Talk:Electronic cigarette

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 January 2019 and 30 April 2019. Further details are available on the course page. Student editor(s): Sailorbo (article contribs). Peer reviewers: Skyguythor.

Nicotine and Passive vaping sections

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Discussions on Nicotine and Passive vaping sections

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

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

Safer than tobacco claim

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

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

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

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

Discussion on safer than tobacco claim

See Electronic cigarette#cite ref-KnorstBenedetto2014 91-0

See "Given that ECs do not generate the smoke that is associated with the combustion of tobacco, EC use is generally considered safer than tobacco use."[1]

References

See Electronic cigarette#cite ref-Burstyn2014 92-0

Also see "Electronic cigarettes (e-cigarettes) are generally recognized as a safer alternative to combusted tobacco products, but there are conflicting claims about the degree to which these products warrant concern for the health of the vapers (e-cigarette users)."[2]

References

Both sources are making a broad claim that e-cigarettes are generally considered/recognized safer than tobacco. If it were changed to tobacco cigarettes rather than tobacco in general that would be a more narrow claim. In this case, both citations verify the same claim. Another source states "Importantly, they are often viewed as safer than tobacco cigarettes, meaning that at-risk populations, including pregnant women, might be more inclined to use them."[3] This is a more narrow claim because it was only tobacco cigarettes rather than tobacco in general.

Both are MEDRS-compliant reviews. J BRAS PNEUMOL[90] has an impact factor of 1.496, as of 2016.[4] BMC PUBLIC HEALTH[91] has an impact factor of 2.42, as of 2017/2018.[5] QuackGuru (talk) 00:44, 26 June 2019 (UTC)

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

Both reviews are making a broader claim it was tobacco products in general rather than only cigarettes. It would be inaccurate to claim it was just cigarettes. The other source was just used to show it was making more narrow claim for only cigarettes. It is not a review.[6] QuackGuru (talk) 14:01, 13 July 2019 (UTC)

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

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

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

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

misbelief that e-cigarettes are safer than traditional cigarettes

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

appear to be safer than traditional cigarettes

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

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

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

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

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

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

One of them is citied to a quote from 2019. The other one is no longer accurate. The last one is still accurate. See "There is no evidence that the cigarette companies are acquiring or producing e-cigarettes as part of a strategy to phase out regular cigarettes, even though some claim to want to participate in “harm reduction."[7] QuackGuru (talk) 19:18, 1 August 2019 (UTC)

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

Association between ecigs and THC

The ref says:

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

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

"This meta-analysis found a significant increase in the odds of past or current and subsequent marijuana use in adolescents and young adults who used e-cigarettes."[8]

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

Please read the subarticle under 'Youth'. See "There is a greater likelihood of past or present and later cannabis use among youth who have vaped.[133]" That is a very different claim than the current claim for e-cigarettes in general. The additional source is making only a narrow claim among youth and therefore does not have the same meaning. The other source that does verify the content does make a broader claim. See "Studies have suggested a "gateway" effect for combustible cigarettes and cannabis use."[9] QuackGuru (talk) 10:23, 29 August 2019 (UTC)

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

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

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

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

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

Recent reports of lung disease and deaths related to vaping

I assume this article is written under MEDRS rules, rather than newspaper reports. So I'm not going to add this myself, I'll leave it to those of you who are familiar with the rules for content here. But after the recent rash of lung disease and death associated with vaping (CDC reports 450 confirmed or suspected cases in 33 states, and three deaths with a fourth under investigation), the CDC has issued a warning: "While this investigation is ongoing, people should consider not using e-cigarette products. People who do use e-cigarette products should monitor themselves for symptoms."[11] Surely that deserves to be reported here? -- MelanieN (talk) 17:51, 6 September 2019 (UTC)

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

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

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

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

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

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

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

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

@DocJames: Are you in agreement with this philosophy? Keep the old and possibly obsolete reports in our article as gospel, and wait 6 months before mentioning that there is new information on the subject of risk? [12]

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

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

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

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

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

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

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

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

Sources

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

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

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

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

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

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

On 02:44, 7 September 2019 an editor added "Following three deaths, on September 6, 2019, the Centers for Disease Control and Prevention recommended against the use of electronic cigarettes. There have been 215 formally reported cases of possible pulmonary disease related to e cigarette use.[115]"[13] The content was sourced to a news article and failed MEDRS.

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

I added on 05:20, 7 September 2019 "Following five firmed deaths in the US, on September 6, 2019, the Centers for Disease Control and Prevention stated that while this investigation is ongoing, people should consider not using e-cigarette products."[14] It had the typo that was corrected on 06:39, 7 September 2019.

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

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

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

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

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

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

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

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

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

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

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

2019 US outbreak of lung illness associated with vaping products

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

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

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

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

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

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

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

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

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

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

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

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

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

QG, I find it hard to believe your approach. We can report that there is an outbreak of lung disease and death associated with vaping, but we can't report that the country's top health agency recommends against vaping? We can't even mention a warning unless the warning is infinite? Oh, and the AMA is now also "urging the public to avoid the use of e-cigarette products until health officials further investigate and understand the cause of these illnesses."[15] Are we not allowed to mention that either? I would add it, but I don't remember which of your multitudinous articles is allowed to have medical society recommendations in it. And BTW Kim D. Petersen, in what possible sense is this issue "US politics to the highest degree"? Is one political party taking one side and the other another side? I have seen no evidence of that. Up to this point the issue and reporting have been focused on the facts and the science. Let's discuss without trying to cloud the issue. -- MelanieN (talk) 18:19, 10 September 2019 (UTC)

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

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

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

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

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

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

See "He's written for WIRED, Rolling Stone and Billboard, and is the former cannabis editor of the San Francisco Chronicle, as well as the author of several cannabis books".[16] He is an expert on the subject of cannabis vapes and others are linking to the articles.

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

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

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

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

According to your statement when the epidemiology is known the warning should be removed. Is that correct? See "Wikipedia's articles are not meant to provide medical advice."[17] A warning rather than following MOS:LEADSENTENCE or writing introduction on the topic is like giving medical advice. Timeless content will remains in the lede. Time sensitive content is like breaking news. QuackGuru (talk) 00:15, 12 September 2019 (UTC)

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

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

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

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

US-centric

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

Two articles on "Safety" and "Adverse effects"

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