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Public Health England - evidence review Aug 2015

E-cigs estimated to be "95% less harmful to health than tobacco products". Press release, with links to the review Little pob (talk) 09:56, 19 August 2015 (UTC)

Okay this is really interesting, and it's important to give it due weight and balance it properly with the negative reports by for example the WHO. I suggest we propose changes here to avoid an edit war – the findings have already garnered some criticism. We should remember that Misplaced Pages is not news so lets take it slow.

This was released immediately upon the UK-report. I'm unsure it qualifies a reliable source, but it can give some insight. Stanford – Scientists say e-cigarettes could have health impacts in developing world

Note: The UK report is under the OGL licence – similar to CC-BY, but I think not compatible. I'll look into it. It can be use, see {{OGL-attribution}} -- CFCF 🍌 (email) 11:10, 19 August 2015 (UTC)

That "E-cigs estimated to be "95% less harmful to health than tobacco products"" is not news either - the new report merely endorses the conclusions of: Nutt, D.J., et al., "Estimating the harms of nicotine-containing products using the MCDA approach.", European addiction research, 2014. 20(5): p. 218a 2012 - see page 76 of the report. I haven't noticed that our articles mention that - how strange! Of course they are so indigestible to read that I may have missed it. Johnbod (talk) 14:13, 19 August 2015 (UTC)

We currently state "In 2015 Public Health England released a report stating that e-cigarettes are 95 per cent safer than smoking." here

While this is a primary source.Doc James (talk · contribs · email) 15:29, 19 August 2015 (UTC)

As of a couple of hours ago, yes - that should be qualified a bit. They say "best estimates show" this (p. 5). Johnbod (talk) 17:39, 19 August 2015 (UTC)

QuackGuru has now reverted this - I didn't like the exact wording but I don't agree at all that this should not be mentioned here - if so the WHO report and half the other statements should come out too. However I agree with User:S Marshall below that the article should probably remain stable during the Arbcom case, and while the dust settles on the report. After the Arbcom case we should try to begin a comprehensive clean-up of the article, which I think everybody except Quackguru agrees is a mess. Johnbod (talk) 02:04, 20 August 2015 (UTC)

• I'm opposed to radical changes to the article until the Arbcom case is concluded. At that point and once we have some behavioural guidelines from Arbcom that will make this article easier to improve, I intend to begin a Medcom case where we'll discuss deleting all of the factlets, most of the statistics, and all of the known unknowns from this article. Then I'll AfD all of the forks one by one with the objective of achieving one, single, comprehensible article on the subject. I'd suggest that we consider the new source during the Medcom case and not now.—S Marshall T/C 16:30, 19 August 2015 (UTC)

I half agree with this - I think it should first be incorporated (along with some other recent stuff) in Safety of electronic cigarettes and Positions of medical organizations regarding electronic cigarettes before here. That we can start now. I don't think "the forks" should go. Johnbod (talk) 17:36, 19 August 2015 (UTC)

Delete the facts? Ah no that does not sound like a good idea. I personally come to an encyclopedia looking for facts. Doc James (talk · contribs · email) 03:32, 21 August 2015 (UTC)

I presume he means the strings of repetitions or virtual repetitions, rather randomly sourced and of various dates, that characterize this article. Anyone coming to this article for "the facts" is likely to emerge baffled on many key points. Johnbod (talk) 11:46, 21 August 2015 (UTC)

I hope so. Replacing hard numbers with subjective terminology like "lots" is not something I support. Doc James (talk · contribs · email) 15:18, 21 August 2015 (UTC)

I specifically mean the factlets: small pieces of trivial information which are perfectly true, and well-sourced, and useless to the general reader. At the moment, the only editing technique that has been used on this article has been:- (1) find a source; (2) find a factlet or statistic from the source; (3) cite it carefully and precisely and add it to the article; and (4) group the factlets by topic. It's not currently permitted to remove any sourced text from this article at all, which is why the key points are going to be so hard for readers to extract from the article.

We'll make relatively little progress on this point until we can reach agreement about who the target audience is. Right now, the article is only accessible to people who're comfortable with statistics, polysyllabic words and writing that's densely populated with data; people who can read large amounts of data-rich, noun-heavy text and extract the key points with little effort; in fact, people with university degrees who make decisions for a living. Once the article ownership issues are in remission, the correct behavioural constraints are in place and the time has come to discuss this article's content, I will argue that this article is written for the wrong audience.

I also have specific concerns about the practice of grouping statistics from different studies together into the same paragraph. We should only be inviting readers to compare statistics from different studies if we're sure the studies used similar methods.—S Marshall T/C 01:12, 22 August 2015 (UTC)

The Guardian story. There is an arbcom case about this article now?!? EllenCT (talk) 18:12, 19 August 2015 (UTC)

This is a single report. It is not a review. The evidence presented in reviews has not change yet, anyhow. It belongs at Positions of medical organizations regarding electronic cigarettes. See Talk:Positions_of_medical_organizations_regarding_electronic_cigarettes#Public_Health_England_Report_August_2015 for the discussion. QuackGuru (talk) 18:56, 19 August 2015 (UTC)

Nice try, QuakGuru - But: Public Health England (PHE) is an executive agency of the Department of Health in the United Kingdom and NOT a medical organization! Furthermore IT IS an expert independent evidence review.--Merlin 1971 (talk) 19:57, 19 August 2015 (UTC)

See WP:WEIGHT and WP:SUMMARY. Do they cite a (PMID 24714502) primary source or a review? QuackGuru (talk) 20:02, 19 August 2015 (UTC)

