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This is an old revision of this page, as edited by Jonny Quick (talk | contribs) at 04:51, 24 August 2015 (→‎Wikipedia seeks WP:V). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Template:Ecig sanctions

Dated incorrect information

"While tobacco smoke contains 40 known carcinogens,[16] none of these has been found in more than trace quantities in the cartridges or aerosol of e-cigarettes.[16]" See Electronic cigarette#Harm reduction. This is false information. For example, "Depending on the heating temperature, the compounds may surpass the levels of cigarette smoke.[12]" See the Electronic cigarette aerosol page. QuackGuru (talk) 06:26, 6 August 2015 (UTC)[reply]

I read this and it red-flagged a bit for me, because it doesn't give some sense of scale. The mere presence of one or all of these carcinogens in nicotine "juice" doesn't necessarily mean that it's noteworthy, but the untempered statement that they are there could be inflammatory. Carcinogens are everywhere, and in everything. The most relevant point is whether or not the levels are high enough to warrant concern. Failing to note their presence could be perceived as bias, but simply saying that they are there is also biased, so some tempering language should be included, i.e. what percentage is present and how close are those levels to (for example) cigarettes. What if nicotine juice as 0.000001% of the toxicity of cigarettes? Then just saying that the toxins are there is misleading. I have no better suggestion now, but that's the direction I'd like to go on this point.Jonny Quick (talk) 17:22, 6 August 2015 (UTC)[reply]
That "Depending on the heating temperature, the compounds may surpass the levels of cigarette smoke.[12]" does not necessarily mean that the quantities are more than trace in either. One day someone will analyse and rate the carcinogenic potential of the estimated 15,000 compounds in a cup of coffee. Johnbod (talk) 16:42, 7 August 2015 (UTC)[reply]
Also I'm wondering how false and misleading that statement is "depending on heating temperature". Sure, if you heat the nicotine juice so that the Propylene_glycol BURNS (like sugar burns carbon-black) then sure it might cause cancer. Burning sugars cause cancer. But who is going to want to inhale nicotine juice superheated to the point that the sugars burn? Doubt Vaping heating technology has advanced to the point that it could even do that, but maybe. In any case, I think the citation needs to get dug into in order to determine if that statement is a legitimate one, or if the citation is some kind of illegitimate shill (or whatever the technical wikipedia word would be). I don't know wikipedia that much, but I've been on the internet long enough to know that internet marketers are capable of anything, to include making up fake and scary-sounding "studies" to scare people away from (vaping) and towards (tobacco).Jonny Quick (talk) 02:42, 8 August 2015 (UTC)[reply]
This is was I meant. QuackGuru (talk) 02:53, 8 August 2015 (UTC)[reply]
Thanks for the link. I've read the JAMA article and it seems JAMA is saying that the nicotine juice COULD be "overheated" to the point that the liquid becomes toxic, but gives no sense of whether or not that is something that anyone would want. I think I remember something a few years back that burned sugars are carcinogenic, and it's possible that is what JAMA is describing, but the question is whether or not it actually happens. Currently researching that. At this point I regard the JAMA article's assertion as a theoretical possibility but has not proven to be a realistic concern. I would think that overheating the e-liquid would cause the flavor of the vapor to be destroyed, and defeat the entire purpose for the activity, and for no possible benefit that I can see at this point. So while the JAMA article may be technically accurate, I wonder how applicable/realistic it is.Jonny Quick (talk) 16:55, 8 August 2015 (UTC)[reply]
I added some information about the flavor to make it more clear. Most people don't know the e-liquid varies in cytotoxicity. QuackGuru (talk) 17:35, 8 August 2015 (UTC)[reply]
I did some research on the "JAMA" article, read the article, understood the article, then went around asking some well-informed Vapers what it meant. That article, in particular, is HATED, and I mean HATED by these people, and with good reason. Consensus is what JAMA did was disassemble and modify an e-cigarette so that the heating element superheated the juice (water, propylene glycol, nicotine, flavors, etc...) to the point that it actually was BURNED and not "vaporized". Burned e-juice is well-known in the culture as a "dry hit" and preventing a dry hit is one of the 1st things a new Vaper learns to do. Burned e-juice tastes terrible. There is at least one other way in which a Vape Device can deliver a burned, terrible-tasting gas to inhale, one of which involves actually burning something inside the device known as the "wick". The heating element can also burn. None of these "malfunction" type of situations are normal, or desired, by anyone. This isn't a situation where a dopey teenager uses an aerosol in a manner in which it was not produced for (breathing it, instead of spray-painting grafitti). NO ONE, does this, EVER. Defeats the whole purpose of having flavored juice, and I'd also wonder if the chemical of the nicotine (and it's desired effect) isn't destroyed when the device delivers a "dry hit". So what does this mean about JAMA? It means that either JAMA lied and was patently, openly and boldly dishonest in their "research" by trying to claim that Vaping Devices were capable of delivering carcinogens during normal use, or someone else is trying to use their research to make the false, fabricated, patently dishonest claim that there is some public health concern here to even discuss. It's the intellectual and moral equivalent of rerouting the exhaust of a car directly into the passenger area of the car and then disingenuously standing back, pretending to be stupid and making the claim that operating a car will cause carbon monoxide poisoning, and then expect the entire world to prove you are wrong, lying, or both. SOMEONE is both wrong and lying, the only question is who.Jonny Quick (talk) 22:41, 8 August 2015 (UTC)[reply]
I do not know which "JAMA" article you are referring to. QuackGuru (talk) 19:16, 9 August 2015 (UTC)[reply]
PP 76-77 of the new Public Health England report discuss just this point, and study. Johnbod (talk) 15:01, 19 August 2015 (UTC)[reply]

