Talk:Health effects of tobacco/Archive 1

David Myer Quote

I propose the removal of the David Myer quote “ Imagine that cigarettes were harmless—except, once in every 25,000 packs, an occasional innocent-looking one is filled with dynamite instead of tobacco. Not such a bad risk of having your head blown off. But with 250 million packs a day consumed worldwide, we could expect to have more than 10,000 gruesome daily deaths—surely enough to have cigarettes banned everywhere. ”

—David Myers [11]

For the following reasons

It doesn't relate to health effects of smoking, rather the reaction to risk in human behavior

It appears out of context in the paragraph

It's a fallacious argument comparing an instant and violent death to one cause by smoking

It adds nothing relevant to the paragraph but supplies a superfluous (and possibly false i haven't bothered checking) interpretation of the numbers already supplied

(Mcgurney12 (talk) 05:52, 2 December 2008 (UTC))

 Done That violates WP:NPOV and I'm wonder why I didn't catch that. Nevertheless, thank you for helping us find that. In a few days, perhaps it would be a good idea to copy-edit this article. ChyranandChloe (talk) 03:46, 3 December 2008 (UTC)

NPOV

Article does not have any information on positive stress relief effects for people who do not mind (or care about) carcinogenic elements of tobacco. Guroadrunner (talk) 00:21, 30 December 2007 (UTC)

I've just reverted your edits. If you don't like the lack of info on "positive stress relief effects" in the article, then you need to go out and find (a) evidence smoking relieves stress, (b) evidence that's positive in terms of physical or psychological well-being, and (c) include them in the article. I'm sure such studies exist, but please look for them yourself rather than unilaterally tagging the article NPOV because you have an unsourced, POV personal opinion about possible positive effects of smoking.

You also (1) removed a fact tag without giving a proper explanation (and this was a fact request for a negative effect of smoking, so if a source isn't found it should come out the article), (2) added a who tag to a sentence which cited the review in question a line further down, (3) selectively removed sourced poor survival data, and (4) cut two external links without explaining why they failed WP:EL. I reverted the lot. Nmg20 (talk) 02:17, 30 December 2007 (UTC)

I will deal with this tomorrow, but I can give reasons for all edits. Guroadrunner (talk) 06:07, 30 December 2007 (UTC)

Thanks. Look forward to discussing them. Nmg20 (talk) 11:38, 30 December 2007 (UTC)

First area - EL.

These are the EL I'm removing permanently:

* BBC News: Smoking a pipe 'damages health'

* University of Wisconsin Center for Tobacco Research and Intervention

The first is an article on pipe smoking that really should be a Reference, not an EL. Otherwise it's just a news article and that doesn't do anything or make it special. Use it for referencing instead.

The second is non-notable -- can you provide a rationale why the Wisconsin Ctr for Tobacco Research & Intervention makes itself more notable over other groups? Place the most prominent group in, not this.

Do not re-insert until discussed. Guroadrunner (talk) 16:14, 5 January 2008 (UTC)

Agree with both those. Thanks for the explanations. Nmg20 (talk) 23:51, 7 January 2008 (UTC)

Tobacco Related Diseases

Just thought i'd make a query about the use of the term tobacco related diseases. It seems that many of the diseases have other causes besides smoking and it seems misleading to ascribe all the deaths caused by them to tobacco. I could be wrong but i checked the source and it seemed to be standard anti-smoking boiler plate. I submit that this sentence in its current form doesn't provide a honest interpretation of the facts

"Tobacco related illnesses kill 440,000 USA citizens per year,[6] about 1,205 per day, making it the leading cause of preventable death in the U.S "

also i'll clean up a few other wordings such as "set to kill" (121.45.104.247 (talk) 11:35, 3 January 2008 (UTC))

Many do have other causes, but the 438,000 figure (I'll correct it in a second!) refers solely to those attributable to smoking or exposure to smoke (per the CDC reference). In other words, if you added up all the cases of these diseases, you'd get more than 438,000 deaths - for instance, the myocardial infarction article reveals that about 480,000 people die of MI in the US each year, so those aren't all be being counted as smoking-related!