Did you even look at the review at all? 185 sources where cited!--Merlin 1971 (talk) 20:30, 19 August 2015 (UTC)

Is there a particular page you want summarised? QuackGuru (talk) 20:35, 19 August 2015 (UTC)

It is actually a quote from the introduction of the report stating they are "95% less harmful", not more safe – (how do you measure safety?). I know this soundbite was picked up by a number of news agencies, but I'd like to go through the report before taking it as the only conclusion from the report. -- CFCF 🍌 (email) 22:10, 19 August 2015 (UTC) 

95% less harmful for those who actually quit cigarettes; the report notes most don't: "Given that around two-thirds of EC users also smoke". Cloudjpk (talk) 23:30, 19 August 2015 (UTC)

The report begins with two sections of summaries at different levels of their conclusions. At 111 pages it is I think far longer and in-depth than any other recent review, and very comprehensive on the key issues. It should be mentioned at several places, as its predecessor is, and the WHO 2014 report is. Several assertions currently in the article are contradicted by it, and as the latest and most detailed source it should be mentioned. Johnbod (talk) 01:55, 20 August 2015 (UTC)

"One review found, from limited data, their safety risk is similar to that of smokeless tobacco, which has about 1% of the mortality risk of traditional cigarettes." I did summarize very similar information using a review earlier this year. See Electronic cigarette#Safety. See Electronic_cigarette#cite_ref-Caponnetto2013_17-2

Let me know what you would like summarised for a specific section. I need to know the page number.

For now I added this to "Frequency". QuackGuru (talk) 02:27, 20 August 2015 (UTC)

You are not the gatekeeper for this article. Johnbod (talk) 02:30, 20 August 2015 (UTC)

I added it the other page.

I previously explained the text is redundant for the safety section.

Does anyone have any suggestions for this page? QuackGuru (talk) 03:22, 20 August 2015 (UTC)

Note. The text about the estimated 95% is currently in two other pages. See Positions_of_medical_organizations_regarding_electronic_cigarettes#United_Kingdom. See Safety_of_electronic_cigarettes#Health_benefits_and_concerns. QuackGuru (talk) 20:43, 20 August 2015 (UTC)

I think the general idea of the recent article deserves general treatment in the Lede. The Lede is already horrible and biased and it is wrong to delay the inclusion of contradictory information simply because it's new, after arguing for months and years that the cherry-picked, superficial and inconclusive studies that meant very little to the average reader, nor did they address their most substantive concern which is whether or not vaping was or was not safer than smoking and now we know it the answer is a simple and definitive "Yes". People do not browse Misplaced Pages to see the bureaucratic output from overcautious editors that go from freely and broadly over-interpreting the early FUD of negative reviews with abandon, who then suddenly become paragons of caution and discretion and want to limit Reader's awareness of balancing information that substantially indicates what we've known all along, despite propagandic attempts at feigned hand-wringing. The Lede is horrific and has been for a long time, and it hasn't bothered anyone enough to actually do anything about it besides find reasons why nothing should be done. Now the same failed methods are being proposed in advance of any interest in fixing this misbegotten article, and I have to wonder if there's more going on here than some odd sense of paternalistic responsibility. Cigarettes kill people every single day, and every day this article fails to provide necessary information about a safer alternative, it contributes to those deaths. The hand-wringers here should be thinking about how many people might be dead or dying as a result of being unable to find a safer alternative than smoking.Jonny Quick (talk) 00:28, 21 August 2015 (UTC)

I added it the proper section and the other related page. It was originally added to the safety section but it was not a WP:SUMMARY. For the lede we are going by the overall evidence in accordance with MEDRS and reviews. When the evidence according to MEDRS changes in reviews we can update the lede. QuackGuru (talk) 02:01, 21 August 2015 (UTC)

Lancet editorial

The 95% number turns out to be based on just one source, Nutt (2013). And that source got the number from, as Lancet puts it: "the opinions of a small group of individuals with no prespecified expertise in tobacco control, based on an almost total absence of evidence of harm. It is on this extraordinarily flimsy foundation that PHE based the major conclusion and message of its report." Lancet How shall we summarize this on the page? Cloudjpk (talk) 05:25, 28 August 2015 (UTC)

I fully agree this makes the number somewhat questionable. However I love the double standard. When others have tried to make similar arguments about reviews showing damage or saying ludicrous things we can't question the review but here it comes up on the most positive source.

In terms of how to deal with it in the article adding "although the lancet has expressed doubts over the accuracy of this figure" should cover it. I'm not wholly convinced by the lancet's argument. My understanding of it is PHE used the number as a base line and said evidence is still in comportment with it.

It has been previously estimated that EC are around 95% safer than smoking.

This appears to remain a reasonable estimate.

