Talk:Electronic cigarette/Archive 6

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Primary source

This ref Bullen, Christopher; Howe, Colin; Laugesen, Murray; McRobbie, Hayden; Parag, Varsha; Williman, Jonathan; Walker, Natalie (2013), "Electronic cigarettes for smoking cessation: a randomised controlled trial" (PDF), The Lancet, 382 (9905): 1629–1637, doi:10.1016/S0140-6736(13)61842-5, PMID 24029165 was used in an attempt to support:

A 2013 randomized controlled trial indicated a possible benefit as smoking cessation aid, both with and without nicotine, to the same degree as patches.

The problem is that it doesn't per "we had insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes" There confidence intervals all pass zero. They did not beat the null hypothesis. This is a negative trial. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:18, 21 November 2013 (UTC)

You're being a bit selective there, aren't you? "E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches" The study was to determine if e-cigs are an effective cessation aid, not if they are better than patches. It concluded that they are, just as the edit said. I'm going to WP:AGF and assume you didn't understand the edit, but it was perfectly in accordance with the source.--FergusM1970^{Let's play Freckles} 00:26, 21 November 2013 (UTC)

The text i used was specifically tailored to address that this was a primary source, and it also was specifically tailored not to make claims that the trial didn't arrive at - hence the usage of "indicated". I will assume that you will rewrite the text, for instance by removing the comparison to patches, so that the current article doesn't leave the impression that no controlled trials have been made. I'm very open for a word change. But a complete removal is too much. --Kim D. Petersen 00:29, 21 November 2013 (UTC)

To go by WP:MEDREV - which secondary source does this primary source contradict? What makes it a minority opinion? etc. --Kim D. Petersen 00:31, 21 November 2013 (UTC)

Additionally: both the Odum et al(2012) and the Caponnetto et al(2013) reviews both point out that the smoking analogue (mimicking the smoking rituals) effect of the e-cigarette is a likely factor in its possible efficacy as a smoking cessession product. So the study is quite in line with the two reviews that we cite. So where is the WP:MEDREV rationale for removing the text? --Kim D. Petersen 02:12, 21 November 2013 (UTC)

Blah blah primary source blah MEDRS blah blah prominent international organization blah mainstream blah. You know what he's going to say - if he bothers to answer.--FergusM1970^{Let's play Freckles} 00:34, 21 November 2013 (UTC)

This is an excellent example of why we do not use primary sources. The authors misinterpreted/overstate their own results. What they found was " nicotine e-cigarettes vs placebo e-cigarettes 3·16 [95% CI -2·29 to 8·61])" Notice how the confidence intervals cross zero. This means that there is no significant difference between e-cigs and placebo. They do not comment on if they had enough power to show that e-cigs are equivalent to patches. They do state that they "had insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes". I would be interested to see what their primary endpoint was pre trial. But this is all work a good review article dose and why we use good review articles. We could use this article to argue that a 2013 RCT found no benefit of e-cigs over placebo. But I do not generally use primary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:34, 21 November 2013 (UTC)

OK, this is clearly not a misunderstanding, so bye bye WP:AGF. The edit you removed did not claim that e-cigs beat patches. The placebo, of course was another e-cig. The study is fine and the edit represented it accurately. Your justification for removing it is highly misleading. Got a better one?--FergusM1970^{Let's play Freckles} 00:37, 21 November 2013 (UTC)

Excuse me? Placebo here is e-cigarettes without nicotine - and that result is not surprising to anyone who is vaping or following that field! It is the "smoking analogue" effect in e-cigarettes that make them effective - not the nicotine! --Kim D. Petersen 00:41, 21 November 2013 (UTC)

Your comment would make sense if we assume that patches aren't effective though - so i'm WP:AGF in that this is the case, and that your objection is that there wasn't a cold-turkey population added to the study to make it fully comprehensible. Rather silly of The Lancet not to capture this in review though. --Kim D. Petersen 00:45, 21 November 2013 (UTC)

So lets rewrite it to:

A 2013 randomized controlled trial found no statistically significant difference in smoking cessesion between e-cigarettes with nicotine, traditional NRT patches and e-cigarettes without nicotine.

Would that be an acceptable usage then? --Kim D. Petersen 00:51, 21 November 2013 (UTC)

Why clutter with the word "statistically"? Otherwise, that change seems fine to me. The one that implied a significant benefit was misleading. -- Scray (talk) 01:42, 21 November 2013 (UTC)

I don't see how you got from "possible benefit" to "significant benefit"? Other than that i see no problem with removing "statistically".. i was writing it up as conservatively as i could. --Kim D. Petersen 01:53, 21 November 2013 (UTC)

Well, I inferred it from the earlier version. The larger question may be whether to use this primary source at all; might be better to wait for coverage in peer-reviewed secondary sources. -- Scray (talk) 03:47, 21 November 2013 (UTC)

With regards to a secondary MEDRS source, that would depend on how long the review cycle is on this topic, does anyone know?

As a primary source it doesn't contradict anything that we already have in secondary sources ((Odum 2012),(Caponnetto 2013)), or gives a surprising result considering these, thus i cannot see it as problematic with regards to WP:MEDREV. But it does inform us that some controlled studies are being made - which i find important considering the rest of the section. --Kim D. Petersen 04:23, 21 November 2013 (UTC)

The rule isn't "if no secondary source is found all primary sources are good to go", there are plenty of other considerations. I would agree to a very general mention in a Research section saying something like "Researchers are looking into the safety and effectiveness of e-cigs for smoking cessation" without stating any primary study result. Zad68 04:27, 21 November 2013 (UTC)

I don't know where you got the impression that i would even consider a rule such as the one that you quote in your first sentence. In fact i made it clear that secondary sources already exist, and that the results from this study is completely in line with what they are already stating. Again ((Odum 2012),(Caponnetto 2013)) are already cited in the article. --Kim D. Petersen 04:32, 21 November 2013 (UTC)

Agree with Scray and Doc James that we should wait for this to get picked up by a secondary source. The authors are pretty clear that their numbers are too weak to make any kind of recommendation about the use of e-cigs based on them. This study might be useful if it's picked up by an authoritative secondary source, but it's not our call to make here. I can't see how this article can be cited here in a way that accurately reflects the weakness of the results and also somehow also shows that is justified for inclusion in a general encyclopedia article. Zad68 04:25, 21 November 2013 (UTC)

We aren't quoting or making any recommedations with that text - nor are we contradicting or making surprising statements considering the already cited secondary sources. All that is really stated, which isn't already in those secondary sources is: There are controlled studies being made. --Kim D. Petersen 04:32, 21 November 2013 (UTC)

It should not be more than a few months before a secondary source includes this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:11, 21 November 2013 (UTC)

If the review cycle is that short for this topic, then i'm certainly willing to wait. I had the impression that the review cycle was significantly longer, considering the low number of review articles found on medline. --Kim D. Petersen 05:24, 21 November 2013 (UTC)

This is an active area of research, especially with the topic getting this much press. When bedbugs hit the press in the developed world it was less than 6 months before dozens of review articles appeared.Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:46, 21 November 2013 (UTC)

Digging a little deeper

Polosa, Riccardo; Rodu, Brad; Caponnetto, Pasquale; Maglia, Marilena; Raciti, Cirino (2013), "A fresh look at tobacco harm reduction: the case for the electronic cigarette" (PDF), Harm Reduction Journal, 10 (10), doi:10.1186/1477-7517-10-19, PMID 24090432{{citation}}: CS1 maint: unflagged free DOI (link)

- would this be a suitable secondary source? (the bullen ref is citation 82,83 in that paper) --Kim D. Petersen 05:49, 21 November 2013 (UTC):

Yes it is an okay secondary source. The lead author has some relation to the industry so not entirely independent. Will need to be balanced against other positions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:02, 21 November 2013 (UTC)

So it should be a safe citation for the above proposed text? With the caveats of not being safe for general usage yet? Ie. since it doesn't contradict what is already established in other secondary refs used? --Kim D. Petersen 06:07, 21 November 2013 (UTC)

Sure it would support "A 2013 randomized controlled trial found no difference in smoking secession rates between e-cigarettes with nicotine, e-cigarettes without nicotine and traditional NRT patches." IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:26, 21 November 2013 (UTC)

Anyone else wants to chime in before i make the edit? --Kim D. Petersen 06:51, 21 November 2013 (UTC)

Multiple reverts

FergusM1970Please stop reverting and re-adding content to the article that has not been accepted through consensus. I have reverted your acts as vandalism, please refrain from further WP:vandalism. To see why it constitutes as vandalism see WP:GAME and the hoaxing section of WP:Vandalism. -- CFCF (talk) 14:13, 21 November 2013 (UTC)

I realize that might be quite a long shot, but I hope you realize you have long since passed WP:3RR, and I hope other editors can come here to aid in the issue. -- CFCF (talk) 14:21, 21 November 2013 (UTC)

The issue is the constant and increasingly blatant POV-pushing by you and a couple of others. It's become very obvious that anything, secondary source or not, that doesn't fit your views is going to be repeatedly deleted even if that means outright lying about your reasons for doing so. Look at your repeated deletion of the information on nicotine. You deleted it, were asked why you'd deleted it and said you didn't have an answer. Then you deleted it again. Still no explanation as to why - in fact you sneaked it through along with an edit to a different section. Your behavior and that of Doc James has been utterly outrageous.--FergusM1970^{Let's play Freckles} 14:29, 21 November 2013 (UTC)

It was removed prior to my edits reverting your misinterpreted citations. Adding it has not been a matter of direct consensus, and you were just throwing it in alongside a number of other inconsistent edits that were reverted. It may very well go in, but there needs to be discussion and consensus about among other things where it should be placed. The best solution would be if you referred to previous discussion, instead of demanding justification anew every time your edits are reverted. -- CFCF (talk) 14:37, 21 November 2013 (UTC)

It's about the addictiveness of nicotine. I'd say it's perfectly bloody obvious where it should be placed, seeing as how we have a section that says "Addiction" at the top in nice big letters.--FergusM1970^{Let's play Freckles} 14:43, 21 November 2013 (UTC)

As for referring to previous discussion, what's the point? Nine times out of ten it's just going to say "only secondary sources will be accepted according to our completely OTT interpretation of WP:MEDRS." Except now we have a secondary source and - surprise! - that isn't acceptable either. This article's Health section is a fucking travesty. All reference to studies on smoking cessation is being systematically deleted on the grounds that they'll rebut a WHO claim - not a secondary source, just a claim - that the studies don't exist, WHICH THEY CLEARLY DO. Spurious grounds are being invented to eradicate any figures on how many young people smoke cigarettes. The section on addiction isn't allowed to say how addictive nicotine is. There is a systematic pattern of edits, deletions and reversions that slant the article towards the ANTZ agenda to an absolutely ludicrous degree. Your own comments on the talk page, including your ridiculous claims that e-cigs contain tobacco and emit smoke, makes it clear that you are hopelessly biased and can't reasonably be expected to make NPOV edits.--FergusM1970^{Let's play Freckles} 14:49, 21 November 2013 (UTC)

Most of what you write is simply not correct. The issue you bring up here are simple not true. There are many ways to develop consensus other than edit warring. You have been blocked 4 times now for edit warring and have multiple warning for the same on your talk page.Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:53, 21 November 2013 (UTC)

I told you already; I have fuck all to say to you until you explain your repeated misleading edit summaries.--FergusM1970^{Let's play Freckles} 14:58, 21 November 2013 (UTC)

And just so there's no ambiguity here let's have a little recap of what you did. Yesterday you deleted an edit on the grounds that "Source does not show that e-cigs are better than placebo." All very well, except the edit wasn't claiming that. In other words your edit summary was irrelevant and misleading. Now that could have been an accident, but myself and another editor both raised it with you at the time. Then today you reverted exactly the same edit and justified it with exactly the same edit summary. This repetition makes it clear that you're deliberately using deception to maintain your preferred version of the article, and that's a lot worse than breaking 3RR.--FergusM1970^{Let's play Freckles} 15:03, 21 November 2013 (UTC)

Its fully viable as per WP:N -- CFCF (talk) 15:06, 21 November 2013 (UTC)

WTF? We're not talking about WP:N, Mr Irrelevant. We're talking about a repeated pattern of leaving misleading edit summaries.--FergusM1970^{Let's play Freckles} 15:10, 21 November 2013 (UTC)

Yes, and by not proving any substantial benefit over placebo it is basically saying nothing, which is why the edit summaries aren't misleading, but point to violation of WP:N.-- CFCF (talk) 15:20, 21 November 2013 (UTC)