I also reverted the "set to kill" wording, as it's an accurate report of what was said in the article, and the changes made the sentence nonsensical. Nmg20 (talk) 15:15, 4 January 2008 (UTC)

Convention for mentioning health in tobacco-related articles?

There's an ongoing discussion in Talk:Cigar #Health effects should be covered about whether the Cigar article should be silent about health issues (and merely put Tobacco and health in its "See also" section; see this version for an example), or whether Cigar should briefly discuss health issues and then list Tobacco and health in the main article (see this version for an example, and see this comparison for a difference listing). Is there some convention in this area that I'm not aware of? I personally find it strange that an article on cigars would not discuss health issues at all. Eubulides (talk) 00:10, 17 January 2008 (UTC)

I'm not aware of any convention. I think it would make the most sense to briefly mention any health risks involved in cigar smoking, with a {{see also}} to this page for a more detailed discussion. If we duplicate too much detail, these articles turn into denialist skeptical POV forks unless closely monitored. MastCell ^Talk 00:23, 17 January 2008 (UTC)

Relationship of Lung Cancer and Tar in cigarettes

There is no subheading relating to the role of tar, how tar is formed in the burning of a cigarette, or the relationship between tar and lung cancer. This is a serious matter because I believe tar is the major threatening component. The tar is serves as the signficant medium of toxic chemical and free radical delivery that causes so much damage to the lungs.

Also, i think it needs to be addressed that there is no "half-way" discussion, the pros and cons are listed, but no discussion is entertained about how the media is rather extreme in their discussion of cigarettes, and no mention of devices which trap tar, such as Tarblock or Sino Cigarette FilterSino Cigarette Filters, which utilizes the Venturi principle to trap tar. Rook2pawn (talk) 18:20, 16 February 2008 (UTC)

Interesting idea. Do you know of any independent scientific work suggesting or supporting this? Nmg20 (talk) 22:52, 18 February 2008 (UTC)

I don't know what's really being said here in this paper but here is a quote I pulled from http://pubs.acs.org/cgi-bin/abstract.cgi/crtoec/1998/11/i05/abs/tx970159y.html

"Previously, we have shown that aqueous cigarette tar (ACT) extracts contain a long-lived tar radical that associates with DNA in isolated rat alveolar macrophages and causes DNA damage in isolated rat thymocytes."

Tar is formed by the incomplete combustion of tobacco leaf proteins and sugars. There is no way to reduce tar, nor really a way to "add" tar. Tar is a product of burning.

This is why "Low-Tar" cigarettes have vent holes, because the gimmick is to just inhale less smoke, which obviously isn't quite effective. Since tar is sticky, the nicotine binds to the tar in the delivery to the lungs and body. Thus, trapping tar also traps nicotine, defeating the purpose of the cigarette. However, the cigarette "should" be relatively safe in the sense that >95% reduction (http://blocktar.com/labreport.html) of tar means that if tar is in fact the ultimate cause of lung cancer and diseases, then a tar "blocked" cigarette should be proportionally safer. There are reports that say reducing tar (as in low-tar cigarettes) contributes little to reducing cancer, which makes sense in that relatively similar amounts of tar is delivered and absorbed, but to actually find a way to trap tar seems quite different in what it could result in. Rook2pawn (talk) 09:58, 1 March 2008 (UTC)

British Doctors' study

User:HKTony has been trying to alter the British doctors study results as they're reported here. Quite simply, quitting smoking is not a primary analysis in the paper. The first mention of ex-smokers in the results section appears in the sixth section, after all the main analyses have been concluded, and former smokers get no mention in the abstract of the paper. The study never uses the word "quit", either.