— page 12

They're clear that this is an estimated figure and so should we be. I don't think there's any doubt there's dispute over this figure amongst experts.SPACKlick (talk) 08:14, 28 August 2015 (UTC)

I don't see any need to mention "doubts" - vast numbers of assertions in the article are disputed between the sources. There's dispute both ways - the BBC carried an interview with a professor very recently who said he thought the figure too low, it was "more like 99%" less risky. But yes, these are all estimates, and in fact likely to remain so for decades, if not forever. Since most/nearly all serious vapers are ex-smokers, distinguishing between the effects of the former smoking & the vaping, if the vaping risk is indeed low, will be a real challenge when the long-term studies eventually arrive. Note also that many if not most sources in recent years have expressed an unquantified view that e-cigs are less risky than smoking; Nutt et al. in 2014 are I think the first to put a number on that, even if as a guesstimate. PHE express strongly their concern that media coverage (perhaps including us here) has led to a growth in the incorrect perception that e-cigs are more dangerous than cigarettes, & seem to have deliberately pushed the 95% figure as one that journalists and the public can understand. It will be interesting to see if any rival figure is proposed by critics, and what that would be based on! Johnbod (talk) 13:46, 28 August 2015 (UTC)

Lancet's point isn't that this an estimate. Of course it is. Lancet's point is that this estimate turns out be based on "the opinions of a small group of individuals with no prespecified expertise in tobacco control, based on an almost total absence of evidence of harm". Perhaps an accurate summary would be: Lancet has criticized this number, pointing out it's based on survey of opinion, not data. Cloudjpk (talk) 15:02, 28 August 2015 (UTC)

The data, such as it is, is "an almost total absence of evidence of harm". It's not that people haven't looked for that evidence, they just haven't found it, to the satisfaction of Nutt & his colleagues. Johnbod (talk) 15:31, 28 August 2015 (UTC)

Nutt was satisfied; he's the guy who got the panel that came up with number. Lancet's point is the number is notably lacking evidence; it is an opinion. How shall we incorporate this? Cloudjpk (talk) 16:53, 28 August 2015 (UTC)

Parsing note: Nutt wasn't satisfied that the many papers trying to demonstrate harm had come up with anything significant. Nor were PHE or the Lancet. Johnbod (talk) 14:18, 29 August 2015 (UTC)

Lancet's point is that there is "almost total absence of evidence of harm", to which Nutt et al. have attached a number. It's not an opinion, but a guesstimate for something Lancet agree with, though they disagree with attaching the somewhat random number. Johnbod (talk) 17:54, 28 August 2015 (UTC)

Actually, Lancet's point here is not about lack of evidence of harm for e-cigarettes. It was "a lack of hard evidence for the harms of most of the products": a range of nicotine products that included e-cigarettes, that the panel was asked about. (The quote is actually from Nutt). And the number is not presented by PHE as a guesstimate; that too is Lancet's point. Now: how shall we summarize Lancet accurately? Without getting into all the back-and-forth? How about: "Lancet has criticized this number as based on opinion, not hard data".Cloudjpk (talk) 19:02, 28 August 2015 (UTC)

Why don't we stick to what they actually say, rather than what you would like them to have said. Any mention should in any case be in the "safety of..." article not here. There are any number of assertions in this article that have been challenged, criticized, & disagreed with, & at present the style imposed on the article is to entirely ignore all of that. Johnbod (talk) 01:39, 29 August 2015 (UTC)

OK, what they actually say is "the opinions of a small group of individuals with no prespecified expertise in tobacco control were based on an almost total absence of evidence of harm. It is on this extraordinarily flimsy foundation that PHE based the major conclusion and message of its report...PHE claims that it protects and improves the nation's health and wellbeing. To do so, it needs to rely on the highest quality evidence. On this occasion, it has fallen short of its mission." Shall we add that then? Cloudjpk (talk) 06:37, 29 August 2015 (UTC)

And per WP:Weight we wouldn't put that much detail in an editorial's rebuttal of a review. The PHE saw the estimate, looked at the evidence and have backed the estimate. The editorial attacks the origin of the number in order to dispute the PHEs agreement with it but it doesn't account for the PHE having assessed that estimate in the light of evidence. I'm having real De Ja Vu from the discussion of the MCneil criticism of WHO here. 1SPACKlick (talk) 11:38, 29 August 2015 (UTC)

Are "we" changing now the sourcing and including criteria for health claims?--TMCk (talk) 14:13, 29 August 2015 (UTC)

I'm not sure why there's discussion on how to weight the comment "small group with no prespecified expertise in tobacco control". The point is that assessing relative risk isn't a tobacco control issue, it's a medical/scientific one. -Jim bexley speed (talk) 02:04, 30 August 2015 (UTC)

I wondered about that too. Johnbod (talk) 03:06, 30 August 2015 (UTC)

• Some further statements on this, links copied from below:

Letters to the Lancet from the PHE: and

Nutt fights back, as does Farsalinos, and pushing back against the pushback. Johnbod (talk) 01:56, 4 September 2015 (UTC)

Misplaced Pages seeks WP:V

If the text is unsourced please add a citation needed tag or verify the claim with a citation. Unsourced text is forbidden. QuackGuru (talk) 06:34, 23 August 2015 (UTC)

I see you found a source for this fundamental fact without any difficulty, as I said would be the case. Thanks. Personally I prefer that the text is correct rather than wrong but referenced, though I can see there are other views. Johnbod (talk) 13:45, 23 August 2015 (UTC)

Personally I prefer no unsourced text even if true. QuackGuru (talk) 18:37, 23 August 2015 (UTC)

Requiring every single statement in the article be sourced is the primary reason why it is completely unreadable. It's a Frankenarticle.Jonny Quick (talk) 04:51, 24 August 2015 (UTC)

If one does not source every single statement someone will come along and tag it with in no time. Doc James (talk · contribs · email) 04:57, 24 August 2015 (UTC)

Johnbod I agree with you when it comes to less controversial articles, but as any statement here is likely to be challenged we need to properly source all statements.-- CFCF 🍌 (email) 05:25, 24 August 2015 (UTC)

I left an edit summary explaining the issue, & QG then challenged it and fixed it. It was not in fact a statement anyone else was ever likely to challenge. On inspecting a number of statements with accessible sources here, too many have turned out not to accurately reflect their source. Many many more have inaccessible sources, which is concerning. Johnbod (talk) 09:59, 24 August 2015 (UTC)