Firstly this has fuck all to do with WP:N, so stop trying to distract the discussion with irrelevancies. Secondly what you are referring to as a placebo was another e-cig that contained 0mg liquid. The study showed that e-cigs - with nicotine or otherwise - are about as effective as patches for smoking cessation, and as patches are regarded as effective your argument fails the sanity test. This was also pointed out to Doc James yesterday; unless you're arguing that patches are ineffective - and that won't fly, because every health agency in the world says they are - then trying to argue that e-cigs aren't effective is at best misguided and at worst dishonest.--FergusM1970^{Let's play Freckles} 15:28, 21 November 2013 (UTC)

Question(s)

It appears that that information is not in the article anymore. Is that correct? And if so, why? Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 15:52, 20 November 2013 (UTC)

Apparently no source that doesn't explicitly mention e-cigs is allowed to be cited for this article.--FergusM1970^{Let's play Freckles} 15:54, 20 November 2013 (UTC)

There's now also a study that suggests lower abuse potential in e-cigs; it can be found here. I'd add it to the article myself but there wouldn't be much point. Either Doc James or Lesion would just delete it.--FergusM1970^{Let's play Freckles} 18:19, 20 November 2013 (UTC)

Seeing as it is a primary source they would be completely correct in doing so. Also this study is from 2012, it isn't new. -- CFCF (talk) 18:27, 20 November 2013 (UTC)

Get this into your head: there is no ban on using primary sources unless they're being used to rebut a secondary source, which is not the case here. You can't just invent rules to uphold your POV.--FergusM1970^{Let's play Freckles} 18:30, 20 November 2013 (UTC)

Mine and as far as I can tell Wikipedia's point of view is that we should stick to well-based and reviewed scientific knowledge, and I think that's exactly the reason the rules were created, so except for your claim that I'm inventing guidelines I think they very much align with my views. -- CFCF (talk) 18:50, 20 November 2013 (UTC)

Exactly. We should stick to well based and reviewed scientific knowledge. In fact MEDRS says specifically that mere position statements, no matter how prominent their originators, are less authoritative than the research. The problem here is that a group of editors, including you, are willfully ignoring that to push a POV. From reading the Health section you'd think no studies have been done.--FergusM1970^{Let's play Freckles} 20:06, 20 November 2013 (UTC)

Copyedited you latest edit to reflect that it wasn't a review, but a report. Also it might be fun to note that the CDC classifies electronic cigarets as tobacco in that reference. -- CFCF (talk) 21:26, 20 November 2013 (UTC)

I know. Stupid as that is, because of course they no more contain tobacco than a piano contains elephants, this review (it was a CDC analysis of NYTS data) just reinforces the point - e-cigs are not a gateway into tobacco use, because even when you count them as beef tobacco, they are becoming more popular but tobacco use is going down.--FergusM1970^{Let's play Freckles} 21:30, 20 November 2013 (UTC)

I don't read the NYTS study that way - you are making a base assumption (<tobacco + >ecigs => ecigs are effective) which isn't addressed in the survey at all. Basically you are making a jump to conclusion based on insufficient data - just as those that read it as "gateway!" are. (ie. they assume that >ecigs mean that those who use ecigs will transfer to tobacco later - which is also not addressed) --Kim D. Petersen 23:18, 20 November 2013 (UTC)

Yeah, there isn't anything that merits claiming a causal link in the article, which is why I worded my edit to indicate correlation only. However given that most e-cig users are current or former smokers I'm pretty confident that when more work is done that's what will be found. It certainly blows the "gateway" idea out of the water though. No matter what concerns people claim to have it simply isn't happening.--FergusM1970^{Let's play Freckles} 23:48, 20 November 2013 (UTC)

I'm curious as to why that was removed as well? The above discussion doesn't seem to address this at all. --Kim D. Petersen 23:19, 20 November 2013 (UTC)

It was removed by User:CFCF. I'm not quite sure why; the edit comment just mentioned lack of consensus.--FergusM1970^{Let's play Freckles} 23:56, 20 November 2013 (UTC)

It wasn't removed by me originally, but by another user, so I can't answer for it. -- CFCF (talk) 07:55, 21 November 2013 (UTC)

You can't answer for the original deletion but you can certainly answer for yours. Are you going to tell us why you deleted it?--FergusM1970^{Let's play Freckles} 09:42, 21 November 2013 (UTC)

Can you answer for why you deleted it THIS time?--FergusM1970^{Let's play Freckles} 13:17, 21 November 2013 (UTC)

I moved it to the section on addition, which is were it fits [1] better. Part of what was reffed to the source was removed here [2] and the rest reworded here [3] Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:35, 21 November 2013 (UTC)

It's becoming increasingly difficult to WP:AGF when this statement, which is a flat-out falsehood, is added to your various misleading edit summaries. The material we're talking about wasn't moved or reworded, as you claim; it was deleted without explanation.--FergusM1970^{Let's play Freckles} 09:22, 21 November 2013 (UTC)

OK, I have restored it to the Addiction section, where it fits better. I assume everyone is OK with that.--FergusM1970^{Let's play Freckles} 09:28, 21 November 2013 (UTC)

The "removal" diff[4] that you are referring to is not in any way or form about the content in question, the only commonality between the two, is that they use the same reference. --Kim D. Petersen 17:00, 21 November 2013 (UTC)

Recent edits

This change[5] has me confused. Why is the sentence

use of most tobacco products (including cigarettes) and overall tobacco use fell over the same period

been changed into

use of certain tobacco products such as hookah were shown to have fallen over the same period.

Considering that the reduction in overall users of any "tobacco" product (cigarettes, cigars, smokeless tobacco, tobacco pipes, bidis, kreteks, hookahs, snus, dissolvable tobacco, or electronic cigarettes) have fallen in all categories of users except Black non-Hispanic high-schoolers? The first version to me seems to be the more correct summary given the reference. --Kim D. Petersen 08:44, 21 November 2013 (UTC)

I've fixed it. It was a fairly transparent attempt to minimize the importance of the study.--FergusM1970^{Let's play Freckles} 09:02, 21 November 2013 (UTC)

Read the references conclusions, not the data tables. No mention of the decrease of tobacco overall was made in the conclusions. This may be because it isn't statistically significant. -- CFCF (talk) 11:09, 21 November 2013 (UTC)

Whatever. How silly of me to think the article could possibly be allowed to show a fall in cigarette consumption.--FergusM1970^{Let's play Freckles} 11:39, 21 November 2013 (UTC)

If you have a question concerning the findings of the CDC I suggest you take it up with them. -- CFCF (talk) 12:37, 21 November 2013 (UTC)

The same CDC that concealed the fall in tobacco consumption while wittering on about a gateway effect, then tried to sneak the actual data out six weeks later? Hardly seems worth the bother. In any case the graph - showing a clear reduction in cigarette smoking - is now linked from the article. That will do for now. I think we all know that e-cigs are a substitute for cigarettes rather than a gateway to them, and soon enough the secondary sources will be available. A year from now this article is going to look very different, because none of the evidence is on the ANTZ side.--FergusM1970^{Let's play Freckles} 12:45, 21 November 2013 (UTC)

If you doubt the credibility of the CDC you shouldn't have cited them in the first place. Concerning what the article will state in a year from now that is quite irrelevant, see WP:BALL. -- CFCF (talk) 12:53, 21 November 2013 (UTC)

Oh, I don't doubt their credibility and in fact I have immense respect for them. I simply acknowledge that they're a political organization, not a scientific one, and as expected they shape the information they release to support their policy goals. One of these is a quit or die approach to smoking cessation, so naturally they don't want to provide evidence that e-cigs are safe or effective. Their actual research is perfectly sound and credible; their public presentation of it, however, is likely to be affected by their agendas. That's obviously the case here, because it's clear from their own data that as e-cig use increases cigarette smoking is going down. However that doesn't support the "gateway" narrative they're following, so they omitted the data from their initial press releases. Hardly a surprise and certainly not illegal.--FergusM1970^{Let's play Freckles} 12:59, 21 November 2013 (UTC)

Well i can buy that ... partly. The reason for the "partly" is that the first version has relevance for this article, while the second one doesn't. It is rather irrelevant to the topic of electronic cigarettes whether hookah usage has fallen/risen or been stable. I would consider the reading of the table to be rather straight-forward since there is no doubt involved in the figures... none whatsoever - "tobacco" usage fell, all over the line! It is only in specific demographical subgroups that it gets hairy - with the black non-hispanics, and that is not something we're interested in here. --Kim D. Petersen 16:06, 21 November 2013 (UTC)

According to CFCF it's not even OK to cite the figures without mentioning that they represent a fall in smoking. This is just blatant double standards. Statements of concern are redefined as secondary sources and can't be challenged in any way, but an actual study gets nitpicked to death because it contains the "wrong" answers. Personally I've had about enough of the impenetrable cloud of wank that surrounds this article.--FergusM1970^{Let's play Freckles} 17:08, 21 November 2013 (UTC)

Full protection

The article has been fully protected three weeks due to the edit war that was reported at WP:AN3#User:FergusM1970 reported by User:Jmh649 (Result: Protection, warnings). If editors on the talk page can agree on a change, they can make an WP:Edit request and an admin will respond. EdJohnston (talk) 17:19, 21 November 2013 (UTC)

Thanks Ed. Hopefully this will improve the situation. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:01, 22 November 2013 (UTC)

Edit-Request regarding 2013 randomized study addition

Per consensus reached in Talk:Electronic cigarette#Primary source - Please add this:

A 2013 randomized controlled trial found no difference in smoking cessation rates between e-cigarettes with nicotine, e-cigarettes without nicotine and traditional NRT patches.

As a new paragraph after the first paragraph in Electronic_cigarette#Smoking_cessation. Thank you. Kim D. Petersen 17:44, 21 November 2013 (UTC)

References used above:

Question: Secession or cessation? --Redrose64 (talk) 21:29, 21 November 2013 (UTC)

cessation CFCF (talk) 21:43, 21 November 2013 (UTC)

Yep, cessation, sorry english is my second language, and that is not a particularly intuitive spelling :) --Kim D. Petersen 22:05, 21 November 2013 (UTC)

Done --Redrose64 (talk) 22:18, 21 November 2013 (UTC)

Thanks, all that really needs to be there however is the secondary source. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:03, 22 November 2013 (UTC)

I know, but i find it generally useful to have the discussed study linked as well. --Kim D. Petersen 03:01, 22 November 2013 (UTC)

"As the electronic cigarette industry grows"

I don't believe consensus is required to correct an obvious error. The vaping subculture is not made up of the e-cig industry, it's made up of e-cig users. To argue that inserting the word "industry" (and thereby making the statement incorrect) is "less ambiguous" is nearly as laughable as claiming that e-cigs contain tobacco. Out of respect for 3RR I'll leave it for now, but somebody needs to fix that.--FergusM1970^{Let's play Freckles} 13:36, 20 November 2013 (UTC)

Your edits do not rely on the sources referenced. Please read them before arguing that reverting your edits was wrong. The first source makes several comments on the growth of the industry, not on usage. It goes as far as to bring citations from a Dr Simon Chapman OAM, who "is Australia's leading anti-tobacco voice" saying:

"No one has ever heard of a nicotine patch club or a nicotine gum club, where people are addicted to these things say 'let's all get together, you know I'm a patch wearer, you're a patch wearer, let's have a club, we've got something in common,"

&

Dr Chapman says the big tobacco industry has five goals in the e-cigarette market, all of them are about re-socliasing smoking.

“[They want] to get people to use e-cigarettes as well as cigarettes, not instead of. Hey you have given up smoking, but you can come back to smoking because nicotine is not a problem, well nicotine is a problem,” Dr Chapman said.

