Revision as of 22:47, 6 March 2015 editCFCF (talk | contribs)Extended confirmed users, IP block exemptions, Pending changes reviewers, Rollbackers35,041 edits At least comment why you think it's relevant, not just restore it. There hasn't been discussion for 1 month← Previous edit | Latest revision as of 01:26, 30 September 2024 edit undoRena1425 (talk | contribs)4 editsNo edit summary | ||
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== Move discussion in progress == | |||
==New review== | |||
"Due to many methodological problems, severe conflicts of interest, the relatively few and often small studies, the inconsistencies and contradictions in results, and the lack of long-term follow-up no firm conclusions can be drawn on the safety of ECs. However, they can hardly be considered harmless." | |||
There is a move discussion in progress on ] which affects this page. Please participate on that page and not in this talk page section. Thank you. <!-- Talk:Usage of electronic cigarettes#Requested move 28 November 2023 crosspost --> —] 13:48, 28 November 2023 (UTC) | |||
Might be useful for mentioning the issues with conflict of interest in the literature. ] (] · ] · ]) 09:25, 2 February 2015 (UTC) | |||
:I think this part should come in "Serious methodological problems were identified. In 34% of the articles the authors had a conflict of interest." ] 09:44, 2 February 2015 (UTC) | |||
::The statement that "they can hardly be considered harmless" seems uncontroversial to me and I would recommend that it's included in the article. E-cigarettes contain nicotine; nicotine isn't harmless; so e-cigarettes can hardly be considered harmless. QED.—] <small>]/]</small> 10:13, 2 February 2015 (UTC) | |||
:::The statement is speculation. ] 02:40, 3 February 2015 (UTC) | |||
:::No nicotine isn't harmless but neither is any drug/medicine, I doubt that we are going to make a point of saying "nicotine patches / NRT can hardly be considered harmless" or "ibuprofen can hardly be considered harmless" even though both are true. However the review uncovers some important facts and is a lot more neutral than some I have seen in the past, it also found significant conflicts of interests involving both the pharmaceutical industry and e-cigarettes companies, something I've suspected for sometime. It describes the main Harm Reduction vs Cessation debate going on within the medical community relatively well: | |||
:::<blockquote>Health professionals who advocate “harm reduction” compare ECs with CCs, focus on smokers only, believe that ECs have no negative long-term health effects, that nicotine is a harmless recreational drug and that smokers are unwilling/unable to quit. These views are strongly supported by the EC/tobacco industry. On the other hand, health professionals working with public health point out that CCs are the most harmful legal products on the market (everything seems safe compared to smoking) and fear potential long-term health hazards. Other major concerns are that the product is spreading to never-smokers and ex-smokers, citizens unexposed to CCs, that many smokers have dual use (using both products) or switch instead of quitting, and that widespread EC-use will re-normalize smoking. This view is supported by the medical industry producing smoking cessation products.</blockquote>] (]) 02:59, 3 February 2015 (UTC) | |||
{{unindent}}Well, I don't agree with either of you. There's overwhelming evidence that nicotine is toxic. It's certainly not speculation to say so.<p>As far as Levelledout's point is concerned, to say "Nicotine isn't harmless but neither is any drug/medicine" is to treat e-cigarettes like drugs and medicines, which I think we've overwhelmingly agreed is inappropriate. They aren't drugs or medicines, and the fact that they do cause harm isn't to be concealed behind weaselling language. We ought to come straight out and say so.—] <small>]/]</small> 10:56, 3 February 2015 (UTC) | |||
:{{TQ|There's overwhelming evidence that nicotine is toxic.}}. As there is for Caffeine, Taurine, Ethanol, and Capsaicin. Use of all of which is common in recreational consumer products. As with all toxicity the danger is in the dose and nicotine toxicity is not in itself, so the real question is Is nictoine toxic in doses associated with e-cigarettes. And the answer to that is in usage no and in storage of liquids maybe/yes depending on strength and size. | |||