Johnbod If you or anyone needs help accessing any sources just mail me, I have pretty much everything. -- CFCF 🍌 (email) 15:56, 24 August 2015 (UTC)

The issue with this edit is that there is a reference at the end of the sentence that did not verify the claim. In the future I hope a tag is added to the sentence if the meaning is changed or ask on the talk page for a source. No worries. QuackGuru (talk) 18:26, 24 August 2015 (UTC)

Spotted OR

See diff. Do both sources verify the word "some"? QuackGuru (talk) 16:44, 25 August 2015 (UTC)

The two sources are the "some" - and one could could quickly compile a longer list, probably just from the repetitive titbits that litter the article. Johnbod (talk) 00:44, 26 August 2015 (UTC)

Putting two refs together is obviously OR. The type of OR is WP:SYN. Each individual source must very the claim "For some" otherwise it should be removed. QuackGuru (talk) 02:31, 26 August 2015 (UTC)

Yeah, this is about the first of these where I agree with Quack. Do we have any source claiming certainty on this? The "some" is clearly OR and I have removed pending source. SPACKlick (talk) 11:53, 26 August 2015 (UTC)

When you have a group of different reviews drawing somewhat different conclusions from the same limited body of evidence you can either follow the QG method of scattering contradictory bullet points over the article at different places with no attempt to give context, or attempt to describe the situation as it is. If several studies say the same thing, it is not OR or WP:SYN to group them as such. SYN deals with the situation where people "combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources", which is not what I did. Johnbod (talk) 12:01, 26 August 2015 (UTC)

I agree in principle but your use of "some" here doesn't group them. It takes a statement of overall position "The benefit is uncertain" and caveats it to a limited group "For some, the benefits are uncertain". This would imply either there is some second group that has certainty or some other group about which we can be certain. Either way it's at odds with the conclusion of the RS's that there is great uncertainty over the long term benefits on smoking cessation. SPACKlick (talk) 12:10, 26 August 2015 (UTC)

I'm open to rephrasing but there is a clear division in the conclusions on whether EC are useful in smoking cessation drawn by RS sources in the last two years, and just stating the different conclusions at different places merely baffles the reader. The other group include Cochrane & PHE who conclude ECs can be useful. The two text versions are:

a) mine: "As of 2014, research on the safety and efficacy of e-cigarette use for smoking cessation is limited. A 2014 Cochrane review found limited evidence of a benefit as a smoking cessation aid from the two randomized controlled trials (RCT) that had been published at that point, but the conclusions drawn from these trials vary. For some, the benefit of e-cigarettes for quitting smoking is uncertain, and they have not been subject to the type of efficacy testing as nicotine replacement products. A third RCT published in 2015 was interpreted as strengthening the evidence for their efficacy in smoking cessation, as was a UK cross-sectional population survey...."

b) QG's: "As of 2014, research on the safety and efficacy of e-cigarette use for smoking cessation is limited. A 2014 Cochrane review found limited evidence of a benefit as a smoking cessation aid from two randomized controlled trials (RCT). The benefit of e-cigarettes for quitting smoking is uncertain and unproven, and they have not been subject to the type of efficacy testing as nicotine replacement products. A third RCT published in 2015 was interpreted as strengthening the evidence for their efficacy in smoking cessation, as was a UK cross-sectional population survey...."

QG's text implies that Cochrane also thinks that "The benefit of e-cigarettes for quitting smoking is uncertain and unproven," - where do they say that? That does represent WP:SYN (as regards "unproven" - "uncertainty" naturally goes with the territory). Johnbod (talk)

The current text does not suggest that Cochrane also thinks that "The benefit of e-cigarettes for quitting smoking is uncertain and unproven,...". That is a totally different sentence using different citations. The previous text was too wordy. For example, the part "but the conclusions drawn from these trials vary." is unnecessary and does not tell the reader much. This article is written for the general reader.

"These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking."

"Because electronic cigarettes are unproven as cessation aids, are unregulated,..."

"The benefit of e-cigarettes for quitting smoking is uncertain and unproven, and they have not been subject to the type of efficacy testing as nicotine replacement products." The current sentence is sourced. QuackGuru (talk) 19:09, 26 August 2015 (UTC)

I couldn't agree with these points less, but will have to return to this later. Frankly, you have some cheek reminding me that "This article is written for the general reader"! Isn't it strange how completely different your preferred bullet point style is from anything that people trained professionally to write for the general reader use. And also how complaints about your style on this page stretch back through the archives at very regular intervals. Johnbod (talk) 12:14, 27 August 2015 (UTC)

There was even more vague wording and OR. QuackGuru (talk) 04:48, 31 August 2015 (UTC)

I will have to return to these later, but it is unhelpful to the reader to eliminate all references to RCTs. It's a pity you won't actually just read the sources complete. What is it you "could not verify" about: "Adriaens, K., et al., Effectiveness of the electronic cigarette: An eight-week flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints. Int J Environ Res Public Health, 2014. 11 (11): p. 11220-48? PHE Report p.46, & note 41. Johnbod (talk) 14:31, 31 August 2015 (UTC)

The text at Electronic cigarette#Smoking cessation says "A third RCT in 2014 found that smokers who were not interested in quitting, after eight weeks of e-cigarette use 34% who used e-cigarettes had quit smoking in comparison with 0% of users who did not use e-cigarettes, with considerable reductions from smoking in the e-cigarette group." The word some was OR and this was OR. There was not a third RCT published in 2015 and the wording was unreadable and vague for the general reader. QuackGuru (talk) 19:08, 31 August 2015 (UTC)

