e-cigarette use. See "Healthcare organizations in the UK in 2015 have encouraged smokers to try e-cigarettes to help them quit smoking and also encouraged e-cigarette users to quit smoking tobacco entirely.[214]" Cherry picking one organisation over another to include in the lede is not neutral. QuackGuru (talk) 20:15, 7 September 2019 (UTC)

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

On 02:44, 7 September 2019 an editor added "Following three deaths, on September 6, 2019, the Centers for Disease Control and Prevention recommended against the use of electronic cigarettes. There have been 215 formally reported cases of possible pulmonary disease related to e cigarette use.[115]"[104] The content was sourced to a news article and failed MEDRS.

You stated on 04:33, 7 September 2019: "So somebody added this to this article - Following five confirmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products.[1]" The content was not added to this article before 04:33, 7 September 2019. I added it to the subarticle that included the typo. You copied the content and the source from the subarticle and corrected the typo.

I added on 05:20, 7 September 2019 "Following five firmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products."[105] It had the typo that was corrected on 06:39, 7 September 2019.

It would POV to start that paragraph with the CDC content. The CDC source does not contradict any content in that paragraph. Not a single sentence is contradicted by the CDC statement. The CDC source does not quantify the risks. QuackGuru (talk) 19:47, 7 September 2019 (UTC)

At least we have now qualified that flat statement "the risk of serious adverse effects, including death, is low", so that it now says "was reported as low in 2016". You say the CDC does not quantify the risks? You mean they don't say low, medium, high? The CDC is still investigating, but "We suggest you not use this product" seems kind of like evaluating the risk as high. But I'm not going to go to the mat on that one. Putting it last at least makes chronological sense.

My issue right now is at another related article. The CDC information is now in all three related articles - this one, the Safety one, and the Adverse effect one. As it absolutely should be since it is highly relevant info for those three subjects. At the article Safety of electronic cigarettes I added the CDC information to the text and the lead. QuackGuru removed this - In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe respiratory disease.(CDC reference) - from the lead, with the edit summary Center for Disease Control and Prevention statement is in another subarticle in the lede and is mentioned twice in the e-cig article. It is not a summary of the body. I disagree with this. The informtion is vital and absolutely belongs in the lead. Just because something is in one article doesn’t mean it can’t be in related articles too if it is relevant and important. And if the problem was that the actual warning is not described in the text, that's easily solved: let’s add it to the text. Nothing could be more relevant to safety than a CDC warning! -- MelanieN (talk) 20:33, 7 September 2019 (UTC)

Stating "We suggest you not use this product" does not quantity the risk.

Other organisations recommend their use. That's the reason it should not be in the lede in this article or across subnarticles. The Positions of medical organizations on electronic cigarettes article has a recommendation in the lede. See "Healthcare organizations in the United Kingdom in 2015 have encouraged smokers to try e-cigarettes to help them quit smoking and also encouraged e-cigarette users to quit smoking tobacco entirely.[10]" It is better to stick to the facts rather than add recommendations or warnings from organisations to the lede. QuackGuru (talk) 20:50, 7 September 2019 (UTC)

Well, I disagree. This is not just an "organisation", this is the CDC, warning that use of these products is associated with serious illness and death, and recommending that people not use them. That is "the facts", far more than any years-old article. The situation has changed, there is new information. I wonder what those "healthcare organizations in the United Kingdom" are going to say now. BTW note that you are not the sole judge of what goes into these articles. User:Doc James appears to agree that this material is important enough for the lead. -- MelanieN (talk) 23:46, 7 September 2019 (UTC)

And I see you have now removed it from the lead of the "Adverse effects" article too, claiming it is "off topic." -- MelanieN (talk) 23:51, 7 September 2019 (UTC)

This is not occurring in the "United Kingdom". This is a US-centric event. The content added to the lede is too US-centric. The US FDA acknowledges it was the cannabis vaping products rather than all vaping products in general. There is a disagreement between the CDC and US FDA.

It was the use of vitamin E-containing cannabis products that caused the illnesses rather than e-cigarettes in general, according to preliminary findings. QuackGuru (talk) 00:27, 8 September 2019 (UTC)

None of which is relevant; we are not going to put any of that preliminary/still being investigated stuff in the article, although you seem awfully sure of yourself that it's been established. I just maintain that the CDC warning should be in the lead of all three articles. Let's wait to see what others think. -- MelanieN (talk) 03:25, 8 September 2019 (UTC)

It is a valid argument this is only an outbreak in the US. An article on beef does not have a warning of E. coli bacteria in the lede. While the investigation is preliminary/still being investigated there should not be a warning in the lede in this article. You have not made a case for the CDC warning to be in the 'Safety' section here. It is in the 'Positions of medical organizations' section. Mentioning it twice in the body is excessive. When it is in the lede of the safety article it should be in the safety section per SYNC. But no argument has been made to add it to the lede of multiple articles. Since it is only a US-centric event and it is not e-cigarettes in general it should not be in the lede. It was cannabis e-cigarette products that contained high amounts of vitamin E acetate in the US, according to preliminary lab results. QuackGuru (talk) 09:02, 8 September 2019 (UTC)