{{quote|It is unlikely that a person would overdose on nicotine through smoking alone, the US Food and Drug Administration (FDA) states in 2013 "There are no significant safety concerns associated with using more than one OTC NRT at the same time, or using an OTC NRT at the same time as another nicotine-containing product—including a cigarette." Spilling a high concentration of nicotine onto the skin can cause intoxication or even death, since nicotine readily passes into the bloodstream following dermal contact.}} | |||
The above is from Wikipedias ] Page ] (]) 11:08, 3 February 2015 (UTC) | |||
*Are you seriously contending that e-cigarettes are harmless, SPACKlick?—] <small>]/]</small> 12:26, 3 February 2015 (UTC) | |||
::That wasn't the point I was advocating. The point I was advocating was that saying "E-cigarettes are harmful BECAUSE nicotine is toxic" is incorrect. In order for me to answer whether or not I consider e-cigarettes harmless, I'd need a fixed definition of harmless because in the literal sense, nothing is Or rather there is at most one action at any given time that is harmless and all other actions are harmful relative to it. But all of this is a sidebar ] (]) 14:24, 3 February 2015 (UTC) | |||
::Of course they aren't harmless, but there is a difference between harmless and what is generally considered to be "safe". Harmless means no risk attached to them whatsoever and the vast majority of things have some risk attached to them. Making a point out of the fact that they have finite risk is a fallacy itself in my opinion. What really matters is the quantity of risk of harm associated with them.] (]) 12:34, 3 February 2015 (UTC) | |||
::*So your position is this excellent medical source says e-cigarettes "can hardly be considered harmless", but we should leave that out because making a point of it is a fallacy?—] <small>]/]</small> 13:33, 3 February 2015 (UTC) | |||
::::Well no not exactly. We already basically have the statement in the article, there's no need to add it again: | |||
::::<blockquote>Safety subsection: As of 2014, e-cigarettes cannot be regarded as harmless.</blockquote> | |||
::::But my problem is that negative opinions like this rarely get attributed to the author, instead simply being spoken in Misplaced Pages's voice. They also generally end up appearing as bytesize quotes looking like weasel words since we say that they can't be considered as harmless, but don't say how this is true or to what extent. My position is that statements like this should be attributed, fully explained and put into perspective. Public Health England provides also provides a good balanced explanation: | |||
::::<blockquote>Despite some manufacturers’ claims that electronic cigarettes are harmless there is also evidence that electronic cigarettes contain toxic substances, including small amounts of formaldehyde and acetaldehyde, which are carcinogenic to humans, and that in some cases vapour contains traces of carcinogenic nitrosamines, and some toxic metals such as cadmium, nickel and lead. Although levels of these substances are much lower than those in conventional cigarettes, regular exposure over many years is likely to present some degree of health hazard, though the magnitude of this effect is difficult to estimate.</blockquote>] (]) 16:57, 3 February 2015 (UTC) | |||
{{unindent}}Ah, I'm sorry, you're quite right: it does say that. That part of the article is so incredibly boring to read that my brain shuts down in self-defence, so I've failed to observe it until now.—] <small>]/]</small> 17:24, 3 February 2015 (UTC) | |||
:Yep, that particular subsection is very disjointed to the extent that its a chore to read and contains some very poorly written statements. I think I might suggest some improvements soon.] (]) 19:31, 3 February 2015 (UTC) | |||
::You do realize the irony, right? The Pisinger "review" criticizes studies for conflicts of interests, yet both authors have deep and long-standing associations with Pharma and smoking-cessation services. ] (]) 07:53, 4 February 2015 (UTC) | |||
:::Can you please provide evidence for these assertions.] (]) 15:37, 4 February 2015 (UTC) | |||
== |
== Cannabis == | ||
Vaping isn't only for nicotine. I'd like to see this article expanded to include the increasingly common practice of vaping cannabis products. ] (]) 22:57, 28 March 2024 (UTC) | |||