--CFCF (talk) 13:50, 20 November 2013 (UTC)

Neither the source nor Chapman - a doctor of sociology, by the way, not medicine - states that the growth of the industry is responsible for the emergence of the subculture. As the industry is located in China and the subculture is located in the USA and Europe, and representatives of the two rarely if ever meet, it would be rather strange if it was.--FergusM1970^{Let's play Freckles} 13:58, 20 November 2013 (UTC)

Since when is pointing out that someone is a sociologist going to decrease their credibility in questions pertaining to sociology? As to your other statement, it's just ridiculous. You're not going to find sources backing that claim. -- CFCF (talk) 14:03, 20 November 2013 (UTC)

What I am pointing out is that the sources do not support the claim that it is the industry that's creating the vaping subculture. Deciding that because the article mentions both there must be a link is blatant WP:SYNTH. Pointing out that the loudest (if not necessarily leading) voice in Australian tobacco control is helpful in judging his competency to decide whether or not nicotine is a problem; the FDA don't seem to agree and neither do most medical tobacco control specialists (Etter, Britton etc.) Now, as for the rest, what are you arguing with? That the e-cig industry is located in China - which it is - or that the vaping subculture is located in the west - which it is?--FergusM1970^{Let's play Freckles} 14:11, 20 November 2013 (UTC)

Also the article here on Wikipedia doesn't state any causative link between growth of the industry and the emergence of groups, only that both phenomena have occurred simultaneously. -- CFCF (talk) 14:06, 20 November 2013 (UTC)

Don't be disingenuous. "As the electronic cigarette industry grows, a subculture has emerged" clearly implies a link.--FergusM1970^{Let's play Freckles} 14:11, 20 November 2013 (UTC)

It implies temporal correlation, not causation. Would you rather have:

Simultaneous to industry growth, a subculture has emerged

You're not going to argue away the correlation in time as stated by the articles.-- CFCF (talk) 14:17, 20 November 2013 (UTC)

This is what I mean about people editing articles on subjects they know nothing about. The subculture, and its use of mods rather than cigalikes, has nothing to do with the industry. Want to know why they're called mods? Because all the industry was making was cigalikes, so people modified flashlights. The industry has diversified in response to the growth of the subculture, not driven it. Anyway I'm done. You go right on arguing that cheese contains beef until you're blue in the face.--FergusM1970^{Let's play Freckles} 14:21, 20 November 2013 (UTC)

Source? -- CFCF (talk) 14:26, 20 November 2013 (UTC)

Go read an e-cig forum. What do you expect, a WHO paper on how people started making atomisers out of wire and wicks and screwing them into the bulb holder on a Maglite? While you're at it look up the difference between cheese and beef. It might help you understand this subject better.--FergusM1970^{Let's play Freckles} 14:32, 20 November 2013 (UTC)

Read this. Moo.--FergusM1970^{Let's play Freckles} 14:36, 20 November 2013 (UTC)

I think you've misunderstood what Wikipedia is WP:NOT#FORUM -- CFCF (talk) 14:34, 20 November 2013 (UTC)

You asked for a source about the origin of mods. I'm not suggesting putting it in the article because I know it's not up to scratch. However I am asking you to remove the misleading word "industry" from that paragraph because it implies a link that does not exist. It's very obvious that you know nothing about e-cigs or vaping and I really think it would be helpful if you learned a bit before editing this article any more. Just some very basic facts would be enough, such as that they don't contain tobacco or involve combustion.--FergusM1970^{Let's play Freckles} 14:51, 20 November 2013 (UTC)

We've been here before, I don't think anyone else here agrees with those statements. I don't think versing myself in the ramblings of "vaping" zealots on various internet forums will change anything either, instead I will be reading and citing articles and papers from trustworthy sources. The nicotine is refined from tobacco, and as such we are speaking of a product of tobacco. I still believe the use of the term vaping is a semantic embellishment to escape negative connotations associated with smoking. -- CFCF (talk) 15:09, 20 November 2013 (UTC)

Oh FFS. the nicotine is extracted from tobacco but it is not tobacco. It could just as easily be extracted from aubergines or tomatoes. As for the term "vaping" it's used because, in the complete absence of smoke, to call it "smoking" would be stupid. By insisting that e-cigs produce smoke and contain tobacco you're revealing that you are the zealot, and a dishonest one at that.--FergusM1970^{Let's play Freckles} 15:19, 20 November 2013 (UTC)

Maybe the English language is stupid [6], but I don't see the relevance in that. As for your tobacco claim, the fact is it is extracted from tobacco, not from tomatoes or aubergines, and as such it is a tobacco product. -- CFCF (talk) 15:31, 20 November 2013 (UTC)

Yes, the nicotine is extracted from tobacco. That does not mean that e-cigs contain tobacco. They do not. Neither do they produce smoke.--FergusM1970^{Let's play Freckles} 15:34, 20 November 2013 (UTC)

If you read the entry concerning smoking as a noun you will see that smoking does not demand the production of smoke. Also, this does not pertain to the article in question, please stick to WP:TPNO, and refer to WP:IDHT before pushing your point further, as per a more than significant majority do not agree with your sentiments. -- CFCF (talk) 15:41, 20 November 2013 (UTC)

"Smoking is a practice in which a substance, most commonly tobacco, is burned and the smoke is tasted or inhaled." Epic fail; e-cigs don't burn anything and users aren't inhaling any smoke. Now, here is a Nicorette inhalator. Is this a tobacco product that people smoke? If it is then it's an FDA-licensed one. If it isn't then neither are e-cigs.--FergusM1970^{Let's play Freckles} 15:46, 20 November 2013 (UTC)

Noun, smoking (countable and uncountable, plural smokings) The inhalation of tobacco, or use substances. just in case you missed the article I linked.

[7] gives you numerous definitions of smoke as well such as a cloud of fine particles suspended in a gas. This is why I normally don't argue semantics, seems your epic fail isn't anywhere to be found. -- CFCF (talk) 16:06, 20 November 2013 (UTC)

So by that definition using a Nicorette inhaler is smoking? I find this usage rather funny - sorry. (and that would also make any asthmatic who uses an inhaler a smoker - lol). --Kim D. Petersen 23:33, 20 November 2013 (UTC)

The article you linked is, to put it kindly, incoherent. What the fuck is "The inhalation of tobacco, or use substances" supposed to mean in English? If it makes sense at all then it seems to define any use of any substance in any manner as "smoking," which even for someone who thinks cheese contains beef is absurd. Also it's a verb, not a noun. Smoke is a product of combustion. E-cigs do not produce smoke. Now take your nasty little prejudice away.--FergusM1970^{Let's play Freckles} 17:07, 20 November 2013 (UTC)

Cigar from Maya sicar "to smoke rolled tobacco leaves[8], Cigaret as in a small cigar, and electronic cigaret as in a device that through electronic means emulates smoking, why I refer to its use as smoking. Also see [9] Smoke That which resembles smoke; a vapor; a mist. Please refrain from name-calling, it is against policy and can get you banned. Also -- CFCF (talk) 18:34, 20 November 2013 (UTC)

I didn't call you any names. By all means continue to insist that vaping is really "smoking" despite the complete lack of smoke, but all you're doing is revealing your irrational prejudice.--FergusM1970^{Let's play Freckles} 18:42, 20 November 2013 (UTC)

See picture 9 for the "smoking" woman :)) TMCk (talk) 16:37, 20 November 2013 (UTC)

Yep, that is most definitely a smoker by that definition - rather funny really :) --Kim D. Petersen 23:35, 20 November 2013 (UTC)

Are we talking about this exert from the article? "As the electronic cigarette industry grows, a subculture has emerged which calls itself "the vaping community"

If so, I am the one that added it in. I get Fergus point and think he is correct. It is not the e cig industry that created the subculture, it is the user themselves. Perhaps could we rephrase it like this: "As electronic cigarette grows in popularity blablablablabla"64.58.172.54 (talk) 06:13, 22 November 2013 (UTC)

The statements that mech mods contain no wires or solder are incorrect,

The comments about mech mods having no wires is incorrect. There is always minimal wiring between battery, switch and vaporiser. The statement that there is no soldering is untrue, as soldered joints may be used to affix the wires. The distinguishing points regarding mechanical devices are the mechanical rather than electronic switch and the absence of any control or monitoring features. JonoClouds (talk) 12:16, 22 November 2013 (UTC)

JonoCloudsWhat is the suggested edit, which paragraph and what should it state and with what sources? Should the current text just be removed? CFCF (talk) 12:41, 22 November 2013 (UTC)

No, you are wrong. I have a Nemesis in front of me, stripped down to its component parts. There are no wires and there is no solder. Same goes for my K100 and M16. Mech mods do not contain wires.--FergusM1970^{Let's play Freckles} 13:24, 22 November 2013 (UTC)

I disagree with this edit because it is factually incorrect. I'm not aware of any mech mod that does contain wiring. I'll try to find a source but I'm not all that hopeful at the moment. However JonoClouds claims there is always minimal wiring, and this is simply not true.--FergusM1970^{Let's play Freckles} 13:24, 22 November 2013 (UTC)

Mech Mod consists of a battery tube in which the battery directly touches the positive of of the device.The circuit is completed by a switch that comes into contact directly with the negative of the battery. There are no wires in a mech... No solder either. I disagree with the edit as well.75.95.37.92 (talk) 16:37, 22 November 2013 (UTC)

Not done: please provide reliable sources that support the change you want to be made. Many electronic circuits are built on a printed circuit board. Miniaturised circuits often use surface-mount technology where the components have very short leads, and may consist of nothing more than a metal cap at each end (like this capacitor, which is probably only about 0.1 inches (2.54 mm) long). Such SMDs may appear to be attached directly to the PCB, but there is a tiny amount of solder used to make the joint. --Redrose64 (talk) 16:41, 22 November 2013 (UTC)

The thing about mech mods is they don't contain PCBs. They just have a simple circuit formed by the metal casing and a push-button mechanical switch. There aren't any wires and nothing that needs solder.--FergusM1970^{Let's play Freckles} 17:09, 22 November 2013 (UTC)

Query regarding usage of a primary study/survey to cite non medical data.

I'm asking for us to use table 2. in this primary WP:MEDRS source

• Foulds, J.; Veldheer, S.; Berg, A. (2011), "Electronic cigarettes (e-cigs): views of aficionados and clinical⁄public health perspectives" (PDF), Int. J. Clin. Pract., 65 (10), doi:10.1111/j.1742-1241.2011.02751.x, PMID 21801287

The usage is to remedy the problems mentioned above in the #The reference/citation problem thread. Table 2 in this study verifies that amongst experienced users the regular "cig-a-like" is being discarded for more advanced models. It also verifies that variable voltage etc devices exist, and are not just used by a limited audience.

This is not a study i would use to cite medical data from, or any other similar information. The only usage i'm suggesting is as a superior WP:V reference in this limited area - the alternative is to use less reliable sources for such information (such as product, vendor or review sites). --Kim D. Petersen 03:09, 23 November 2013 (UTC)

Another study for usage to get at this kind of data would be:

• Etter, Jean‐François; Bullen, Chris (2011), "Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy." (PDF), Addiction, 106 (11): 2017–2028, doi:10.1111/j.1360-0443.2011.03505.x, PMID 21592253

Which also addresses the prevalence of e-cig model types, and their usage in various countries. Again this is not for the medical data, but it is rather unlikely that this kind of data would be addressed in a secondary source regarding the medical usage, and considering where the research is currently active. :) --Kim D. Petersen 03:24, 23 November 2013 (UTC)

disambiguation

Disambiguate Intellectual Property Office to Intellectual Property Office (United Kingdom). Ruby Murray 12:15, 23 November 2013 (UTC)

Done --Redrose64 (talk) 14:39, 23 November 2013 (UTC)

The reference/citation problem

So!!!

I have added quite a bit of info in the "Construction" section of the article and I find myself with a citation problem.

Valid references are very hard to find in the e-cig world about the technical aspect of devices since the industry is oh so very young.

• The news outlets don't talk about them in a technical POV, all they care about is legislation and health hazards/benefits.

• Most of the more advanced electronic devices or mechanical devices are not patented.

• Nobody went to college to learn how to build a PV so there are no Ph D. to be found that could validate the information.

So all there is left are manufacturers and vendors that do have the correct information about how these things actually work. I can see why referencing a vendor or manufacturer could be problematic.

Anybody have a suggestion? I think that removing the info that, imho, cannot be referenced without citing vendors or manufacturer would simply be denying the existence of a very real industry. TheNorlo (talk) 06:33, 22 November 2013 (UTC)

This is a common problem on Wikipedia, especially with "new" topics in the public arena that don't have a long pedigree yet, but unfortunately the standard remedy is to simply not include such material, until such time as you can find an independent reference for it. Wikipedia isn't in the business of confirming or denying the existence of industries. Its a publicly edited encyclopedia that requires included material to be cited to a reliable source. This may seem a too-restrictive filter at times, but WP doesn't really have a good replacement for it yet.--Kdtully (talk) 06:43, 22 November 2013 (UTC)

Caponnetto, Pasquale; Campagna, Davide; Cibella, Fabio; Morjaria, Jaymin B.; Caruso, Massimo; Russo, Cristina; Polosa, Riccardo (2013), "EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study", PLOS ONE, 8 (7), doi:10.1371/journal.pone.0066317, PMID 23826093 {{citation}}: Cite has empty unknown parameters: |1=, |2=, |3=, |4=, |5=, |6=, |7=, and |8= (help)CS1 maint: unflagged free DOI (link)

Gives some detail, even though it has certain connections to the industry. CFCF (talk) 07:01, 22 November 2013 (UTC)

Erh? No. That study uses a rather old fashioned device - quite far from current standards. The Categoria ecig (used in the study) compared to modern devices is, figuratively speaking, like a Model T compared to a Tesla Model S. --Kim D. Petersen 07:53, 22 November 2013 (UTC)

I was pondering about the same problem earlier, when i tried to fix some of the citation-needed tags. From what i can see, the only way around it is to cite products where possible, and attempt not to use vendors (ie. to verify that VV/VW devices exist), and keep away from making statements about things like how common the individual devices are. There is (iirc) a US vapor magazine, which might be valuable for some information beyond the mere existance of devices. If i recall correctly, from how Open-source software was covered in the past, in cases like this blogs (of high quality) can be used, but keep away from definitive statements. --Kim D. Petersen 08:00, 22 November 2013 (UTC)

In any case there is time to figure out a solution, since the page is locked for the next few weeks, so nothing much can be done atm. --Kim D. Petersen 08:03, 22 November 2013 (UTC)

Just throwing it out there. I know most blogs are not acceptable references. But what makes a blog credible or not. Let say, GrimmGreen blog or PBusardo or Scott's bolg (igetcha69). They are well respected reviewers of devices. Could they be a good source of info? I guess not, but... TheNorlo (talk) 23:17, 23 November 2013 (UTC)

In the circumstances I don't see why it wouldn't be acceptable. WP:MEDRS only applies to the section on health; everything else in the article is about a recreational device, so it's not reasonable to insist on peer reviewed papers.--FergusM1970^{Let's play Freckles} 23:37, 23 November 2013 (UTC)

Edit-Request to stay in line with cited study

Change There are both controlled and non-controlled studies that show possible benefit. to There are non-controlled studies that show possible benefit.