Propose to Restructure Entire Article Titled "Personal Vaporizers" (or similar)

After a couple of weeks research, I am of the opinion that using the term "ecigarette" as a comprehensive word to describe the entire class of personal vaporizers is one of the fundamental problems of the article. The broad category class "umbrella" term should be something like "Personal Vaporizer" or "Personal Vaping Device" or similar, with old-school, 1st generation e-cigarettes, cigalikes, etc... as separate sections within the article. Many of the research studies being quoted in the article were done on e-cigarettes and not the newer personal vaping devices and so that research does not, and/or may not apply to the entire class of devices. People searching for "e-cigarettes" specifically could be redirected to the more general article on the entire class of devices.Jonny Quick (talk) 05:14, 24 August 2015 (UTC)

Research literature does not make this distinction, as such neither do we. You'd have to make a strong case with sourced to back you up. As for name choice see WP:COMMONNAME. -- CFCF 🍌 (email) 05:23, 24 August 2015 (UTC)

I just have a feeling that's simply not true, and I also wonder about how you come to represent "we"? You are throwing bureaucratic obstacles in the path of improving the article when common sense is clear. You seem to be avoiding the assertion that "personal vaping devices" is an umbrella term that includes "ecigarettes". Do you deny this? Are you trying to claim that some vaping devices are ecigarettes, but not all ecigarettes are vaping devices? If so, please give a single example of an ecigarette that is not a vaping device, as I can certainly show hundreds of examples of vaping devices that are not ecigarettes. Also, how come you to know the sum total of all the "research" literature, and are able to speak with some authority? You sound certain that there isn't a single reliable source that places the correct relationship between ecigarettes and vaping devices, and I get the impression you don't want to, and for reasons I can only imagine. Finally I don't agree with, and disagree with, and don't care about whatever added, extra obstruction you seem to think is required here. I think a consensus on the truth of it, with some reasonable research to verify it should be enough. I also think you are trying to use wikipedia policies, etc... to try to prevent improving this article from it's current, laughable and unreadable state. Or do you disagree and believe that the article is fundamentally "good", because if so then perhaps wikipedia policies need to change. My instinct here is that it is your role on this article is to find "Misplaced Pages" sounding reasons to oppose change and improvement to this article, simply for opposing change. Somewhere there's a thing about "building an encyclopedia". Are you here to build an encyclopedia, or parrot wikipedia policies in order to prevent an inaccurate and useless article from being improved?Jonny Quick (talk) 05:50, 24 August 2015 (UTC)

Electronic cigarettes is the most common term used in teh literature. We should likely stick with this term. Doc James (talk · contribs · email) 05:54, 24 August 2015 (UTC)

And in the media too. That some 'vaping devices ... are not ecigarettes' is not the general usage afaik. Johnbod (talk) 09:53, 24 August 2015 (UTC)

It's certainly my experience that both in the academic sphere and the end user sphere variations on E-cig/electronic cigarette is the more common label and that PV/vape are more hobbyist terms. SPACKlick (talk) 15:29, 24 August 2015 (UTC)

The most famous common name is "electronic cigarette". QuackGuru (talk) 18:26, 24 August 2015 (UTC)

Again back to the point of the question. I say "All ecigarettes are vaping devices, but not all vaping devices are ecigarettes." That statement right there, true of false, will illustrate the direction this article needs to go. It's either "A" or "B". Please pick one and make your explanation as to why you picked one or the other, and not mention less important points, such as the wrong word may happen to be more popular (with media outlets that do not know the difference between the two). Those media outlets come HERE for clarity, and not the other way around.Jonny Quick (talk) 22:59, 24 August 2015 (UTC)

Let me try to put this mildly – it does not matter what you "say". Get some reliable sources according to WP:RS & WP:MEDRS and stop wasting time on anecdotes. -- CFCF 🍌 (email) 06:33, 25 August 2015 (UTC)

Stop trying to redefine the subject. First I do not "say" (your word) "2 + 2 = 4", 2 + 2 really does equal 4, and I don't care, and no one cares, whether or not every single "reliable source" on the entire internet says otherwise. 2 + 2 does not, and will never, equal 5. Do not use the absence of any reliable sources or published material or whatever irrelevent terminology you are using to prevent basic common sense from guiding this article. Do not try to change the subject from what is to what someone "says" and also stop avoiding answering the basic and fundamental question that should determine the structure and foreseeable future of this article. Are all ecigarettes vaping devices and some vaping devices not cigarettes? Yes or no. Answer this fundamental and direction-defining question. Stop using inapplicable and irrelevant "official" Misplaced Pages policies to prevent this article from undergoing necessary change. Stop pretending to be interested in improving this article while the actual results of your efforts are to maintain the terribly flawed, inaccurate and biased nature of this article, for reasons that cannot be expressed here, but are perfectly obvious to anyone that happens to read these words. Stop changing the subject to something else. Please answer the question: Are more general terms like "vaping devices" an umbrella term for the entire class, within which other terms like "ecigarettes" should fall, or not. And if not please give useful answers and explanations for why you think the way you do. Also explain how then you propose to deal with the term "Vaping Devices" and similar. Do you propose a completely separate article? If so, how will you (in the exact same absence of any "published material" going to differentiate between "vaping devices" and "ecigarettes". By what standard would you use? This article doesn't even define the ecigarette in a manner that contrasts it with a "vaping device". Perhaps some of the obstructionists would like to include a separate section in the "ecigarette" article titled "vaping devices" so that the encyclopedia gives the false impression to the readers that vaping devices are a subsection of the larger class of "ecigarettes" instead of the truth, which is the other way around. Note to anyone else reading this, I'm not telling these people something they don't already know. Please note how much effort they are putting into pretending to "not get it". Someone else can post the link to the wikipedia thing about "not getting it". I read that in other articles, when discussion pages go south like this. That usually gets pasted when editors that certainly know better pretend that they don't.Jonny Quick (talk) 05:24, 27 August 2015 (UTC)

CFCF Welcome the new user. It is nice to have comments here from new people.