2019 US outbreak of lung illness associated with vaping products

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

See "In September 2019 the Center for Disease Control and Prevention issued a statement recommending against the use of e-cigarettes because of their association with severe lung disease in the US.[104]"

This is now an "outbreak" rather than isolated cases in a few US states. Therefore, this new sentence should be rewritten to summarise the 2019 US outbreak of lung illness associated with vaping products without including in the lede CDC's statement recommending against their use. Sticking to the facts is far more neutral rather than the current opaque sentence that does not explain there is an outbreak. QuackGuru (talk) 18:45, 8 September 2019 (UTC)

Yes, the outbreak (good that you are now using that wording) should be summarized in a sentence in the lead and should be in the body of the article somewhere. But I still say the CDC warning SHOULD be in the text and in the lead. The fact that the CDC has advised people not to smoke these things is actually the single most important "fact" that should be in this article. But most people will leave here no wiser than they got here. Here's why: like all of your e-cig articles (how many are you up to now?), this article is a daunting wall of text. They consist of hundreds of thousands of bytes, where every published journal article is given a sentence, regardless of how old they are or what the most current information is - with the effect that no significant information can gleaned from the article by most readers. Some kind of digesting and summarizing is desperately needed. -- MelanieN (talk) 21:53, 8 September 2019 (UTC)

Since this is a US-centric event the CDC warning should not be in the lede. The current evidence indicates it was the illegal cannabis vaping products containing the Vitamin E that resulted in the outbreak in the US. That's not e-cigarette products in general. Therefore, it is overkill to mention the CDC warning in the lede. QuackGuru (talk) 22:04, 8 September 2019 (UTC)

I have rewritten that sentence to include the outbreak as a reason for the recommendation. It is NOT yet established that the vitamin E is responsible. On the contrary, the CDC says their reports include people who used various devices and liquids. The FDA has a much smaller sample and less rigorous evaluation methods; they may be jumping to a conclusion. (The media is picking it up, which is why we don't use media reports.) And the CDC has not retracted their recommendation to avoid e-cigarettes. -- MelanieN (talk) 22:12, 8 September 2019 (UTC)

Including the part "and recommended that people not use the devices while the outbreak is being investigated." is breaking news type content that definitely should not remain in the lede. QuackGuru (talk) 22:18, 8 September 2019 (UTC)

You have said that about eight times now. Doc James and I disagree. Consensus rules here; you don't WP:OWN the article even though you appear to think you do. -- MelanieN (talk) 01:38, 9 September 2019 (UTC)

Doc James has not commented about rewriting the content or removing the part about the CDC's recommendation based on further comments.

It looks a bit silly to keep a temporary recommendation in the lede. The FDA has come to a different conclusion but those details are in the subarticle. I have made a "new" argument that it is a "breaking news type content" because the recommendation is only "...while the outbreak is being investigated." That's only a temporary recommendation. If editors still want to keep it in the lede the recommendation part should be cut out IMO. It was *not* a recommendation in general that people should consider stop using e-cigarettes. The CDC said it is only while they are investigating the matter for people to consider stop using e-cigarettes. Therefore, by the time they are done investigating their recommendation is no longer relevant to the lede. What is the point to keeping a moot recommendation in the lede? QuackGuru (talk) 03:08, 9 September 2019 (UTC)

Just to break your argument about consensus. For once i agree with QG. This is US-centric, it is an ongoing case (not news), and it is also US politics to the highest degree. This kind of thing, is exactly what Wikipedia is not. If there is a need, then start a subarticle on this particular outbreak, where it is also possible to cover the regional responses, as well as the linkage to blackmarket THC and Vitamin E acetase -- Kim D. Petersen 06:12, 10 September 2019 (UTC)

Someone can draft a RfC I guess. But a one sentence summary in the lead is perfectly appropriate IMO. Doc James (talk · contribs · email) 13:17, 10 September 2019 (UTC)

The current sentence in the lede is not a good summary of this section. Either fix it or remove it, is the best approach. QuackGuru (talk) 13:28, 10 September 2019 (UTC)

QG, I find it hard to believe your approach. We can report that there is an outbreak of lung disease and death associated with vaping, but we can't report that the country's top health agency recommends against vaping? We can't even mention a warning unless the warning is infinite? Oh, and the AMA is now also "urging the public to avoid the use of e-cigarette products until health officials further investigate and understand the cause of these illnesses."[106] Are we not allowed to mention that either? I would add it, but I don't remember which of your multitudinous articles is allowed to have medical society recommendations in it. And BTW Kim D. Petersen, in what possible sense is this issue "US politics to the highest degree"? Is one political party taking one side and the other another side? I have seen no evidence of that. Up to this point the issue and reporting have been focused on the facts and the science. Let's discuss without trying to cloud the issue. -- MelanieN (talk) 18:19, 10 September 2019 (UTC)