So as to follow the reference stated at Electronic_cigarette#Smoking_cessation. Thank you.

CFCF (talk) 19:14, 21 November 2013 (UTC)

I certainly don't support this edit. There are both controlled and non-controlled studies, as you are well aware. Please only suggest edits where a consensus exists.--FergusM1970^{Let's play Freckles} 19:27, 21 November 2013 (UTC)

(ec)*Although not sourced in the present state of the article, that would be a knowingly outdated and thus false statement.TMCk (talk) 19:29, 21 November 2013 (UTC)

Alternatives then are to let the entire passage go, or find a secondary source stating these controlled studies. As it stands we have unsourced statements added by FergusM1970 CFCF (talk) 19:49, 21 November 2013 (UTC)

An even better alternative would be to reinsert the sources that you and Doc James deleted...--FergusM1970^{Let's play Freckles} 19:52, 21 November 2013 (UTC)

Look, you just got caught knowingly trying to have a false statement added to the article. POV-pushing is not allowed on Wikipedia. Drop it.--FergusM1970^{Let's play Freckles} 19:57, 21 November 2013 (UTC)

No it most certainly is not which is why this needs to be fixed, but those primary sources go against secondary sources and should not be added. CFCF (talk) 20:01, 21 November 2013 (UTC)

And here we go again. A statement that there are no primary sources is not a secondary source. It is ridiculous to suppress the primary sources to avoid rebutting a claim that they don't exist, and that is what you are trying to do. As TMCk has already pointed out to you, suppressing the primary sources in this case is not bringing the article into line with WP:MEDRS; it's knowingly inserting false information.--FergusM1970^{Let's play Freckles} 20:05, 21 November 2013 (UTC)

(edit conflict)Actually it doesn't - since there are secondary source(s) that supports that exact contention. I also wonder what primary source that you are referring to? --Kim D. Petersen 20:08, 21 November 2013 (UTC)

Which secondary source are you referring to? If the statement is to stay it needs a citation. Give one and it stays. As it is now the statement needs citation and that is what the discussion should be about.CFCF (talk) 20:16, 21 November 2013 (UTC)

You have already been told quite clearly what the discussion was about: You trying to get false information inserted into the article.--FergusM1970^{Let's play Freckles} 20:21, 21 November 2013 (UTC)

Discussion here is about the sentence in the article, as I understand you are suggested it be completely omitted? CFCF (talk) 20:32, 21 November 2013 (UTC)

(edit conflict)There is an edit-request just above this one - i suggest that you read it, which i assumed that you had, since you reverted based on the discussion about it. That secondary source (Polosa et al 2013) also refers to this controlled trial:

Caponnetto, Pasquale; Campagna, Davide; Cibella, Fabio; Morjaria, Jaymin B.; Caruso, Massimo; Russo, Cristina; Polosa, Riccardo (2013), "EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study", PLOS ONE, 8 (7), doi:10.1371/journal.pone.0066317, PMID 23826093 {{citation}}: Cite has empty unknown parameters: |1=, |2=, |3=, |4=, |5=, |6=, |7=, and |8= (help)CS1 maint: unflagged free DOI (link)

Which i wont add yet, since Riccardo Polosa is a coauthor of the study, and primary author of the secondary source, and thus could be construed as being self-promoting here. --Kim D. Petersen 20:36, 21 November 2013 (UTC)

The control in the two RCTs were non nicotine containing e-cigs. Thus why the Bullen trial referred to them as "placebo" e-cig. The two Randomized Controlled Trials that compared nicotine containing e-cigs to placebo e-cigs found no significant difference to the control group. They thus did not "show benefit" or in other words were negative and why I agree with CFCF that Fergus's edit was inappropriate. If there are further secondary sources that may support this statement would be happy to look at them. Right now the source associated with it does not support it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:13, 22 November 2013 (UTC)

What the study showed was that e-cigs, whether they contain nicotine or not, are about as effective for smoking cessation as nicotine patches. Your argument only makes sense if you're saying that patches don't work, in which case you have a problem - lots of studies that say they do.--FergusM1970^{Let's play Freckles} 08:59, 22 November 2013 (UTC)

As far as i can tell the control group in the trial was the NRT patches (performance below, equal or higher than test) - the placebo group was (according to the author) added as "We included the placebo e-cigarettes group to explore the role of behavioural replacement by e-cigarettes, independent of nicotine delivery in cessation", which i read that as an extra factor, although i can see your point... but that raises a very large question-mark to me with regards to NRT's as a smoking cessation product (a whole other can of worms).

It is not surprising that the mimic of regular smoker behavioral patterns in itself is effective, it is one of the major arguments for e-cigs as a smoking cessation/harm reduction tool, as several of our secondary sources point out (including the 2011 one quoted just below the new entry). Hope i cleared up my thoughts here? --Kim D. Petersen 03:48, 22 November 2013 (UTC) [ie. note to future studies: include a secondary control that doesn't involve other mimicing than feel between fingers (ie. no vapor and no inhalation) :D --Kim D. Petersen 03:52, 22 November 2013 (UTC)]

The study shows possibly no benefit with e-cigs being the same as placebo and possibly a benefit with the same as NRT. We should see what the primary endpoint was. I think the line we added sums it up without saying that the study is either positive or negative. I guess one could argue it is sort of both. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:04, 22 November 2013 (UTC)

You're either completely failing to understand a key point or being deliberately misleading again. The "placebo" was also an e-cig. The study found that e-cigs, whether they contained nicotine or not, were about as effective as a licensed NRT that has passed rigorous tests for efficacy. It demonstrated that e-cigs work but could not conclude if they work any better when they contain nicotine.--FergusM1970^{Let's play Freckles} 09:48, 22 November 2013 (UTC)

Is it stated this is a benefit over already present NRT patches, and not just equivalent efficacy? It may well be included in a future review, but are there any current secondary sources that prove benefit? The central word here is in that case benefit and I suggest removing the claim and awaiting future reviews that would prove it or to rewrite it to "There are non-controlled studies that show possible benefit, while a single controlled study shows equivalent efficacy to already available NRT patches. - or something of that effect. Edit: you beat me to it DocJames CFCF (talk) 09:13, 22 November 2013 (UTC)

I'm honestly baffled now. Are you saying that nicotine patches offer no benefit?--FergusM1970^{Let's play Freckles} 09:48, 22 November 2013 (UTC)

I'm saying it is not up to Wikipedia to decide. Does the secondary source claim electronic cigarets show benefit over, or just equivalent efficacy to already known working NRTs? If such is the case the article should not claim benefit. CFCF (talk) 11:57, 22 November 2013 (UTC)

You have already been told that your proposed edit is intentionally misleading and you're just reinforcing that statement. If e-cigs are as effective as NRT then, for purposes of smoking cessation, that is a benefit. To argue otherwise is to argue that NRTs have no benefit, and I don't think you're going to find anyone other than Doc James to back you on that. The article is talking about the benefit of e-cigs for smoking cessation, not their relative efficiency compared to other methods.--FergusM1970^{Let's play Freckles} 13:23, 22 November 2013 (UTC)

We cannot make that claim without secondary sources claiming it. Having to repeat myself over and over again gets tiring, but; Wikipedia is not to judge if there has been found benefit, we can only cite secondary sources that state so. And I would also like to point out that efficacy is not the same as efficiency. CFCF (talk) 18:54, 22 November 2013 (UTC)

Jesus wept. The issue is whether or not there have been controlled studies showing benefit. There have, and you know it. All you are trying to do is have that information removed from the article because you don't want it to be there. You have no consensus for this change and it clearly isn't uncontroversial. As has already being pointed out you are knowingly trying to insert false information. Just drop it.--FergusM1970^{Let's play Freckles} 19:03, 22 November 2013 (UTC)

They haven't shown any benefit over already present therapy, and the references do not reflect what is in the text. Consensus isn't achieved by one person writing 100 replies so that it obscures all possibility of consensus. CFCF (talk) 19:44, 22 November 2013 (UTC)

Does the edit you're whining about say that they show any benefit over NRT? No, I don't believe it does! YET AGAIN you are using dishonesty to distort the argument. To show a benefit for smoking cessation they don't have to show an advantage over NRT; they just have to show that they can aid smoking cessation, and by performing as well as NRT that's exactly what they did. Now stop trying to get your POV put back in.--FergusM1970^{Let's play Freckles} 19:58, 22 November 2013 (UTC)

• Along with Doc James I support this edit suggested by CFCF. The source this sentence cites says "Recent uncontrolled studies, reported that a certain number of smokers have quit using electronic cigarettes." It does not say anything about controlled studies and so the sentence in the article as currently written isn't supported by the source; the suggested edit fixes this problem. Right now Fergus is the only one arguing against this edit, but his responses here asking that a new source be added show that he is indeed aware the source cited doesn't support the current sentence. If there are controlled studies, they can be added later via a separate edit request, but this edit should be applied right away to fix this problem. Zad68 20:38, 22 November 2013 (UTC)
• I come late to this dispute. I'm rather dismayed by the amount of name-calling and accusation-flinging I see above. Please stop it, it does nothing to further rational discussion. Rather than refer to editors (or their behaviour) it is far more useful to refer to their edits, using wp:DIFFLINKs where necessary.
• Now, on to content: So far as I can tell the most significant line in the the Lancet paper is: "Achievement of abstinence was substantially lower than we anticipated for the power calculation, thus we had insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes" Translation: the difference in effect, if any, is too small to verify with this small a cadre. It's a controlled study, but tells us very little. In regards of CFCF's original suggested edit (above at 19:14 UTC yesterday), I don't see any real justification for There are non-controlled studies that show possible benefit.. Almost by definition non-controlled clinical studies will not conclusively "show", they at most "find", "indicate" or "suggest". Certainly primary reports on those studies should not be put, in the encyclopedia's voice, to say they "show" what their authors state. LeadSongDog come howl! 21:35, 22 November 2013 (UTC)

• You are talking past each other here (imho).
  1. Premise: NRT are beneficial to smoking cessation.
  2. Result of study: Ecig(w+w/o) are equivalent in efficiency to NRT patches.
  3. Derived (1): Ecigs (w+w/o) are equivalent to NRT in smoking cessation.
  4. Conclusion is either:
     • Derived (2a): Ecigs (w+w/o) are beneficial to smoking cessation.
     • Derived (2b): NRT's are not beneficial to smoking cessation.

Where you are talking past each other with here is in forgetting where the baseline is, which is NRT's. You can attack 2a with the argument that the premise is wrong (ie. chose 2b) - which it might be, as i noted to Doc James above. But i think that the premise is pretty much established medical knowledge, thus i oppose the change. --Kim D. Petersen 22:24, 22 November 2013 (UTC)

Let me be more clear: The keyword in the sentence we are talking about is possible benefit... if you accept that the conclusion is torn between 2a and 2b, then this is still a correct sentence according to the controlled study we are discussing! Thus once more i oppose. --Kim D. Petersen 22:48, 22 November 2013 (UTC)

Your list of conclusion options is incomplete. It should also include a third altenative:

• 1. Derived (2c): The study findings are inconclusive.