Jonny Quick, Misplaced Pages is a summary of what is already published, and not original thought or unpublished observations. Misplaced Pages is supposed to copy what other sources say and not diverge from what is already published. If there is an idea that you want included in Misplaced Pages then please present sources which have already published that idea, so that they can be cited. In this article, things get tense because the sources are unclear, so there is lots of room for you to propose ideas if you present sources that first published them. Blue Rasberry (talk) 13:46, 25 August 2015 (UTC)

Blah, blah, blah, please read my words to the previous editor as the apparantly apply equally to you. 2 + 2 does not equal 5, and no honest editor acting in good faith would ever propose that the article reflect a falsehood that everyone knows to be false. It's an indicator of a lack of common sense and dishonesty on your part to, whatever nonsense about "good faith" obstructionists may spew, like Forrest Gump says "Good faith is as good faith does." Stop blathering the empty words of building an encyclopedia and build the encyclopedia instead. Please answer the fundamental and direction defining question "Are all ecigarettes vaping devices, and some vaping devices not ecigarettes." and allow the article to be what it is supposed to be, instead of insisting upon it remaining the misbegotten pile of drivel that it is.Jonny Quick (talk) 05:32, 27 August 2015 (UTC)

Vaping is Not Like Smoking

An electronic cigarette (e-cig or e-cigarette), personal vaporizer (PV) or electronic nicotine delivery system (ENDS) is a battery-powered vaporizer that simulates the feeling of smoking, but without the tobacco combustion.

I realized last night that the entirety of this article is one long argument against an unstated and false premise, and that premise goes something like "ecigarettes are a safe and effective alternative to cigarettes". Maybe that was a reaction to how ecigarettes were marketed and maybe that is the reaction from corporate lobbies, etc... I don't know, but if you mentally compare that idea, that ecigarettes are a safe and effective alternative to smoking, then almost all of this articles problems are explained. Please note the title of the article is NOT "Reasons why ecigarettes are not a safe and effective alternative to smoking", but if the article is going to be that, then it should be titled appropriately, so if anyone objects to any fundamental changes in the articles POV and underlying structure, then they should also be in favor of changing the title to more accurately reflect what the article is really about.

The very 1st sentence says it all, where it makes the hard-wired connection, and comparison to tobacco and the smoking of tobacco, as if (the more accurate umbrella term) "Personal Vaping Device" (or similar) is not a standalone device with no connection to cigarettes and tobacco whatsoever. Insecticide ALSO has nicotine, so perhaps the Lede should include a few lines about how ecigarettes are similar to, and contrast with, toxic chemicals used to kill insects.

Therefore I propose that the entirety of this article be completely scrubbed of any references to cigarettes, tobacco, smoking, etc... unless there is a specific section in the article for doing expressly that. Otherwise this article conflates two very different devices, activities, etc... and creates confusion between the two, instead of clarity.Jonny Quick (talk) 22:55, 24 August 2015 (UTC)

• I'm afraid our article has to be based on the sources, and what the decent sources do is compare and contrast vaping with smoking. I don't think it would even be possible to write an article that says what e-cigs are, what they're for and who uses them, without referring to cigarettes, tobacco and smoking. They're devices for delivering a nicotine hit used by tobacco smokers, ex-smokers, and a minuscule, negligible number of people who've never smoked.—S Marshall T/C 23:06, 24 August 2015 (UTC)

And you've failed to address all the substantive points I made, and given a very convoluted explanation for why the article cannot change. It simply MUST be this way. First, let's take 2 giant steps backwards and understand that whatever your merit your points may have, they are based on the fundamental flaw of failing to structure the article accurately, that vaping devices are the general class and "ecigarettes" are a subsection within that class. Now all the limitations you claim exist in your source material evaporate and all that's left to do is construct an honest and informative article about the devices and the activity of using them, instead of the cobbled-together "Frankenarticle" of junk science and FUD. And now we're not encumbered with this ridiculous notion that every single sentence in the article must have a verbatim source, and all the other myriad tactics and strategies that have been employed over the course of this articles "creation" to prevent it from being an accurate and unbiased and encyclopedic article about vaping devices and vaping, instead of a pretext to publish inadequate, biased, and (at least in one particular JAMA article) scientifically dishonest studies. Hundreds of Welsh school children all agree, this article increases the likelihood that they will use cigarettes.Jonny Quick (talk) 05:44, 27 August 2015 (UTC)

Changing the name wouldn't change the subject, or the treatment. A statement last year by the Royal Society for Public Health did rather eccentrically call for everyone to "Stop calling the product electronic cigarettes", though they don't suggest an alternative & use the term themselves, and of course their interest is entirely rooted in smoking cessation. The proposition that "ecigarettes are a safe and effective alternative to cigarettes" is certainly not a "reaction to how ecigarettes were marketed" as in the US & UK, & I think other countries too, those selling e-cigs have for legal/regulatory reasons to avoid any reference to them having any role in smoking cessation at all. Johnbod (talk) 13:21, 27 August 2015 (UTC)