The UK's National Centre for Smoking Cessation and Training has issued downplaying concerns and stating that smoking cessation professionals should support e-cigarette users.--] (]) 14:10, 17 February 2015 (UTC) | |||
::Not a government or medical position. Appears to be an "interest group". Would be interesting to know who funds said interest group? | |||
::Goal is "support the delivery of smoking cessation interventions provided by local stop smoking services" <s>Not a suitable source.</s> ] (] · ] · ]) 22:55, 28 February 2015 (UTC) | |||
:::Interest group? It was set up with a Department for Health grant in partnership with the National Health System (and academics) and has received funding from Public Health England. ] (]) 01:15, 1 March 2015 (UTC) | |||
::::Yup here right lower corner it says "community interest company" | |||
::::The website in question does not call itself "NHS Centre for Smoking Cessation and Training" but the "National Centre for Smoking Cessation and Training" | |||
::::It appears they are selling their content | |||
::::Just because they may have received a grant from the NHS does not mean there conclusions are that of the government. | |||
::::] (] · ] · ]) 01:53, 1 March 2015 (UTC) | |||
:::::It sort of does actually. Their main function is training NHS & other staff to run smoking cessation courses etc, set up and funded by the NHS/PHE/government. The "community interest company" is for reasons such as so they don't count as civil servants with vast pensions, unions etc etc. They won't make their own policy I think you'll find, and will not be out of step with government/NHS/NICE views. But they are not the ideal source for public-facing government pronouncements, which is not really their role. ] (]) 03:58, 1 March 2015 (UTC) | |||
::::::Looks like a position statement to me. ] 04:11, 1 March 2015 (UTC) | |||
:::::::How is it that press releases from antis are position statements but position statements from NHS-funded cessation groups aren't? I think some people need to take a step back from this article and look at their POV issues before contributing again.--] (]) 11:28, 1 March 2015 (UTC) | |||
::::::I don't disagree with Johnbod's view that they don't technically represent government opinion. But they are an organisation set up in partnership with government that provides expert advice to government agencies (NHS stop smoking services) and therefore I see no problem with using them for position statements on the basis of them being a "nationally recognised expert body".] (]) 13:23, 1 March 2015 (UTC) | |||
:::::::They would certainly count as that. Their website is not terribly clear on their status, but is clearer. The Department of Health (ministry) put 3 years of funding for NHS smoking cessation training out to tender, which was won by ], & they are the vehicle set up by UCL for this. The idea was I think, that after that period they would get much of their income by charging the NHS employers for their courses; not sure how that has turned out. Now their core funding is from ]. As an NHS "smoking practicioner"(!) I think by now you need to be "accredited" by them, having passed their courses. From the report (p8) UCL "hosting" ceased in 2012, and they are apparently supposed to be self-supporting. On a further point raised by Doc James, from "NHS Centre for Smoking Cessation and Training" to "National Centre for Smoking Cessation and Training" was a name change, in 2012 (p 9, and at the start of the report). By March 2012 9K people had received training courses and 5K had passed, at least 75% NHS staff (p.14). The report included a list of research publications they have produced/contributed to, on the effectiveness of cessation interventions and such like. I've just noticed that ]'s (old) logo is at the bottom of the start of the report, with others, so they probably get or got some cash from them, or help from the CRUK funded health behaviour unit at UCL, a group of whom I trained when ] there. So I should declare an interest. At the very least a para should be added to the UK section of ], so I have done that. ] (]) 13:46, 1 March 2015 (UTC) | |||
:This is the full briefing (much longer) . Although not (presumably) peer-reviewed, it includes a review of studies, with 82 given in the references at the end. ] (]) 15:03, 1 March 2015 (UTC) | |||