In fact that is effectively what the study's published result says, as I indicated just above. LeadSongDog come howl! 22:54, 22 November 2013 (UTC)

Sure, but that would be dishonest, since the paper doesn't state that. You can argue that "it effectively states that"... but this would be WP:OR from the description given in the secondary source (as well as the primary). But even given your "inconclusive" it still shows a possible benefit. (which is what i had with the "torn between 2a,2b" argument). --Kim D. Petersen 23:19, 22 November 2013 (UTC)

To explain why i state that this would be a wrong conclusion, is that it contradicts what the controlled study set out to do, which was to confirm the hypothesis that e-cigs were more efficient than NRT's - not whether e-cigs were efficient or not. This result was not reached - instead they showed that e-cigs w+w/o were as efficient as NRT's - and they did. (read the papers background and interpretation). --Kim D. Petersen 00:29, 23 November 2013 (UTC)

Perhaps you read "Achievement of abstinence was substantially lower than we anticipated for the power calculation, thus we had insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes" differently than I do. To me it is a crystal-clear acknowledgement that they could not make such conclusions given the data they had available. The authors deserve credit for making such a courageous statement. It is never easy to admit that a study's design was flawed, but that is the responsible thing to do. If they can continue the study with additional cadre, the data so far remains usable and could yet generate significant results, but no, it does not "show a possible benefit" any more than it "excludes the possibility of a benefit". It simply does not "show" any significant effect size.LeadSongDog come howl! 08:47, 23 November 2013 (UTC)

Kim the issue is what you have done is basically original research. A reading into the review something it does not state explicitly. We do not Wikipedia generally state what is not stated by the source in question.

The whole point of an RCT is to compare an active measure to a placebo. When compared to the placebo their was no effect. Thus study was negative. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:56, 23 November 2013 (UTC)

By the way this RCT did not find that patches were effective as it too was no better than placebo e-cigs Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:17, 23 November 2013 (UTC)

So you are saying 2b. But while you state that i'm doing WP:OR, you fail to see the beam in your own eyes here. If you read the protocol for the trial, you will notice that it is actually an hypothesis (superiority/equivalence) randomized controlled trial between NRT and e-cigs - with the placebo group thrown in to see how effective non nicotine e-cigs are in comparison. Which is also why the third group is so small. Our secondary source also emphasizes this by their (underlining mine) "However, the statistical power was insufficient to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes. As for other clinical studies with e-cigarettes, adverse events were very mild.". The paper itself concludes "E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches, and few adverse events.".

The thing that throws you here (i guess) is the "placebo" naming. Please read the paper. (there is also a pre-trial paper where you can see that this isn't a later addition to "hide" a bad result). E-cigs without nicotine have previously (in 2ndary sources) been shown to have an effect on withdrawal symptoms, by their mimic of smokers rituals. Addiction is not just limited to the physical :) --Kim D. Petersen 10:26, 23 November 2013 (UTC)

Note: I'm not just trying to argue against consensus - but am trying to understand how you are reading this, as well as to learn. I'll accept whatever consensus that this evolves into, but without discussion this would just be majority rule instead of a true wikipedia consensus :) --Kim D. Petersen 10:29, 23 November 2013 (UTC)

I am not arguing to add a line that says "there are RCT that probably show no benefit" to Wikipedia. If I were you would definately have a point regarding me supporting OR. Placebo's are difficult. They have compared acupuncture to placebo acupuncture to nothing. And acupuncture and placebo acupuncture are both better than nothing but equal. This does not mean acupuncture "works". Do they sell e-cigs without nicotine? Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:33, 23 November 2013 (UTC)

Huh? You didn't even know that many e-cigs don't contain nicotine? Wow.--FergusM1970^{Let's play Freckles} 13:46, 23 November 2013 (UTC)

I apparently forgot about the no nic part... Yes, all e-liquid shops sell 0% nicotine liquids - and amongst the vapers that i know, roughly 1 in 5 do not use nicotine at all - but still crave the feel to not slip back to cigs. So yes, it plays a rather important role amongst vapers. --Kim D. Petersen 14:04, 23 November 2013 (UTC)

I change nic levels up and down all the time, between 0 and 24mg. It just depends on what sort of mood I'm in, whether I have a deadline to meet or whatever. No-nic is definitely a significant part of the e-cig market. In fact when I switched from smoking I was using only 0 and 6mg liquid. I only started using high nic in the last couple of months.--FergusM1970^{Let's play Freckles} 14:19, 23 November 2013 (UTC)

I'm not in any way or form ignorant of the placebo effect (the real one - not how it colloquially is understood), But in the hypothetical accupuncture case you invoke here, there is no control at all. In the case we are talking about with regards to e-cigs - the control is the already established effect of an accepted functional treatment (NRT patches), to test the hypothesis that e-cigs is a superior treatment against. They didn't find that, we agree - instead they found the equivalence case. To put it in accupuncture terms - you would test accupuncture vs. an already established working treatment. --Kim D. Petersen 11:42, 23 November 2013 (UTC)

I have the feeling that consensus is pointing towards removing the entire sentence, is that right?CFCF (talk) 12:42, 23 November 2013 (UTC)

No, i would say that "no consensus yet", is the correct statement. (and there is certainly none to remove it completely). --Kim D. Petersen 13:05, 23 November 2013 (UTC)

"E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches, and few adverse events." Really this seems to end the discussion. The study shows a benefit. I don't honestly see how someone can argue with that.--FergusM1970^{Let's play Freckles} 15:05, 23 November 2013 (UTC)

I guess we could have a RfC to bring more eyes to the issue. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:24, 23 November 2013 (UTC)

Doc James timewasting tactic #3: "Let's have an RfC." Read the damn sentence. It's perfectly clear. "E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit." There is no need for an RfC or any more discussion. Controlled studies exist that show a benefit for smoking cessation. Consensus goes with the weight of evidence and you have been presented with the evidence.--FergusM1970^{Let's play Freckles} 23:34, 23 November 2013 (UTC)

Where in the review article ([10]) is the sentence that you quote? Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:40, 23 November 2013 (UTC)

Where did I say it was in the review article? Please read comments carefully before arguing with them. However if you want a quote from the review try this: "If the public continues to be misled about the risks of THR products, millions of smokers will be dissuaded from switching to these much less hazardous alternatives." Repeated surveys show that many smokers are dissuaded from switching to e-cigs by dishonest scaremongering about imaginary health risks, and millions of them are likely to die as a result. The determined effort to push a "quit or die" POV in this article is part of that scaremongering. There are controlled studies showing a benefit, just as the article now says; stop trying to insert deliberately misleading information.--FergusM1970^{Let's play Freckles} 23:55, 23 November 2013 (UTC)

Okay thanks. You are still set on using the conclusions of primary sources to refute those of secondary source. I would call this RCT negative. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:57, 23 November 2013 (UTC)

Oh FFS. A statement in an information sheet that there are no studies is not a secondary source. It's just a claim, and it is instantly refuted as soon as a study is identified. Stop trying to game the rules.--FergusM1970^{Let's play Freckles} 00:13, 24 November 2013 (UTC)

Since the study did not really show a benefit it does not count as a study that shows a benefit. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:17, 24 November 2013 (UTC)

Of course it showed a bloody benefit. It showed that e-cigs work just as well as NRTs.--FergusM1970^{Let's play Freckles} 00:45, 24 November 2013 (UTC)

I think from here we need to formulate a new version that sticks to the facts of the situation. A suggestion of possible formulations are:

• 1. There are non-controlled studies that show possible benefit.
• 2. Studies have been made concerning benefits, but remain inconclusive.
• 3. Controlled studies concerning benefits are inconclusive.
• 4. Both controlled and non-controlled studies have been made.
• 5. Non-controlled studies have shown benefit, while controlled studies have been shown inconclusive.

These all in different ways weigh in WP:MEDRS, and stick to the citations while being slightly different. Unfortunately No. 4 probably falls under WP:REL. If no consensus over these can be reached we will need to instigate an RfC.CFCF (talk) 00:19, 24 November 2013 (UTC)

I do not agree with any of your suggestions. It's fine the way it is. The controlled study showed a benefit - e-cigs are at least as effective as nicotine patches - and it is deliberately misleading to imply otherwise. Also stop with the WP:N crap. That applies to articles, not content within them. That's twice you've tried to pull that one now.--FergusM1970^{Let's play Freckles} 00:45, 24 November 2013 (UTC)

You're right I of course refer to WP:REL, edited to reflect that. CFCF (talk) 00:56, 24 November 2013 (UTC)

As for "the facts of the situation," here they are: In a controlled study obsolete e-cigs of a type that's no longer available and is far less efficient than current models outperformed the most commonly used NRT, although not by a large enough margin to gain statistical significance. In an uncontrolled study an equally obsolete e-cig comfortably outperformed nicotine patches when used by smokers who didn't want to quit. I fully accept that there aren't yet enough secondary sources to state conclusively that e-cigs outperform NRT, but all the evidence is pointing that way. Therefore to insist that no studies have showed benefit, on the grounds of one statement in a WHO fact sheet that isn't based on any real world data at all, is simply POV pushing.--FergusM1970^{Let's play Freckles} 00:50, 24 November 2013 (UTC)

• Support 2 or 5. I believe these follows the cited sources the best. Would need to add the newer study in case of 5. CFCF (talk) 00:58, 24 November 2013 (UTC)

I don't think anyone's very interested in the fact that you support your own suggestions. All of which, by the way, are intentionally misleading.--FergusM1970^{Let's play Freckles} 01:08, 24 November 2013 (UTC)

Medical Letter

There is a Nov 11, 2013 review of e-cigs in the Medical Letter.[11] Wondering if anyone has access? Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:51, 24 November 2013 (UTC)

No, but seeing as it contains this little gem - "their use has been increasing over recent years, primarily among smokers, but also among non-smokers" - it's obviously non-evidence-based shit, so it probably isn't going to add much. E-cig use among never smokers is somewhere between negligible and zero. Of course many non-smokers use them, including myself, but that's because we switched from smoking to vaping.--FergusM1970^{Let's play Freckles} 01:21, 24 November 2013 (UTC)

Okay discusses the two RCTs (the PLoS 2013 and Lancet 2013) among other trials and concludes "Their efficacy as aids in smoking cessation remains to be established and their long-term safety is unknown. Use of electronic cigarettes by non-smokers could lead to nicotine addiction and possibly cardiovascular toxicity." Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:41, 24 November 2013 (UTC)

I'm fine with adding that, as long as it's made clear that every study shows use by never smokes is somewhere between negligible and zero. OTOH if it's used as a standalone statement with no context then I oppose adding it, on the grounds that it's just a hypothetical worry. Is there any research showing that a never smoker has become addicted to nicotine through e-cig use? I'll even accept a primary source, just as long as it's actual data and not a "concern."--FergusM1970^{Let's play Freckles} 16:31, 24 November 2013 (UTC)

Access is available through trial to that publication (my University doesn't have access): Don't really think it adds anything unfortunately. The only interesting thing about it is that it is newer and maybe that its has some information on the devices. Just realised you must have gotten access to it before me.CFCF (talk) 16:46, 24 November 2013 (UTC)

The interesting thing is that even after combining the RCTs it still finds effects regarding cessation remaining to be established. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:48, 24 November 2013 (UTC)

I'm curious about that one... no abstract, and the journal seems to have very low impact rating? But since i'm not familiar with medical journals ... --Kim D. Petersen 19:59, 24 November 2013 (UTC)

Yes it is not the best secondary source. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:38, 25 November 2013 (UTC)

POV editing

Can people please stop adding statements such as "including the nicotine in e-cigs" when this isn't supported by the source? The fact is that there are no studies on how addictive nicotine is to humans when not delivered in tobacco smoke, and strong circumstantial evidence that moderately high doses can be used daily for 6 months without creating addiction. Smoking is most certainly highly addictive, but this article isn't about smoking.--FergusM1970^{Let's play Freckles} 09:30, 16 November 2013 (UTC)

People may be concerned that some editors believe e-cigs contain magical nicotine which isn't addictive to any users. Seppi333 (talk) 09:40, 16 November 2013 (UTC)

Some of them don't contain any nicotine. In any case the point is that nobody has any idea what potential for addiction e-cigs have. Nicotine patches, which according to the FDA deliver nicotine more effectively than e-cigs do, can be used daily for 6 months without creating dependency. All the addiction studies have been on tobacco products, which isn't relevant here. If you do have any studies about the addiction potential of pure nicotine in humans now would be a good time to put them on the table.--FergusM1970^{Let's play Freckles} 09:43, 16 November 2013 (UTC)

Here's four: Seppi333 (talk) 09:47, 16 November 2013 (UTC) Edit: If you want primary sources, wikipedia doesn't use those. Seppi333 (talk) 09:48, 16 November 2013 (UTC)

References

I hope I'm not pointing out the blindingly obvious here, but none of those are studies. They're reference texts. Where's the experimental data?--FergusM1970^{Let's play Freckles} 09:48, 16 November 2013 (UTC)

The reference text for the addiction chapter from the book I just added is a page long. Check it out in your local library and read the studies. Given that nicotine is cited throughout the chapter, I'm sure a fair number of them are include it. Seppi333 (talk) 09:52, 16 November 2013 (UTC)

Actually there are exactly zero clinical trials on pure nicotine's potential for dependency in humans, just animal trials - which, as you know, point to only weak addictiveness. On the other hand non-smokers can use nicotine patches for six months without becoming addicted. That suggests that when not delivered in tobacco smoke nicotine has little potential for causing dependency. The FDA have even acknowledged that NRT - which apparently delivers more nicotine than e-cigs do - aren't addictive.--FergusM1970^{Let's play Freckles} 09:55, 16 November 2013 (UTC)