Sourced text deleted from lede

The text summarized the body. See "Although the reduction in health risks for people who use electronic cigarettes has not been quantified, we estimate it as similar to that reported for smokeless tobacco, which has approximately 1% of the death risk of smoking".[1] There was a previous talk page consensus. See Talk:Electronic cigarette/Archive 24#Smokeless tobacco. QuackGuru (talk) 03:33, 13 August 2015 (UTC)[reply]

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 [2] Little pob (talk) 09:56, 19 August 2015 (UTC)[reply]

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 Wikipedia 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)[reply]
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)[reply]
We currently state "In 2015 Public Health England released a report stating that e-cigarettes are 95 per cent safer than smoking.[95]" here [3]
While this [4] is a primary source.Doc James (talk · contribs · email) 15:29, 19 August 2015 (UTC)[reply]
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)[reply]
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)[reply]
  • 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)[reply]
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)[reply]
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)[reply]
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)[reply]
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)[reply]
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)[reply]

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

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)[reply]

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)[reply]
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)[reply]
Did you even look at the review at all? 185 sources where cited!--Merlin 1971 (talk) 20:30, 19 August 2015 (UTC)[reply]
Is there a particular page you want summarised? QuackGuru (talk) 20:35, 19 August 2015 (UTC)[reply]

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) [reply]

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

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)[reply]

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 Wikipedia 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)[reply]
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.[5] 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)[reply]

Not ready for the article yet

By a JAMA peice that backs up that e-cig use may lead to increased rates of traditional cig use.[6] Doc James (talk · contribs · email) 13:17, 19 August 2015 (UTC)[reply]

Mentioned in this new CRUK comment piece by a leading UK expert. Johnbod (talk) 13:32, 19 August 2015 (UTC)[reply]
The accompanying editorial makes a clearly point: "Because the only outcome measure was any use of a tobacco product during the past 6 months, the analysis could not distinguish students who had just tried a few cigarettes from those who progressed to regular smoking during follow-up. The latter is the greater concern, and the current study cannot determine whether e-cigarette exposure was associated with that outcome."--Merlin 1971 (talk) 19:51, 19 August 2015 (UTC)[reply]
Agree which is why I say the piece is not ready for the article. Doc James (talk · contribs · email) 03:19, 21 August 2015 (UTC)[reply]

"A 2012 review found electronic systems deliver less nicotine than smoking, raising the question of whether they can effectively substitute for tobacco smoking over a long-term period."