::Thanks, in fact we are using this as a source in the article in the construction section.] (]) 20:28, 1 March 2015 (UTC) | |||
:They have different nomenclature and health effects. E-cigarettes replace cigarettes. THC vapes are not intended to simulate cigarettes and are often referred to as vape pens. | |||
==RFC on daughter page== | |||
:While all e-cigarettes are based on glycerin and/or propylene glycol, THC vapes usually use an oily substance. ] (] • ] 02:29, 18 April 2024 (UTC) | |||
There is an RFC on the Safety of electronic cigarettes. The RFC is asking if Sources like Press releases should be used to make medical claims. ] 22:44, 19 February 2015 (UTC) | |||
::they are position statements. Only one of the two was released in the form of a press release. ] (]) 15:28, 20 February 2015 (UTC) | |||
==Even unguided e-cigarette use among smokers unwilling to stop smoking is effective in causing smoking cessation== | |||
== Edit request == | |||
What is this meant to mean?—] <small>]/]</small> 16:31, 18 April 2024 (UTC) | |||
From the lead section, paragraph 3: "''Emissions from e-cigarette may contain tiny ultrafine particles of flavors''." This should use the plural form "e-cigarettes". ] <span style="color:#3CB371">¤</span> </small>]] 12:47, 4 March 2015 (UTC) | |||
::Thanks agree. ] (] · ] · ]) 20:16, 5 March 2015 (UTC) | |||
:It looks like someone read a study, took it as fact, and copied the text into the lead. I've tried to remedy it. ]] 17:09, 18 April 2024 (UTC) | |||
==Revert 24th April 2024== | |||
Re: {{diff2|1220517884|this revert}}. | |||
AlexGallon, I can see why you've done this, but with this particular article we need to bear in mind our audience. A substantial proportion of the people who type "electronic cigarette" into the search box are teenagers considering taking a puff—and English isn't necessarily their first language. So the lead of this particular article tries to use the simplest possible grammatical constructions. Short, declarative sentences in the active voice with as few subclauses as possible. We can use college level English in the body text; it's just the lead that needs to be super-accessible.—] <small>]/]</small> 08:06, 24 April 2024 (UTC) | |||
:Understood, and I agree with your reasoning{{snd}}very well explained, so thank you. ] (]) 18:59, 25 April 2024 (UTC) | |||
== Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes. == | |||
This line is not supported by it's own sources, especially in the context of it's section regarding "gateway drugs". It has a heavy lean towards the negative. | |||
> Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes. | |||
Suggest changing this to: | |||
> There is little evidence to suggest that e-cigarettes act as a gateway to traditional smoking at present, and further research is needed to clarify the strength and veracity of any correlations between the two. However, evidence does suggest that those who have smoked e-cigarettes will try a traditional cigarette at least once in their life. | |||
--- | |||
This source does not even discuss the topic, it is not a research paper related to the discussion: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.006416 | |||
The only thing remotely related is from the Author of the study speaking their personal opinion regarding potential ethical concerns, for it to be _potentially_ a gateway drug: | |||
"The growing ubiquity of e-cigarettes lends itself to ethical scrutiny. Many have expressed concern about the potential for e-cigarettes to act as a “gateway” to cigarette smoking.39,40 Unlike other NRTs, e-cigarettes provide a recreational function and could feasibly entice unintended product users (eg, nonsmokers and youth) to engage in smoking-like behavior when they otherwise would not. However, it is unclear how many youth or nonsmokers are purchasing these products." | |||
-- | |||
This source specifically states there is not enough evidence: https://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf | |||
Quote (Page 6, point D): | |||
"These data do not allow the conclusions to be drawn as to whether this is a sign | |||
of adolescent smokers switching to ENDS, an established pattern of dual use, or a temporary | |||
experimentation fashion. Therefore, in the absence of longitudinal data, existing evidence does | |||