Alternatively (to contradict you), you could just look up the FDA Rx info on any prescription NRT, which would require a clinical trial. Seppi333 (talk) 09:58, 16 November 2013 (UTC)

NRTs require a clinical trial to prove safety and efficacy - not potential for addiction, on which the FDA position is "NRT products sold OTC do not appear to have significant potential for abuse or dependence." Now, as e-cigs deliver less nicotine than OTC NRT, it seems premature to declare that they're addictive.--FergusM1970^{Let's play Freckles} 10:00, 16 November 2013 (UTC)

I'd like to direct you to section 9 of what an example Rx info looks like. Seppi333 (talk) 10:03, 16 November 2013 (UTC)

OK, great. So as the FDA are saying that a wide range of non-tobacco nicotine-containing products "do not appear to have significant potential for abuse or dependence" we can assume that's the conclusion reached by clinical trials?--FergusM1970^{Let's play Freckles} 10:06, 16 November 2013 (UTC)

Are you going to link that or am I to assume you're the new voice of the FDA? Seppi333 (talk) 10:08, 16 November 2013 (UTC)

I thought you'd never ask. Here.--FergusM1970^{Let's play Freckles} 10:09, 16 November 2013 (UTC)

If you're interested, you can also read about how six months' daily use of nicotine at a level equivalent to smoking nearly a pack a day did not cause withdrawal symptoms or continued use of nicotine in any of the subjects.--FergusM1970^{Let's play Freckles} 10:13, 16 November 2013 (UTC)

That doesn't surprise me. There are many addictive drugs that are like that. I've added the statement/quote to the section. In any event, I'm heading off to sleep. Seppi333 (talk) 10:17, 16 November 2013 (UTC)

Erm, like "not very addictive"? Anyway thanks for your last edit and have a good night.--FergusM1970^{Let's play Freckles} 10:19, 16 November 2013 (UTC)

You're suggesting this one study—of older people with amnestic MCI—that wasn't even designed to investigate the addictive qualities of nicotine should be used to overturn the general scientific consensus from the world's most influential scientific bodies on the matter? No. Zad68 05:33, 18 November 2013 (UTC)

If there's a scientific consensus on the addictiveness of clean nicotine I assume it's based on hard data? The FDA doesn't seem to think there's a consensus, seeing as they've said that prolonged use of NRTs presents "no significant risk" of becoming nicotine dependent. Moving closer to the subject of this article, is there a scientific consensus that e-cigs present an addiction risk? Absolutely not.--FergusM1970^{Let's play Freckles} 06:35, 18 November 2013 (UTC)

I should probably add that the CDC and FDA are hardly the world's most influential scientific bodies. Few people outside the USA have even heard of them. The FDA, for one, arguably isn't a scientific body at all; it's a regulatory agency.--FergusM1970^{Let's play Freckles} 07:30, 18 November 2013 (UTC)

Gradual low doses are not a big issue. Large fast doses are. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:57, 18 November 2013 (UTC)

Oh well then. E-cigs deliver smaller doses than NRT, which is why some people are concerned that they might not be effective for smoking cessation, so clearly there's even less risk of addiction.--FergusM1970^{Let's play Freckles} 07:03, 18 November 2013 (UTC)

The speed of delivery is key. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:17, 18 November 2013 (UTC)

How much do you know about how e-cigs are used? Anything?--FergusM1970^{Let's play Freckles} 07:19, 18 November 2013 (UTC)

I don't think the statement that e-cigs contain lower nicotine doses than NRT is universally true, since one could just put more nicotine into the base. That's not really an issue anyway, since people don't necessarily just use it once. In any event, I backed off from my original position simply because the FDA is a very authoritative source. They do not make statements regarding the safety of drugs off-handedly or without a great deal of research or clinical evidence to support their position. That's exactly why I deleted the material from the tertiary sources, which pre-dated that news release you showed me. If the FDA is not authoritative, then I'd have to re-add what I deleted. Seppi333 (talk) 03:48, 27 November 2013 (UTC)

Gateway

Secondary sources are finally arriving. Here we have a systematic review which IMO would support

"As of 2013 there is no evidence looking at whether or not e-cigs affect the future risk of cigarette smoking."Pepper, JK (2013 Nov 20). "Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review". Tobacco control. PMID 24259045. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

I propose we put this after "e-cigs might increase addiction to and use of nicotine and tobacco products in children" Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:53, 28 November 2013 (UTC)

Yes, I don't see why not. It points out that there is no evidence for the "gateway" claims.--FergusM1970^{Let's play Freckles} 21:24, 28 November 2013 (UTC)

Great so unless someone opposes hopefully we can get someone to add this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:45, 28 November 2013 (UTC)

I'd prefer wording along the lines of "No studies have investigated this hypothesised gateway effect."--FergusM1970^{Let's play Freckles} 22:52, 28 November 2013 (UTC)

Well, doi:10.1136/tobaccocontrol-2013-051122 says several useful things in its abstract's data synthesis section:

The majority of users were current or former smokers. Many users found ENDS satisfying, and some engaged in dual use of ENDS and other tobacco. No longitudinal studies examined whether ENDS serve as ‘gateways’ to future tobacco use. Common reasons for using ENDS were quitting smoking and using a product that is healthier than cigarettes. Self-reported survey data and prospective trials suggest that ENDS might help cigarette smokers quit, but no randomised controlled trials with probability samples compared ENDS with other cessation tools. Some individuals used ENDS to avoid smoking restrictions.

— Pepper & Brewer (2013)

LeadSongDog come howl! 23:27, 28 November 2013 (UTC)

Exactly; no studies have investigated the hypothesised gateway effect. There still haven't been any sensible suggestions as to why e-cigs would lead people to start smoking, in any case.--FergusM1970^{Let's play Freckles} 23:31, 28 November 2013 (UTC)

Using unpublished statements by sources of questionable validity

The text was recently changed to "A number of organizations including the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the Food and Drug Administration have concerns that e-cigs might increase addition to and use of nicotine and tobacco products in children[20][21] although the existing evidence contradicts this.[22]" based on this unpublished study by ASH [12]. IMO ASH should not be used to refute the CDC and FDA.

This paper states "It is unknown if the availability of ENDS serves to alter use of cigarettes among current smokers or leads to increased initiation among non-using youth. Nevertheless, there is concern that ENDS use may undermine social norms about tobacco (Mejia, Ling, & Glantz, 2010), serve as a starter product for cigarettes among youth, or delay smoking cessation among current adolescent" Camenga, DR (2013 Sep 17). "Trends in use of electronic nicotine delivery systems by adolescents". Addictive behaviors. PMID 24094920. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

And this overview agrees that their is little data one way or the other "However, there is little objective information concerning the safety, abuse potential and efficacy of these products.12 Other concerns have been expressed, including that some flavours may appeal to children, that ENDS may become a gateway to smoking or to nicotine addiction, that they undermine smoke-free laws, delay a smoker’s decision to quit or might be used in conjunction with drug misuse.2,3, 13, 14" [13].

I propose we change the text to "although as of 2013 evidence is insufficient to determine if this is the case or not" or some such working.Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:12, 12 November 2013 (UTC)

Support

• Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:16, 12 November 2013 (UTC)
• This wording follows what the sources are saying. Lesion (talk) 12:57, 12 November 2013 (UTC)
• Support. The dissenting "source" wouldn't even satisfy WP:RS. Seppi333 (talk) 14:56, 12 November 2013 (UTC)
• Support. More data from the CDC (already used as a source in the article!): "In 2012, among high school ever e-cigarette users, 7.2% reported never smoking conventional cigarettes ... Moreover, in 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes. This is a serious concern because the overall impact of e-cigarette use on public health remains uncertain. In youths, concerns include the potential negative impact of nicotine on adolescent brain development (4), as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products." Sasata (talk) 15:55, 14 November 2013 (UTC)

"Ever-users" isn't relevant. What matters is regular users. Sure some kids will try e-cigs. Kids will try anything. However if they try an e-cig once, so what? The real question in terms of addiction is how many never-smokers use e-cigs regularly. ASH say 0% and CDC don't even give a figure.--FergusM1970^{Let's play Freckles} 03:38, 15 November 2013 (UTC)

• Support - "ASH" source isn't useful for this, it's not even in the same ballpark, the proposed change fixes this WP:MEDREV problem. Zad68 16:06, 14 November 2013 (UTC)
• Support, as this follows the sources. – Quadell ^(talk) 16:11, 14 November 2013 (UTC)
• Support - Sources are valid and relevant. Eduemoni^↑talk↓ 12:05, 21 November 2013 (UTC)

Oppose

• FergusM It's not necessary to refute CDC because they don't have any data showing uptake by non-smokers. The ASH study shows zero uptake by non-smokers, and it's the best evidence available.--FergusM1970^{Let's play Freckles} 12:20, 12 November 2013 (UTC)
• Support ASH's statement is only "unpublished", if you think that the CDC and FDA statements are. But what this really boils down to, is that the supporting editors want to elevate the CDC/FDA "warnings" about what might happen, into a generic health concern. "MAY" does not translate into an "IS". We are not speaking about a real world problem, but instead about what some organizations consider (contrary to current evidence) to be a likely outcome. --Kim D. Petersen 07:39, 13 November 2013 (UTC)
• Support current wording. The concern by CDC has been expressed, no need to give it additional weight or to undermine existing data, as limited as it may be. Per NPOV we present the info in a neutral way and let the reader decide. It's not WP's job to warn people away from things that WP editors fear might harm them.-- — Keithbob • Talk • 18:19, 29 November 2013 (UTC)

Comments

There's a lot of nonsense being spouted by e-cig opponents. For example do only children like flavours? How can something undermine smoke-free laws when it doesn't emit smoke? These aren't legitimate arguments; there is no evidence to back them up. All the evidence that actually exists says that non-smokers aren't taking up vaping, and the article should make this clear.--FergusM1970^{Let's play Freckles} 12:22, 12 November 2013 (UTC)

This evidence says "Overall, 3.2% of never smoking students reported ever use of e-cigarettes." [14] So there is some evidence. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:35, 12 November 2013 (UTC)

No, there isn't. "Ever users" includes people who tried an e-cig once. As a metric of actual uptake it's useless. What matters is the percentage of current users who are never smokers. What do CDC's figures say about that?--FergusM1970^{Let's play Freckles} 12:40, 12 November 2013 (UTC)

"Might be used in conjunction with drug abuse." WTF? What kind of idiotic argument is this? Should we ban Pringles because they're used in conjunction with drug abuse by stoners who get the munchies? FSM save us from self-proclaimed "public health experts."--FergusM1970^{Let's play Freckles} 12:25, 12 November 2013 (UTC)

This ref states "with competing views on the use of such products as gateways to tobacco use9" [15] Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:32, 12 November 2013 (UTC)

Competing views. Let's just stick with the evidence, shall we? Do you have any evidence to suggest that people are switching from vaping to smoking, or even any credible suggestion why anyone might?--FergusM1970^{Let's play Freckles} 12:38, 12 November 2013 (UTC)

What I am suggesting is that we state it is unknown whether or not e-cigs lead to future cig smoking. And this statement is supported by many sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:41, 12 November 2013 (UTC)

It's also unknown whether or not e-cigs lead to spontaneous human combustion. Want to include that too? It would be just as valid. Do you, or do you not, have any evidence for a gateway effect, or is it just the snus farce all over again?--FergusM1970^{Let's play Freckles} 12:48, 12 November 2013 (UTC)

Fergus, The CDC WHO and FDA are all reliable sources. Please do not dilute the content which is directly sourced to them. E.g. changing wording from "concerns" to "hypothetical concerns" is not appropriate. It doesn't matter if you or I or anyone else is of the opinion that there is no credible evidence. It is enough that these mainstream sources have made these position statements. Lesion (talk) 12:55, 12 November 2013 (UTC)

But what are their position statements? "We don't know." There's no evidence at all to support these "concerns" about gateway effects, so why bother mentioning them? Should we put in everything we don't know? The "concern" that vapers will switch to smoking (which is a ridiculous idea anyway) is purely hypothetical. There's not even the slightest suggestion that it's actually happening and no reason why it would. To include it in the article is just scaremongering. As for young non-smokers becoming addicted to e-cigs, all the FDA, CDC and WHO have are their "concerns," and "concerns" are usually the last refuge of people who don't have any evidence. ASH, on the other hand, do have evidence. People who have never smoked are not using e-cigs.--FergusM1970^{Let's play Freckles} 13:01, 12 November 2013 (UTC)

We mention them because they are major, mainstream orgs, and their positions are therefore encyclopedic. What is the ASH source you mention please? Lesion (talk) 13:05, 12 November 2013 (UTC)