This point hasn't I think featured much in the many more recent reviews. As the PHE report points out, later generation e-cigs can deliver nicotine more effectively, and in any case vapers not getting enough nicotine can just puff more. They discuss the matter in their Appendix C (p. 109 on) and at pp. 70-75 in the main report, analysing recent research. Unless anyone can point to 2014-15 reviews that take this "question" seriously, I think the sentence should be dropped. Johnbod (talk) 14:29, 21 August 2015 (UTC)[reply]

Yes agree. Removed. Needs updating. Doc James (talk · contribs · email) 15:21, 21 August 2015 (UTC)[reply]

Formaldehyde

From para 2: "but high voltage (5.0 V) e-cigarettes may generate formaldehyde agents at a greater level than smoking, which was determined to be a lifetime cancer risk of about 5 to 15 times greater than long-term smoking.[9]". This, and the follow-up studies which only replicated this under "dry-burn" conditions, are covered at pp. 76-78 of the PHE report. They conclude (p. 78) "There is no indication that EC users are exposed to dangerous levels of aldehydes." They are especially critical of the publicity given to this & another study, saying on p. 80: "Two recent worldwide media headlines asserted that EC use is dangerous. These were based on misinterpreted research findings. A high level of formaldehyde was found when e-liquid was over-heated to levels unpalatable to EC users, but there is no indication that EC users are exposed to dangerous levels of aldehydes; stressed mice poisoned with very high levels of nicotine twice daily for two weeks were more likely to lose weight and die when exposed to bacteria and viruses, but this has no relevance for human EC users. The ongoing negative media campaigns are a plausible explanation for the change in the perception of EC safety (see Chapter 8)." - also in their "key findings and summaries". I don't think we should include this in the lead at all, and probably not in sections below in this article either, or if so with the follow-up studies included. It is discussed at more length in Electronic cigarette aerosol, and the "safety of" article also needs adjustment. Johnbod (talk) 01:59, 22 August 2015 (UTC)[reply]

The text is cited to a review. The review cited a study. See here for the study they cited. If the voltage is at 5 then it could create formaldehyde at high levels. See Electronic cigarette aerosol: "One study using a "puffing machine" showed that a third generation e-cigarette turned on to the maximum setting could create levels of formaldehyde between five and 15 times greater than in cigarette smoke.[18]" See Electronic_cigarette_aerosol#cite_ref-McNeill201577_18-0. I made this change to balance the lede. I wrote the text according to each review. QuackGuru (talk) 04:00, 22 August 2015 (UTC)[reply]
But only under artificial/abnormal conditions, as the follow-up studies demonstrated. I'm going to have to take a break on this. Per WP:MEDASSESS this is a high quality source, over which standard reviews should not be privileged. One of the follow-up studies was only published in May 2015. Johnbod (talk) 00:02, 23 August 2015 (UTC)[reply]
That is a study (PMID 25996087). I used two reviews. The review cited another source. QuackGuru (talk) 00:45, 23 August 2015 (UTC)[reply]
No, that (Jensen, NEJM) is the same source that the follow-up study linked above, & page 77 of the PHE report, discuss. Johnbod (talk) 02:34, 23 August 2015 (UTC)[reply]
While high voltage (5.0 V) e-cigarettes may generate formaldehyde agents at a greater level than smoking[10] when above a standard setting,[19] reduced voltage e-cigarettes generate very low levels of formaldehyde.[20]
I adjusted the wording. QuackGuru (talk) 05:19, 23 August 2015 (UTC)[reply]
The wording isn't the problem. It's just wrong. For a start voltage has nothing to do with it; it's power that matters. For another, as PHE said, it's not relevant to the real world.JoLincoln (talk) 16:16, 23 August 2015 (UTC)[reply]
The review has a different view. I tried to carefully word it. There are vapers who turn the device to a higher setting to provide more vapor for better "throat hits". Extra voltage allows the ability to increase the power. QuackGuru (talk) 18:56, 23 August 2015 (UTC)[reply]

Wikipedia seeks WP:V

Resolved

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)[reply]

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