not allow an affirmation or rejection of the role of ENDS in increasing nicotine addiction | |||
among adolescents above existing uptake rates, much less as to whether ENDS lead to smoking | |||
in these countries. Among adults the pattern of dual use seems also the predominant one, | |||
resulting in a reduction of smoked cigarettes and with few never smokers starting to use ENDS | |||
(below 1% of the population)" | |||
-- | |||
This source does not draw conclusions, only specifically stating there is a strong correlation between: | |||
- EVER having used e-cigs and EVER smoking a cigarette (what kind of e-cig use? In passing? Habitual? Etc?) | |||
- Current users of e-cigs and EVER having smoked a cigarette (this does not support the statement above, it is not a gateway if someone who uses e-cigs tries a cigarrette out of curiosity, nothing else being available, or simply tried it at some point in their life, etc). | |||
"Ever users of ENDS/ENNDS had over three times the risk of ever cigarette use (ARR 3·01 (95% CI: 2·37, 3·82; p<0·001, I2: 82·3%), and current cigarette use had over two times the risk (ARR 2·56 (95% CI: 1·61, 4·07; p<0·001, I2: 77·3%) at follow up. Among current ENDS/ENNDS users, there was a significant association with ever (ARR 2·63 (95% CI: 1·94, 3·57; p<0·001, I2: 21·2%)), but not current cigarette use (ARR 1·88 (95% CI: 0·34, 10·30; p = 0·47, I2: 0%)) at follow up." | |||
-- | |||
The only source (https://bmjopen.bmj.com/content/11/3/e045603#T1) which seems to support the lean this statement has, is very unclear with regards to whether the measured effect was "never users becoming habitual tobacco users after using e-cigarrettes", or "former cigarettes users who tried e-cigarettes relapsing to cigarettes", or "never users having _ever_ smoked a cigarette after first using e-cigarettes" and so on. It cannot support the statement it is attempting to. ] (]) 23:48, 15 July 2024 (UTC) | |||
*This is a medical article, so we apply medical sources in accordance with ]. The systematic review and meta-analysis published in the BMJ trumps the WHO paper.—] <small>]/]</small> 19:43, 16 July 2024 (UTC) | |||
*:Regardless, one source which itself does not claim a gateway effect, only a correlation between vaping and smoking, still does not support this statement. It itself makes no claims to a ‘gateway theory’. | |||
*:Only that vapers will eventually try a cigarette at some point. The heavy lean in the context of that section implies use of one leads to habitual use of the other. There is _no_ evidence to support this. ] (]) 21:22, 16 July 2024 (UTC) | |||
*::I'm afraid I read the source very differently. It says: {{tq|meta-analysis showed e-cigarette users were much more likely than non-users to go on to smoke combustible cigarettes, even after adjusting for covariates}}, and {{tq|meta-analysis showed a markedly higher odds of combustible cigarette use in those who had used e-cigarettes}}.{{pb}}My position is that the first of those is not a claim of a correlation. It's a claim that vapers ''go on'' to smoke tobacco, and the sequence is clear: first they vape, then they become more likely to start smoking. "Gateway" is a reasonable way to summarize this.—] <small>]/]</small> 23:32, 16 July 2024 (UTC) | |||
*:::You are implying causation, when there is only correlation. A "gateway" must in itself be the cause, but as we all know, people do not start smoking because they start smoking. The evidence is unclear, and that is clear. ] (]) 23:45, 16 July 2024 (UTC) | |||
*::::For example, I could find a strong correlation between those who drink water, and those who eat food. People who eat food at the start of their life are 9001x more likely to drink water, and people who start drinking water in their life are extremely likely to also begin to eat food. However, neither of these things are caused by each other. | |||
*::::There is simply too many other factors here to suggest that e-cigarrette usage is _the_ cause of later tobacco usage. ] (]) 23:57, 16 July 2024 (UTC) | |||
*:::::The article doesn't say it's _the_ cause. I do understand the difference between correlation and causation, and in my view the BMJ source is clearly claiming the latter and not the former, so there doesn't seem to be much possibility of us agreeing about this.—] <small>]/]</small> 08:49, 17 July 2024 (UTC) | |||