Somebody queried recently why it is "electronic" not "electric cigarette", which seemed a good point, given how straightforward the device is. But everyone uses "electronic". Johnbod (talk) 11:35, 4 September 2015 (UTC)

New sources daily

See http://www.scoop.it/t/the-future-of-e-cigarette QuackGuru (talk) 22:22, 26 August 2015 (UTC)

Useful BBC story here and Medscape one here. And interesting reflections of an ex-WHO tobacco control guy here. Johnbod (talk) 03:38, 27 August 2015 (UTC)

What do you recommend to summarise? QuackGuru (talk) 15:52, 28 August 2015 (UTC)

Nutt fights back, as does Farsalinos, and pushing back against the pushback. Johnbod (talk) 13:30, 30 August 2015 (UTC)

Good Bloomberg piece on the US market, and NHS blog on the "gateway" hypothesis. Johnbod (talk) 00:47, 12 September 2015 (UTC)

Dubious point from of 2011 paper.

The article has, at the start of "Harm reduction": "Tobacco harm reduction has been a controversial area of tobacco control. The health community has not endorsed e-cigarettes as a tobacco harm reduction strategy, in part in response to tobacco industry deception."

1. ^ M., Z.; Siegel, M (February 2011). "Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes?". Journal of public health policy. 32 (1): 16–31. doi:10.1057/jphp.2010.41. PMID 21150942.

- The online version was published in December 2010. I can't see the full paper, but the abstract reads (in full): "The issue of harm reduction has long been controversial in the public health practice of tobacco control. Health advocates have been reluctant to endorse a harm reduction approach out of fear that tobacco companies cannot be trusted to produce and market products that will reduce the risks associated with tobacco use. Recently, companies independent of the tobacco industry introduced electronic cigarettes, devices that deliver vaporized nicotine without combusting tobacco. We review the existing evidence on the safety and efficacy of electronic cigarettes. We then revisit the tobacco harm reduction debate, with a focus on these novel products. We conclude that electronic cigarettes show tremendous promise in the fight against tobacco-related morbidity and mortality. By dramatically expanding the potential for harm reduction strategies to achieve substantial health gains, they may fundamentally alter the tobacco harm reduction debate."

Apart from showing strong signs of being cherry-picked for anti-e-cig points, more recent material makes the wording of the 2nd sentence pretty clearly outdated, as a generalization, as 'Health advocates who are not reluctant to endorse a harm reduction approach' are pretty thick on the ground, though obviously the controversy rolls on. The first sentence is fine, but needs a more recent source. Johnbod (talk) 01:56, 1 September 2015 (UTC)

Per WP:MEDDATE, we can keep the source until a more recent source is found. I have deleted the second sentence for now. QuackGuru (talk) 04:16, 1 September 2015 (UTC)

Thanks. Something that reflected the current state of mixed/emerging acceptance of the harm reduction argument would be useful sometime. Johnbod (talk) 01:14, 2 September 2015 (UTC)

Lancet editorial responses

Please comment on and . Thank you! EllenCT (talk) 23:23, 3 September 2015 (UTC)

See section Public Health England - evidence review Aug 2015 above.--TMCk (talk) 00:17, 4 September 2015 (UTC)

Now section "Lancet editorial".--TMCk (talk) 00:21, 4 September 2015 (UTC)

Archiving

The archiving of all talk pages on this subject has been has been far too sudden, and naturally looks suspicious in the middle of an Arbcom case. One of the pages had fewer than 2,000 bytes turned into an archive! Blanking the page is not normal on WP. Please ask on the talk page before archiving again, QG, since you behaviour has been far from the WP norm. Clearing out the page just encourages people to raise the same issues again and again. Johnbod (talk) 03:40, 10 September 2015 (UTC)

Isn't this page auto-archived? Why do it manually? Sizeofint (talk) 04:27, 10 September 2015 (UTC)

Someone set minthreadsleft to 3, which is absurdly low, especially with 15 day archiving. I'm changing to 15 threads and 30 days and restoring archived sections. EllenCT (talk) 14:40, 10 September 2015 (UTC)

The problem is that length of threads isn't counted by the bot. The best solution would be to have a cutoff at a page length rather than a # of threads. While 3 is too low, 15 is way too high–the number of days was good before. Johnbod – asking on the talk-page just aggravates the problem. -- CFCF 🍌 (email) 20:05, 10 September 2015 (UTC)

I strongly disagree that 15 is high. Most talk pages with archiving settle on around 20 threads and 30 days. 70KB for about 15 threads is not particularly excessive in an article experiencing a lot of discussion. EllenCT (talk) 23:54, 10 September 2015 (UTC)

Me too, though 10 might be ok too. QG simply removed ALL threads on all the pages. Plus several of the threads here were not finished (arguably few of them ever are). Are you suggesting I shouldn't use the talk-page at all - just leave it for QG? Johnbod (talk) 04:40, 11 September 2015 (UTC)

Previous review

See here. "The images lack alt text, which is meant to describe the content of the images to readers who can't see them. Please see WP:ALT for details." QuackGuru (talk) 05:26, 10 September 2015 (UTC)

You are in the middle of an arbitration about your editing issues, and you want to add alt text to images? EllenCT (talk) 14:41, 10 September 2015 (UTC)

I added the alternative text for images per WP:ALT. The alter text is helpful for blind people. See diff. QuackGuru (talk) 20:11, 10 September 2015 (UTC)

Note this guideline has more or less been discontinued, after people with impaired vision said that the instructions on how to describe images were all wrong, & nobody could agree what was the right way. Why bring up this point from 2009 now? Do you really think this is the article's biggest problem? How about the unreadable prose, which literally dozens of people have complained about?