Reference 31. It gives the percentage of both young and adult e-cig users who are not previous smokers. 0% in both cases.--FergusM1970^{Let's play Freckles} 13:09, 12 November 2013 (UTC)

This one [16] Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:10, 12 November 2013 (UTC)

A question: Does the CDC's "concern" that young non-smokers are taking up e-cigs outweigh ASH's finding that they are not? If so, why?--FergusM1970^{Let's play Freckles} 13:11, 12 November 2013 (UTC)

Thank you. I've seen this kind of source before. It is a charity report about a study they have commissioned, with very few details reported that would normally be presented in a scientific publication. I am not sure if this makes it a secondary or a primary source. Depends if the study itself has been published elsewhere I suppose. If we are going to keep this source, it might be appropriate to mention it after stating that all these mainstream orgs state that there is unknown risk. However, need to keep in mind due weight, and this source certainly should not be used as a justification to remove other sources. WP:MEDRS also specifically states not to use a single primary source to refute several other more reliable sources. Lesion (talk) 13:18, 12 November 2013 (UTC)

Why are the other sources "more reliable" when they don't supply any evidence whatsoever to back up their "concerns"? In fact the CDC did their own study on e-cig use among young people and they left that information out. The idea that young never smokers are taking up e-cig use is, as I said, purely hypothetical. There is no evidence that it's happening and in fact all available evidence says it's not.--FergusM1970^{Let's play Freckles} 13:21, 12 November 2013 (UTC)

Where is the CDC's own study please? Apologies I am unfamiliar with this literature. Lesion (talk) 13:22, 12 November 2013 (UTC)

Why did you just revert my edit? It was correct and referenced. If we are discussing the idea that young never smokers might take up e-cig use I do not think it is IN ANY WAY inappropriate to give statistics on the issue.--FergusM1970^{Let's play Freckles} 13:25, 12 November 2013 (UTC)

I reverted it because I would like a few more opinions about whether this is a primary or a secondary source. I am not sure, but I think it might be considered primary since it is presenting new results. Lesion (talk) 13:37, 12 November 2013 (UTC)

Seems like an unusually high standard of references is required on this article - on one side, at least. Unsupported "concerns" appear to be OK, but an actual study isn't?--FergusM1970^{Let's play Freckles} 13:39, 12 November 2013 (UTC)

CDC, WHO etc usually follow the mainstream. You have to agree that it is inappropriate to remove their positions. Wikipedia articles should also follow the mainstream. This does not equate to failing to present other views, but they must be presented with due weight and be based on reliable sources. The question now is whether we use this source, a charity report of a commissioned study ... is it WP:MEDRS or not? It might be best to leave this discussion stand for a few days to gather more opinions before making any decision. Lesion (talk) 13:48, 12 November 2013 (UTC)

I'm not suggesting removing their positions. I just think it would be helpful to point out that their "concerns" about uptake by young never smokers, a gateway effect etc. are purely hypothetical and are contradicted by the available evidence - which I think summarises the "due weight" they have. Opinions do not outweigh evidence. CDC surveyed young e-cig users and clearly found such an insignificant number of never smokers that they didn't even bother to mention it in their study. ASH put the number at 0%. I really don't understand the opposition to having this in the article.--FergusM1970^{Let's play Freckles} 13:52, 12 November 2013 (UTC)

If a source says there are concerns about whether e-cigarretes act as gateway drugs, then we should state this too. If we add the qualifier "hypothetical concerns" this is misrepresenting the source and constitutes original research... Lesion (talk) 14:13, 12 November 2013 (UTC)

You say you are not suggesting removing these sources, yet here is an edit where you did exactly that: [17]. Lesion (talk) 14:15, 12 November 2013 (UTC)

As I recall I suggested removing them from Health Effects, because they don't belong there. I am an e-cig user. If someone at CDC has "concerns" that I might start smoking again, that is not an effect e-cigs are having on my health; it's just an error on his part.--FergusM1970^{Let's play Freckles} 14:25, 12 November 2013 (UTC)

Comments from Seppi333

Copied from User talk:Biosthmors:
These are quotes on the addictiveness of nicotine via any medium from 2 comprehensive research databases that are listed in virtually every drugbox/chembox on wikipedia and which I've extensively cited in articles:

Toxicity and addiction are possible with the use of nicotine from any source. Sustained use of nicotine polacrilex preparations or or orally inhaled nicotine should not be encouraged because chronic consumption of nicotine may result in intoxication and dependence (addiction). In deciding whether to initiate therapy with nicotine polacrilex preparations or transdermal or orally inhaled nicotine, regardless of the presence of disease or pregnancy, the risk of nicotine replacement in a smoking-cessation program should be weighed against the hazard of continued smoking concurrent with nicotine-replacement therapy and the likelihood of achieving smoking cessation without such pharmacologic management.
— Pubchem Compound: Nicotine - Pharmacology section

Nicotine exerts two effects, a stimulant effect exerted at the locus ceruleus and a reward effect in the limbic system... Nicotine is a highly addictive substance. Nicotine also induces peripheral vasoconstriction, tachycardia and elevated blood pressure.
— Drugbank:Nicotine - Pharmacology section (Pharmacodynamics subsection)

That said, nicotine certainly has some beneficial uses and positive effects, but it is without a doubt an addictive drug. Seppi333 (talk) 15:47, 12 November 2013 (UTC)

OK. Show me a study on the addictiveness of pure nicotine in humans.--FergusM1970^{Let's play Freckles} 15:50, 12 November 2013 (UTC)

Those research databases cite studies and ref other RD's. Go to those sections sources. Also, the paper I linked last night by PMID and referenced specific pages and a figure contains that information. Fig 1 explains how nAChR activation can induce DA efflux and in turn how chronic activation of those receptors can cause addiction. In any event, I'm done with this article/thread for now. Seppi333 (talk) 16:08, 12 November 2013 (UTC)

I asked for a study on the addictiveness of pure nicotine in humans. I'll just assume you can't show me one. In fact all the studies I'm aware of are on the addictiveness of nicotine delivered in tobacco, which isn't relevant here.--FergusM1970^{Let's play Freckles} 17:20, 12 November 2013 (UTC)

Sorry, I was under the impression you were familiar with the relevant neuropharmacology topics. nAChRs are nicotinic acetylcholine receptors, as in, the receptors named after their full agonist ligand, called "nicotine." A paper on the effects of receptor activation need not specify that effect for receptor full-agonist ligands, because that relationship (i.e. full agonists induce receptor activation effects) is literally true by definition (of full agonist). I'd suggest purchasing a neuropharmacology reference text if you're going to actively edit and argue on talk pages about neuropharmacology topics. Seppi333 (talk) 05:44, 13 November 2013 (UTC)

Comment on the ASH document: I didn't read this document until this morning. As a statistician, I have to admit the statistical methodology in the paper is laughable, but its not surprising considering it's an unpublished (read: not peer reviewed) primary source with no references. They used online surveys to gather data and so far as I can tell from their (lack of) explanation on methodology/analysis, they simply performed basic hypothesis tests on unrefined/unprocessed, raw data and then generalized their inference to the entire population of GB from that non-representative and non-random sample. Given the number of statistical biases endemic to online surveys, (see non-probability sampling. Also, two notable/obvious examples of biases in their sample data are self selection bias [those who decided to take the survey] and exclusion bias [those without internet who couldn't take the survey] - see sampling bias), their statistical analysis is spurious due to the resulting inconsistent (asymptotically biased) estimators. There are various regression models which can be used to account for these biases and produce consistent estimators, but they didn't even mention their model, which leads me to believe it's just amateur statistical analysis similar to what I described before. The flawed methodology just makes this another obvious case of GIGO, especially since the associated test statistics unequivocally would not follow their standard (ex: Z, T, F) distributions (RE: non-probability sampling). Seppi333 (talk) 14:42, 12 November 2013 (UTC)
Edit: Seeing as how most of the figures are just frequency distributions, I'll also point out that non-probability sampling makes those non-representative of the whole population as well. Seppi333 (talk) 14:49, 12 November 2013 (UTC)

So what i read here is: Online survey => Bunk. That is the gist of what you are saying? I dug a little deeper and found this[18] MEDRS paper that is based upon the research done by ASH. --Kim D. Petersen 08:08, 13 November 2013 (UTC)

That paper isn't a review - it's just an analysis on survey data (primary source); consequently, it's actually not MEDRS. In any event, that was almost my point. In general, statistical analysis on online surveys requires a much more elaborate/technical statistical design to account for non-probability sampling bias/inconsistency. That was the point I was making when I mentioned regression methods exist to deal with that. They're not simple/cookbook/intuitive though. "Simplest" examples: truncated regression (also: truncated distribution for more analytic detail) & tobit model for censored regression. You should be highly skeptical of any analysis using such data because of this problem. As for the peer reviewed primary source, I noticed it used a correction to account for the influence of weighted/quota sampling in variance/CI, but I didn't notice any corrections of the estimators (that's much more important). I only skimmed it, so I may have missed a mention of it, but if it didn't use a statistical design to account for inconsistent estimators from the non-probability samples, then that entire paper is also complete garbage. The point/takeaway from my response to you is: It is very easy to lie with and screw up at a statistical analysis with non-probability samples. Regards, Seppi333 (talk) 09:53, 13 November 2013 (UTC)

Erm, sorry. But while the paper is a primary source, it is a WP:MEDRS source. But none of the other sources (CDC etc) given here are WP:MEDRS secondary sources to what we are discussing here, which is whether or not E-cigarettes are a gateway to addiction. So it is in fact one of the best sources we have so far.

As for your WP:OR about the paper itself - would you please keep that to yourself? Or cite sources that refute the paper. --Kim D. Petersen 10:39, 13 November 2013 (UTC)

Copy/Paste my reply from below: Re: my WP:OR? ROFL. I made 1 statement of observation and 1 statement of fact which you can WP:V in literally ANY statistics textbook. So my reply to that is an emphatic no. I can only assume you have an affinity for the source or the position it takes, given that, until this reply, I hadn't taken any position on content in the article. Also, I'm copy/pasting my first quote from the collapse tab above on the addictiveness of nicotine from any source, citing a tertiary source with ubiquitous citations and/or links on wikipedia drug/chem articles. My molecular neuropharmacology text corroborates the statement, so I could also quote that as well in the event you're of the opinion that pubchem is OR too. Seppi333 (talk) 11:02, 13 November 2013 (UTC)

Toxicity and addiction are possible with the use of nicotine from any source. Sustained use of nicotine polacrilex preparations or orally inhaled nicotine should not be encouraged because chronic consumption of nicotine may result in intoxication and dependence (addiction).
— Pubchem Compound: Nicotine - Pharmacology section

What exactly does the above quote have to do with the discussion here? I'm asking because you seem to remove the hatting of it constantly. The addictive nature or the toxicity of nicotine is not discussed here, nor is it even relevant to this particular discussion. Of course it is addictive, and it has a low LD50??? --Kim D. Petersen 14:19, 13 November 2013 (UTC)

I'm sorry, but your "statistical observation" is being used to denigrate/contradict a peer-reviewed WP:RS - thus it gets into WP:OR. This is exactly why the WP:NOR guidelines are there. Doesn't matter whether you are right or wrong. --Kim D. Petersen 11:59, 13 November 2013 (UTC)

Hah, ok. Go get an admin and tell them of my "talk page OR." I'm not going to rescind my statement. Seppi333 (talk) 13:11, 13 November 2013 (UTC)

You seem to be mistaken about both how wikipedia, and admins work. --Kim D. Petersen 13:30, 13 November 2013 (UTC)

Then get an admin and inform them of my talk page OR and ignorance of WP. Seppi333 (talk) 13:40, 13 November 2013 (UTC)

May i suggest that you read up upon what the role of administrators is on Wikipedia (WP:ADMIN). They do not and cannot act both as administrators and as arbiters of what is and isn't relevant in a discussion (per WP:INVOLVED). --Kim D. Petersen 14:19, 13 November 2013 (UTC)

Not going to bother reading those because I really don't give a **** about this thread anymore. You could always complain to a WP:ADMIN about my talkpage OR, ignorance of wikipedia, and lack of desire to read your links though. Seppi333 (talk) 22:50, 13 November 2013 (UTC)

Kim D. Petersen, the Dockrell et al. source is not a MEDRS source because it is a primary source. There are only limited circumstances where we should be using primary sources, and to contradict the mainstream opinion given by several major orgs (CDC, WHO etc) is not one of them. I do agree it is better quality than the previously suggested ASH report, but this is not saying much since it was a charity report. Thanks to Seppi for the more detailed assessment of these sources. I do not think either is suitable. Lesion (talk) 11:01, 13 November 2013 (UTC)

First of all, lets disperse with the WP:MEDRS issue. Generally for WP:RS peer-reviewed papers are not primary sources (they are secondary). But for WP:MEDRS such a paper, as the one i gave, is considered a primary source, but it is still a WP:MEDRS source. It just has limited applicability. Second, the "mainstream opinion" is not such - since the CDC is here presenting their concerns for what may happen, but are not basing it on research/medical evidence. You forget that the CDC, aside from is regular function, it is also a policy recommendation party in this issue. Third ASH is for british purposes, equivalent to the CDC as a policy advisor - and they are highly regaded as such. You are confusing US ways to conduct such processes with the European one. --Kim D. Petersen 12:12, 13 November 2013 (UTC)

Sorry but none of the other sources (CDC etc) are adressing the specific issue of E-cigs being a "gateway drug" in a way compliant with WP:MEDRS - thus the best source that we have at the moment for anything other than public concern/advocacy/... is the primary source that i gave.