OK, I found the "medical society section" here and in its separate article, so I added the AMA warning. -- MelanieN (talk) 18:39, 10 September 2019 (UTC)

No editor would write an opening sentence with a warning for an article. That's not neutral to include a warning in the lede. Hence, the tag. The CDC and AMA said it is "e-cigarette products" rather than "e-cigarettes". Soon I will be forced to create a new article or stop adding content. New sources are mounting. QuackGuru (talk) 18:28, 10 September 2019 (UTC)

So let me get this straight. At the section in the Safety article, we have paragraph after paragraph quoting multiple reports from multiple states; a full paragraph from the vaping industry saying “it’s not us!”; and every hot new detail about individual brands. The sources for this material are appalling, especially for the stuff about individual brands - it’s websites like Leafy and The Next Web, local newspapers like the Willamette Weekly, and publications like Rolling Stone. Whatever happened to MEDRS? Whatever happened to WP:NEWS? QuackGuru, all of this stuff was added by you; the improperly sourced stuff should be removed by you. And I see you are perfectly comfortable with news reporting on subpoenas issued by state health departments, and quotes from the industry - and yet you continue to insist that we mustn’t quote the nation’s own health agencies. You say that wouldn't be neutral, and yet you quoted in full the warning against street products from the FDA! Obviously this is just a particular "thing" you have about the CDC warning, rather than any objection to warnings in general. I am going to restore the CDC warning to that article, and I am going to remove the "Neutrality is disputed" tags from this article, since obviously you don't have a problem with including such warnings. -- MelanieN (talk) 19:59, 10 September 2019 (UTC)

For the new article there will be the CDC warning in the lede. You can see it in the draft. The safety article is the wrong place to put a warning in the lede. The draft will be completed by this weekend. This has became a major news event and has received significant news coverage. The first sentence will not be a warning. That would be silly. QuackGuru (talk) 20:08, 10 September 2019 (UTC)

Oh, so first it was non-neutral, and now it's "silly"? OK. I would like to hear your comments about the badly sourced information, violating MEDRS and NEWS, in the Safety article. -- MelanieN (talk) 20:28, 10 September 2019 (UTC)

In the Safety article, I have removed the paragraph that had no reliable sources (not even meeting Wikipedia standards, much less MEDRS). And I have added to the lead a sentence about the outbreak (without mentioning the warning). -- MelanieN (talk) 16:07, 11 September 2019 (UTC)

See "He's written for WIRED, Rolling Stone and Billboard, and is the former cannabis editor of the San Francisco Chronicle, as well as the author of several cannabis books".[107] He is an expert on the subject of cannabis vapes and others are linking to the articles.

The sentence about the outbreak (without mentioning the warning) is poorly written and the other sentences about the outbreak should be deleted. It is too much detail for a summary. The lede here should be changed without mentioning the warning. QuackGuru (talk) 19:01, 11 September 2019 (UTC)

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

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

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

According to your statement when the epidemiology is known the warning should be removed. Is that correct? See "Wikipedia's articles are not meant to provide medical advice."[108] A warning rather than following MOS:LEADSENTENCE or writing introduction on the topic is like giving medical advice. Timeless content will remains in the lede. Time sensitive content is like breaking news. QuackGuru (talk) 00:15, 12 September 2019 (UTC)

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

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

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

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

US-centric

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

Two articles on "Safety" and "Adverse effects"

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

Opening sentence

Resolved

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

See "An electronic cigarette or e-cigarette[notes 1] is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioral aspects of smoking, including the hand-to-mouth action of smoking, but without burning tobacco.[76]" That is a very good opening sentence.

The part "but without burning tobacco." does not indicate it is a behavioral aspect, but the aerosol does simulate the look of smoke.

"It says "...by some of the behavioral aspects of smoking". That explains what is meant by "simulates smoking".

There is content for both "chemical and constructive". See "Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor.[77]" Also see "E-cigarettes are automatically activated by taking a puff;[78] others turn on manually by pressing a button.[3] Some e-cigarettes look like traditional cigarettes,[79] but they come in many variations.[3] Most versions are reusable, though some are disposable.[80]"

For the uninformed reader I think the first sentence is fine. QuackGuru (talk) 17:41, 15 September 2019 (UTC)

The point is that "by providing some of the behavioral aspects of smoking" means it's only about behavior which it's not. The word "simulates" is sufficient for that matter as it includes all intended aspects - behavioral, chemical and constructive. Brandmeister^talk 18:16, 15 September 2019 (UTC)

If you don't like the word "providing" then try "replacing" it with another word or adjusting the sentence. QuackGuru (talk) 18:35, 15 September 2019 (UTC)

Fine by me with "and provides". Brandmeister^talk 19:12, 15 September 2019 (UTC)