The prose is rather robotic. Sizeofint (talk) 07:14, 11 September 2015 (UTC)

The prose is uniform throughout the article. When significant viewpoints disagree we include both per NPOV. The lede is a good example of disagreement among WP:MEDRS sources. A recent issue has been WP:OR. Sourced text was replaced with OR. I recently fixed the problematic wording and the poorly written sentences. QuackGuru (talk) 17:38, 11 September 2015 (UTC)

The prose is uniformly poor throughout the article, consisting of often badly over-summarized bullet points that are piled up whether they agree with each other or not, leaving the reader to try to work that out, which is often impossible. Your idea of what is good and poor writing has been consistently disputed by large numbers of editors. Your claim of OR (apparently, anything not written by you) is wrong, and I will return to this matter when I have more time. Johnbod (talk) 17:49, 11 September 2015 (UTC)

Sources often disagree on this topic. For example, see "Their usefulness in tobacco harm reduction is unclear, but in an effort to decrease tobacco related death and disease, they have a potential to be part of the strategy." According to WP:WEIGHT we include both statements for a neutrally written article. QuackGuru (talk) 17:59, 11 September 2015 (UTC)

OR is when the source does not make the claim. I tagged the OR and replaced it with sourced text. OR cannot be verified. QuackGuru (talk) 17:59, 11 September 2015 (UTC)

Note

When there is a WP:MEDRS compliant source then we could include a response to this using a new source. The two sources previously discussed are not WP:MEDRS compliant. QuackGuru (talk) 17:36, 14 September 2015 (UTC)

New evidence

See here. It led to here and here. Will check for reviews. QuackGuru (talk) 17:54, 14 September 2015 (UTC)

Please don't link to things like scoop, which have 20 different stories, and change every few hours. Or if you must, quote the headline. The first one is peripheral for this page, and the second a mouse study. Johnbod (talk) 18:03, 14 September 2015 (UTC)

They have new sources which has led to improving the article. QuackGuru (talk) 18:05, 14 September 2015 (UTC)

The neutrally-minded may also be interested in these, from the same page, which QG did not see fit to inform us about: Smokers who switch to e-cigarettes may breathe fewer toxins - new study, and their top story "Should some Arab countries rethink e-cigarette ban?", with interesting comments from top experts. Johnbod (talk) 18:11, 14 September 2015 (UTC)

New source says 70 percent

• Oscar Raymundo (27 January 2015). "How to Get Started with E-Cigarettes". The Huntington Post. {{cite news}}: Italic or bold markup not allowed in: |publisher= (help) QuackGuru (talk) 18:18, 14 September 2015 (UTC)

A tag was added to the claim but the source said "Because vaping emulates the smoking experience, now 70 percent of American smokers who are looking to quit are turning to e-cigs, according to statistics compiled by Ecigsopedia." We are not using this source for medical claims per WP:MEDRS. We are using this source for the percentage of US smokers who have used e-cigarettes. QuackGuru (talk) 19:11, 14 September 2015 (UTC)

Your edit "As of 2015, about 70% of US smokers have tried e-cigarettes" doesn't match the source as per your cited sentence above.--TMCk (talk) 19:51, 14 September 2015 (UTC)

Possible source for "History"

• Joseph A. Califano Jr. (10 March 2015). "It's About the Kids". The Huntington Post. {{cite news}}: Italic or bold markup not allowed in: |publisher= (help) QuackGuru (talk) 18:33, 14 September 2015 (UTC)

Canada

Quack, since I see you have accepted my change at the legal status article, can you please change this and any other articles to match. The current text " In Canada, they are legal to sell, but nicotine-containing e-fluid is not approved by Health Canada, making vaping technically illegal,..." is as far as I can tell wrong every which way. The activity of vaping is legal, but the sale of nicotine for vaping is not - the exact opposite of what we say. We should have a more authoritative reference too. My understanding is that any nicotine product for vaping would need to be approved by Health Canada, and they have not approved any (& don't currently intend to). I'm assuming this is your text, perhaps wrongly. Johnbod (talk) 18:49, 14 September 2015 (UTC)

I made this change. Some areas in Canada are banning e-cigarettes. QuackGuru (talk) 19:13, 14 September 2015 (UTC)

evidence for banning sales, especially via mail? Local bans on vaping in some contexts, eg offices, are different. Johnbod (talk) 19:38, 14 September 2015 (UTC)

See diff. QuackGuru (talk) 19:42, 14 September 2015 (UTC)

Thanks. a more recent press story, all bans still seem to be on vaping in specific types of places. But what was Health Canada's response to Parliament? I can't see anything. Must we wait for the election? User:Doc James? a July story Johnbod (talk) 20:04, 14 September 2015 (UTC)

Does this help? P Walford (talk) 21:44, 14 September 2015 (UTC)

Yes, somewhat, thanks! There's also a 17 page PDF report by academics, but as it contains a gross error in a statement on the UK situation (top p.7) I was rather put off that. Johnbod (talk) 00:11, 15 September 2015 (UTC)

Public Health Consensus

In light of the recent scientific consensus reached by all major public health organisations in the UK, I think a major rewrite of the entire article is in order to accurately reflect this fact. Let's discuss. Mihaister (talk) 19:46, 16 September 2015 (UTC)

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