*::::::I do not believe that making alarmist statements based on personal interpretations of semantics is valid documentation, reporting, or science. | |||
*::::::Given the three other sources mentioned do not even remotely appear to agree, or are not even remotely related to the topic, it seems very clear that statement was ham fisted in with an intended bias. I’m not sure how that’s not very obvious to you. ] (]) 12:40, 17 July 2024 (UTC) | |||
*:::::::Well, hang on. This article does have quite a number of phrasing problems, and there's definitely a lot of hamfisted language.{{pb}}The article was started by a problematic editor, who is now not allowed to edit any medical articles at all. There was quite a lot of drama about him. The article needs properly checking and rewriting. That's an exercise I've been slowly chiselling away at for years and will continue when I get the opportunity.{{pb}}I won't make the specific edit you ask for, but that doesn't mean I won't listen to you and it doesn't mean I oppose other changes. I would particularly welcome proposals that make the article more accessible (reduce the reading age, simplify convoluted sentences, but without simplifying the underlying thoughts), and I'd also welcome proposals to replace poor sources with meta-analyses and systematic reviews published in medical journals. I do expect you'll be able to find places where previous editors have been unduly skeptical about e-cigarettes, and I do hope to work with you to fix them.—] <small>]/]</small> 14:18, 17 July 2024 (UTC) | |||
== Semi-protected edit request on 15 July 2024 == | |||
{{edit semi-protected|Electronic cigarette|answered=yes}} | |||
Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes. | |||
Suggest changing this to: | |||
There is little evidence to suggest that e-cigarettes act as a gateway to traditional smoking at present, and further research is needed to clarify the strength and veracity of any correlations between the two. However, evidence does suggest that those who have smoked e-cigarettes will attempt a traditional cigarette at least once in their life | |||
See talk page: https://en.wikipedia.org/Talk:Electronic_cigarette ] (]) 23:57, 15 July 2024 (UTC) | |||
*Not done. I'll reply in the other section you started, explaining why.—] <small>]/]</small> 19:39, 16 July 2024 (UTC) |
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Move discussion in progress
There is a move discussion in progress on Talk:Usage of electronic cigarettes which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 13:48, 28 November 2023 (UTC)
Cannabis
Vaping isn't only for nicotine. I'd like to see this article expanded to include the increasingly common practice of vaping cannabis products. Tad Lincoln (talk) 22:57, 28 March 2024 (UTC)
- They have different nomenclature and health effects. E-cigarettes replace cigarettes. THC vapes are not intended to simulate cigarettes and are often referred to as vape pens.
- While all e-cigarettes are based on glycerin and/or propylene glycol, THC vapes usually use an oily substance. Zvi Zig (talk • contribs 02:29, 18 April 2024 (UTC)
Even unguided e-cigarette use among smokers unwilling to stop smoking is effective in causing smoking cessation
What is this meant to mean?—S Marshall T/C 16:31, 18 April 2024 (UTC)
- It looks like someone read a study, took it as fact, and copied the text into the lead. I've tried to remedy it. Reconrabbit 17:09, 18 April 2024 (UTC)
Revert 24th April 2024
Re: this revert.
AlexGallon, I can see why you've done this, but with this particular article we need to bear in mind our audience. A substantial proportion of the people who type "electronic cigarette" into the search box are teenagers considering taking a puff—and English isn't necessarily their first language. So the lead of this particular article tries to use the simplest possible grammatical constructions. Short, declarative sentences in the active voice with as few subclauses as possible. We can use college level English in the body text; it's just the lead that needs to be super-accessible.—S Marshall T/C 08:06, 24 April 2024 (UTC)
- Understood, and I agree with your reasoning – very well explained, so thank you. AlexGallon (talk) 18:59, 25 April 2024 (UTC)
Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes.