Would it be OK to discuss sources relating to similar issues? It may be relevant to discuss the case of Swedish snus, where similar "concerns" about it being a gateway to smoking were raised - and proved to be completely unfounded.--FergusM1970^{Let's play Freckles} 04:38, 14 November 2013 (UTC)

After spending a lot of time sorting through who-knows-what (like who the heck is ASH and why does anyone consider it compliant with MEDRS), I agree with Lesion. We shouldn't even be discussing any addition of ASH-cited text here. SandyGeorgia (Talk) 15:52, 12 November 2013 (UTC)

Sandy, i'm not at all certain as to why we would need a MEDRS reference for this. First of all, this is not about a medical issue, but instead about a projected problem with no real world data to back it up. "MAY"/"MIGHT" does not translate into an "IS". Especially not when real world data does not support this projection ... i would be much more convinced, if and when the data supports the "may". As for ASH they are a highly respected medical NGO within the field of anti-tobacco created by the Royal College of Physicians. They are not an astro-turf outfit or the like which (unfortunately) are so common in the US. --Kim D. Petersen 08:01, 13 November 2013 (UTC) paper] on the surveys. (which if i'm not mistaken is compliant with MEDRS, and which addresses the problem directly (as opposed to the CDC) --Kim D. Petersen 08:13, 13 November 2013 (UTC)

As mentioned in my reply above, it's not MEDRS because it's a primary source. It's also subject to the same data issues I originally raised. It's worth noting that peer review is unlikely to catch the more esoteric/arcane statistical design flaws; in other words, journal publication does not mean the published paper has a valid statistical model. Seppi333 (talk) 10:12, 13 November 2013 (UTC)

Sorry but WP:MEDRS does not discard primary sources, it simply limits where they can be used. Your WP:OR on the other hand is and must be discarded out of hand. --Kim D. Petersen 10:54, 13 November 2013 (UTC)

Re: my WP:OR? ROFL. I made 1 statement of observation and 1 statement of fact which you can WP:V in literally ANY statistics textbook. So my reply to that is an emphatic no. I can only assume you have an affinity for the source or the position it takes, given that I haven't taken any position on content in the article. Nice try though. Seppi333 (talk) 11:02, 13 November 2013 (UTC)

I'm sorry, but your "statistical observation" is being used to denigrate/contradict a peer-reviewed WP:RS - thus it gets into WP:OR. This is exactly why the WP:NOR guidelines are there. Doesn't matter whether you are right or wrong. --Kim D. Petersen 11:59, 13 November 2013 (UTC)

It is not OR to discuss the suitability of a source on the talk page. We should not use primary sources to contradict several other mainstream sources. Lesion (talk) 11:12, 13 November 2013 (UTC)

It is most definitely WP:OR to try to denigrate/dismiss a peer-reviewed paper by making unsupported observations about statistics. If you want to dismiss a peer-reviewed paper, you cite other PR papers that address the specific paper. --Kim D. Petersen 12:18, 13 November 2013 (UTC)

One might suggest you actually read the policy you keep citing - or at least try the search function on that page for "talk." You might just find something like "this policy of no original research does not apply to talk pages" in the very first paragraph of the lead. But who am I to know? After all, I'm ignorant of WP policies and WP:DGAF. Seppi333 (talk) 22:56, 13 November 2013 (UTC)

There seem to be some unrealistic expectations here. Not every reference in Wikipedia has to comply with MEDSR, so I'm not sure why that standard is being applied to a survey on e-cig use. If I was citing an ASH study on smoking prevalence I'm sure it wouldn't be an issue, so why is it unacceptable here?--FergusM1970^{Let's play Freckles} 17:06, 12 November 2013 (UTC)

Thanks also agree that ASH is a completely unsuitable source and that we should not be using it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:35, 12 November 2013 (UTC)

Well there's a surprise.--FergusM1970^{Let's play Freckles} 16:55, 12 November 2013 (UTC)

Lets bridge this abit

My concerns here is primarily about the "gateway drug" issue here, that is the springing point. It is not questionable whether nicotine is an addictive substance or not (of course it is, and that should be discussed). There have been a lot of red-herrings and irrelevant issues. The question is even debateable as to being a MEDRS issue, since it is not based in medical papers or in real world issues, but instead on how various policy and advocacy organizations view that things might play out. Could we please continue this discussion with this in mind? --Kim D. Petersen 12:25, 13 November 2013 (UTC)

That's what I've been saying all along. The ASH study might not be a high quality paper, but it's still a source concerning observations. No matter how reputable an organization, their worries about what might happen don't take precedence over what someone else has reported is happening. Unfortunately some people really do seem unable to see the difference between an actual health effect and a hypothetical one.--FergusM1970^{Let's play Freckles} 04:43, 14 November 2013 (UTC)

Not going to let you censor me on the basis of an irrelevant fringe theory. Sorry. Seppi333 (talk) 06:49, 14 November 2013 (UTC)

I'd actually say that the "gateway effect" argument is the irrelevant fringe theory, no matter who's expressing their concerns about it. That's because we've been here before, with Swedish snus. The exact same ANTZ agitated for a ban on the grounds that snus would act as a gateway into nicotine addiction and smoking, and managed to get it banned everywhere in the EU except Sweden. The result? Smoking prevalence (and lung cancer) in Sweden plummeted and are now less than half the EU average.--FergusM1970^{Let's play Freckles} 07:03, 14 November 2013 (UTC)

You seem not to be aware that the "gateway drug" issue is what the CDC is claiming about E-cigarettes? And that this is one of the main issues for the discussion and text involved? --Kim D. Petersen 06:59, 14 November 2013 (UTC)

I would suggest not deleting comments other users (that I've) written on a talk page again. Reformatting and tabbing is one thing; deletion of other user's comments is entirely another. (I apparently can't read at night) This is not off topic. Even if this were about gateway theory, which is a ridiculous concept, I've addressed that in my comment's second bullet. The CDC sentence includes gateway theory; it is not exclusively gateway theory, because it mentions nicotine. Seppi333 (talk) 07:19, 14 November 2013 (UTC)

Let me summarize this for you. Per these two quoted databases, and my own analysis of the complete garbage that is ASH (I could just use the policy that secondary sources trump primary sources, but I'm amused by the responses I get from mentioning my "talkpage OR"), we have the following two conclusions:

• If an e-cig contains nicotine, it unequivocally will contain the same addiction risk as an equivalent quantity of pure nicotine, adjusted for route bioavailability (that's true for any drug, barring interactions, but I've sourced that obvious fact with the quotes below).
• If an e-cig does not contain nicotine, stating what I just said would be a logical fallacy. Further, I highly doubt that using a vaporizer (a term I'm reserving for "an e-cig without nicotine" - calling a vaporizer an e-cig is an abuse of language) would have any bearing at all on drug use. It unequivocally would have no effect on nicotine addiction, because there are no drug-induced neuroplastic alterations. Seppi333 (talk) 05:52, 14 November 2013 (UTC)

Toxicity and addiction are possible with the use of nicotine from any source. Sustained use of nicotine polacrilex preparations or orally inhaled nicotine should not be encouraged because chronic consumption of nicotine may result in intoxication and dependence (addiction).
— Pubchem Compound: Nicotine - Pharmacology section

Nicotine is a highly addictive substance.
— Drugbank:Nicotine - Pharmacology section (Pharmacodynamics subsection)

Seppi333 (talk) 05:52, 14 November 2013 (UTC)

Yes, but what you seem to be missing is that we don't have any data on how addictive pure nicotine actually is in humans. We don't even have a credible LD50 for it. When divorced from tobacco it's actually a very poorly studied drug.--FergusM1970^{Let's play Freckles} 05:58, 14 November 2013 (UTC)

Lots of drugs have no known LD50 in humans; in some cases, LD50 isn't even a constant (ex: amphetamine has no LD50 in humans in part because it's lethality is stochastic w.r.t. tolerance). There is no metric for drug addiction, so the best you could come up with is an ordinal relationship for addictiveness. There IS a LOT of ordinal data out there. That's the basis for those statements (particularly quote 2). Seppi333 (talk) 06:06, 14 November 2013 (UTC)

OK, so we've established that nobody actually knows how addictive nicotine is in humans but that it's only weakly addictive in animals. Just to put that in perspective, the long-accepted LD50 now appears to be around 5% of the actual value, because nobody's actually tested it since the 1860s and the tests done then were completely unscientific. There's no doubt that nicotine is addictive; the question is, when not consumed through smoked tobacco, how addictive is it? There is circumstantial evidence (a study involving nicotine patches and non-smokers) to suggest the answer is "not very."--FergusM1970^{Let's play Freckles} 06:30, 14 November 2013 (UTC)

I said there is no metric for drug addiction, not there is no data. Ordinal data would mean something like "the relationship between the addictiveness of tobacco, amphetamines, and opiates is x mg tobacco < y mg amphetamine < z mg opiates" if using nonstandard quantities. This isn't even debatable - I gave you a highly reliable secondary source. Seppi333 (talk) 06:53, 14 November 2013 (UTC)

If there's no metric for addictiveness then we can't say it's highly addictive, can we? If we're saying it's highly addictive then clearly there's some way to test for that. Smoking is highly addictive. Pure nicotine, on the other hand, appears to be only weakly addictive. That, in the context of the absurd "gateway" argument, is an extremely important distinction.--FergusM1970^{Let's play Freckles} 06:56, 14 November 2013 (UTC)

Not even going to try explaining why you're wrong again - you're either hopelessly misinformed or just trolling me. Seppi333 (talk) 14:14, 14 November 2013 (UTC)

This is an interesting text [19]. It states that pure nicotine delivered slowly in low doses is not a big deal but that large doses that are given very quickly (like in smoking are). I guess the question is which group do e-cigs fall into? As they are so new this may not be clear yet. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:06, 14 November 2013 (UTC)

Unless I'm missing something it seems to be talking about reinforcing dependency in existing addicts rather than the risk of addicting naïve users. As for e-cigs though the pattern of use is very different from smoking. There's considerable doubt about the claims that they deliver less nicotine than a cigarette - "smoking machines" don't simulate actual e-cig use and those tests only involved 1st generation e-cigs anyway - but unlike smokers most e-cig users tend to take one or two puffs whenever they feel like it rather than using it continuously for several minutes like a smoker with a cigarette.--FergusM1970^{Let's play Freckles} 07:31, 14 November 2013 (UTC)

Protected edit request on 1 December 2013

A New York Times story on electronic cigarettes on November 28th states that Pittsfield, Massachusetts, among other cities in the US, had banned electronic cigarettes in public buildings.

http://www.nytimes.com/2013/11/28/nyregion/bill-would-restrict-electronic-cigarettes-in-new-york.html?_r=0

" New York and Chicago are among the first large cities to consider banning e-cigarettes. New Jersey, North Dakota and Utah have recently included electronic cigarettes in their bans on smoking in workplaces, bars and restaurants, according to the American Nonsmokers’ Rights Foundation.

So have dozens of localities, including Pittsfield, Mass.; Savannah, Ga.; Ketchum, Idaho; and Suffolk County, on Long Island. "

Kwkunes (talk) 02:24, 1 December 2013 (UTC)

Not done: Sorry, but there are two things that you need to do before we can enact your request. First, you need to be more specific. You need to say exactly what text you would place in the article, including where you would put the citations. Second, you need to allow some time for discussion so that regular editors here have a chance to participate. That would show that there is a consensus for the change. If discussion is slow, you can advertise the request at WT:MEDICINE and/or WT:HEALTH. Best — Mr. Stradivarius ^{♪ talk ♪} 02:40, 2 December 2013 (UTC)

Hong Kong - Legal or not?

From the wording on the article, one would assume that, like Australia and some other countries, the sale of any device containing nicotine is illegal - end of story.

However, after reading the citation, I get a different feeling. The website reads: "E-cigarettes containing nicotine and marketed as nicotine replacement therapy are pharmaceutical products under the Pharmacy and Poisons Ordinance and must be registered before sale". (emphasis mine)

Does this mean that electronic cigarettes containing nicotine are legal so long as they do not advertise themselves as a smoking-cessation product? 202.67.112.83 (talk) 12:09, 13 December 2013 (UTC)