This line is not supported by it's own sources, especially in the context of it's section regarding "gateway drugs". It has a heavy lean towards the negative.
> Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes.
Suggest changing this to:
> There is little evidence to suggest that e-cigarettes act as a gateway to traditional smoking at present, and further research is needed to clarify the strength and veracity of any correlations between the two. However, evidence does suggest that those who have smoked e-cigarettes will try a traditional cigarette at least once in their life.
---
This source does not even discuss the topic, it is not a research paper related to the discussion: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.113.006416
The only thing remotely related is from the Author of the study speaking their personal opinion regarding potential ethical concerns, for it to be _potentially_ a gateway drug:
"The growing ubiquity of e-cigarettes lends itself to ethical scrutiny. Many have expressed concern about the potential for e-cigarettes to act as a “gateway” to cigarette smoking.39,40 Unlike other NRTs, e-cigarettes provide a recreational function and could feasibly entice unintended product users (eg, nonsmokers and youth) to engage in smoking-like behavior when they otherwise would not. However, it is unclear how many youth or nonsmokers are purchasing these products."
--
This source specifically states there is not enough evidence: https://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf
Quote (Page 6, point D):
"These data do not allow the conclusions to be drawn as to whether this is a sign of adolescent smokers switching to ENDS, an established pattern of dual use, or a temporary experimentation fashion. Therefore, in the absence of longitudinal data, existing evidence does not allow an affirmation or rejection of the role of ENDS in increasing nicotine addiction among adolescents above existing uptake rates, much less as to whether ENDS lead to smoking in these countries. Among adults the pattern of dual use seems also the predominant one, resulting in a reduction of smoked cigarettes and with few never smokers starting to use ENDS (below 1% of the population)"
--
This source does not draw conclusions, only specifically stating there is a strong correlation between:
- EVER having used e-cigs and EVER smoking a cigarette (what kind of e-cig use? In passing? Habitual? Etc?)
- Current users of e-cigs and EVER having smoked a cigarette (this does not support the statement above, it is not a gateway if someone who uses e-cigs tries a cigarrette out of curiosity, nothing else being available, or simply tried it at some point in their life, etc).
"Ever users of ENDS/ENNDS had over three times the risk of ever cigarette use (ARR 3·01 (95% CI: 2·37, 3·82; p<0·001, I2: 82·3%), and current cigarette use had over two times the risk (ARR 2·56 (95% CI: 1·61, 4·07; p<0·001, I2: 77·3%) at follow up. Among current ENDS/ENNDS users, there was a significant association with ever (ARR 2·63 (95% CI: 1·94, 3·57; p<0·001, I2: 21·2%)), but not current cigarette use (ARR 1·88 (95% CI: 0·34, 10·30; p = 0·47, I2: 0%)) at follow up."
--
The only source (https://bmjopen.bmj.com/content/11/3/e045603#T1) which seems to support the lean this statement has, is very unclear with regards to whether the measured effect was "never users becoming habitual tobacco users after using e-cigarrettes", or "former cigarettes users who tried e-cigarettes relapsing to cigarettes", or "never users having _ever_ smoked a cigarette after first using e-cigarettes" and so on. It cannot support the statement it is attempting to. J. Christ Denton (talk) 23:48, 15 July 2024 (UTC)
- This is a medical article, so we apply medical sources in accordance with WP:MEDRS. The systematic review and meta-analysis published in the BMJ trumps the WHO paper.—S Marshall T/C 19:43, 16 July 2024 (UTC)
- Regardless, one source which itself does not claim a gateway effect, only a correlation between vaping and smoking, still does not support this statement. It itself makes no claims to a ‘gateway theory’.
- Only that vapers will eventually try a cigarette at some point. The heavy lean in the context of that section implies use of one leads to habitual use of the other. There is _no_ evidence to support this. J. Christ Denton (talk) 21:22, 16 July 2024 (UTC)
- I'm afraid I read the source very differently. It says:
meta-analysis showed e-cigarette users were much more likely than non-users to go on to smoke combustible cigarettes, even after adjusting for covariates
, andmeta-analysis showed a markedly higher odds of combustible cigarette use in those who had used e-cigarettes
.My position is that the first of those is not a claim of a correlation. It's a claim that vapers go on to smoke tobacco, and the sequence is clear: first they vape, then they become more likely to start smoking. "Gateway" is a reasonable way to summarize this.—S Marshall T/C 23:32, 16 July 2024 (UTC)- You are implying causation, when there is only correlation. A "gateway" must in itself be the cause, but as we all know, people do not start smoking because they start smoking. The evidence is unclear, and that is clear. J. Christ Denton (talk) 23:45, 16 July 2024 (UTC)
- For example, I could find a strong correlation between those who drink water, and those who eat food. People who eat food at the start of their life are 9001x more likely to drink water, and people who start drinking water in their life are extremely likely to also begin to eat food. However, neither of these things are caused by each other.
- There is simply too many other factors here to suggest that e-cigarrette usage is _the_ cause of later tobacco usage. J. Christ Denton (talk) 23:57, 16 July 2024 (UTC)
- The article doesn't say it's _the_ cause. I do understand the difference between correlation and causation, and in my view the BMJ source is clearly claiming the latter and not the former, so there doesn't seem to be much possibility of us agreeing about this.—S Marshall T/C 08:49, 17 July 2024 (UTC)
- I do not believe that making alarmist statements based on personal interpretations of semantics is valid documentation, reporting, or science.
- Given the three other sources mentioned do not even remotely appear to agree, or are not even remotely related to the topic, it seems very clear that statement was ham fisted in with an intended bias. I’m not sure how that’s not very obvious to you. J. Christ Denton (talk) 12:40, 17 July 2024 (UTC)
- Well, hang on. This article does have quite a number of phrasing problems, and there's definitely a lot of hamfisted language.The article was started by a problematic editor, who is now not allowed to edit any medical articles at all. There was quite a lot of drama about him. The article needs properly checking and rewriting. That's an exercise I've been slowly chiselling away at for years and will continue when I get the opportunity.I won't make the specific edit you ask for, but that doesn't mean I won't listen to you and it doesn't mean I oppose other changes. I would particularly welcome proposals that make the article more accessible (reduce the reading age, simplify convoluted sentences, but without simplifying the underlying thoughts), and I'd also welcome proposals to replace poor sources with meta-analyses and systematic reviews published in medical journals. I do expect you'll be able to find places where previous editors have been unduly skeptical about e-cigarettes, and I do hope to work with you to fix them.—S Marshall T/C 14:18, 17 July 2024 (UTC)
- The article doesn't say it's _the_ cause. I do understand the difference between correlation and causation, and in my view the BMJ source is clearly claiming the latter and not the former, so there doesn't seem to be much possibility of us agreeing about this.—S Marshall T/C 08:49, 17 July 2024 (UTC)
- You are implying causation, when there is only correlation. A "gateway" must in itself be the cause, but as we all know, people do not start smoking because they start smoking. The evidence is unclear, and that is clear. J. Christ Denton (talk) 23:45, 16 July 2024 (UTC)
- I'm afraid I read the source very differently. It says:
Semi-protected edit request on 15 July 2024
This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request. |
Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes.
Suggest changing this to:
There is little evidence to suggest that e-cigarettes act as a gateway to traditional smoking at present, and further research is needed to clarify the strength and veracity of any correlations between the two. However, evidence does suggest that those who have smoked e-cigarettes will attempt a traditional cigarette at least once in their life
See talk page: https://en.wikipedia.org/Talk:Electronic_cigarette J. Christ Denton (talk) 23:57, 15 July 2024 (UTC)
- Not done. I'll reply in the other section you started, explaining why.—S Marshall T/C 19:39, 16 July 2024 (UTC)
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