With this in mind, the changes are ill-advised at best, as are suggestions that other authors need to read the paper. For reasons of weight, I suggest we focus on the primary analyses of the paper. Nmg20 (talk) 19:08, 26 April 2008 (UTC)

From the study - "The main analyses of mortality in relation to smoking seek to determine whether ... the death rate is related to the previously reported smoking habits.". 'Reported smoking habits' in the paper is not simply smoking or not smoking, it assesses a variety of smoking habits.

Re - "former smokers get no mention in the abstract of the paper" - the objective is stated as "To compare the hazards of cigarette smoking in men who formed their habits at different periods, and the extent of the reduction in risk when cigarette smoking is stopped at different ages". The original statement "smoking decreased life expectancy by 10 years" is biased as it represents the worst possible outcome of smoking as demonstrated in the study. A neutral statement would be "smoking decreased life expectancy by up to 10 years" - no? HKTony (talk) 19:54, 26 April 2008 (UTC)

I see what you mean - I was taking "previously reported" there to mean by the authors in previous reports on the data set, but it could equally mean by the patients. And I take the point about the phrasing of the effect on life expectancy - but looking at those Kaplan-Meier curves, there is almost no period except at the very start and the end of the graphs where the lines are less than ten years apart - so I'm wary of the change you suggest. Any other opinions? Nmg20 (talk) 08:34, 29 April 2008 (UTC)

Randomized trial?

I am looking for a paper that will convince me that tobacco is a poison and not a medicine. So far, I have only seen papers discussing the correlation between tobacco use and disease, but this observation is consistent with tobacco being a medicine. Has there been a randomized trial to show that, for instance, quitting improves health? If so, I think that Wikipedia should link to it. If not, then I think we should try to explain how the existing observational studies on smoking are better than the observational studies which led scientists to erroneously conclude that HRT was beneficial. A5 (talk) 13:08, 6 May 2008 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/18570625?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum "Tobacco smoke is both prothrombotic and atherogenic, increasing the risks of acute myocardial infarction, sudden cardiac death, stroke, aortic aneurysm and peripheral vascular disease. Even very low doses of exposure increase the risk of acute myocardial infarction. However, smoking cessation and second-hand smoke avoidance swiftly reduce this risk." Bullen C. Expert Rev Cardiovasc Ther. 2008 Jul;6(6):883-95. —Preceding unsigned comment added by 192.35.79.70 (talk) 20:59, 2 July 2008 (UTC)

Second-hand smoking

I am thinking of adding more information on the effects of second-hand smoking, primarily in youth but in adults as well. This is part of a school project and I will begin tomorrow. Let me know of any suggestions you may have. Magsxemail (talk) 04:18, 15 June 2008 (UTC)

Sounds good. Try to make sure everything is appropriately sourced, and if you can bear it read WP:MEDMOS and WP:MEDRS too! Good luck. Nmg20 (talk) 14:45, 15 June 2008 (UTC)

Hookah Section.

Just a thought, maybe we could/should add a section on hookah smoking. The CDC has a fact sheet that may be of interest: http://www.cdc.gov/tobacco/data_statistics/Factsheets/hookahs.htm. 71.92.157.186 (talk) 15:50, 25 June 2008 (UTC)

smoking as a hobby

i think smoking is a hobby, because, a times some smokers just smoke for pleasure not because it is their habit.and to me it is good if the quantity a person is taking per a given time is not that much. —Preceding unsigned comment added by 66.178.87.148 (talk) 19:47, 26 July 2008 (UTC)

Please see Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_soapbox 66.191.19.217 (talk) 18:40, 20 August 2008 (UTC)

tobacco as disease

tabocco may be a disease if we consider the smoke as source for carbon moaoxide which is harmful to health. —Preceding unsigned comment added by 66.178.87.148 (talk) 19:54, 26 July 2008 (UTC)

Pipe smoking section

There is an inclusion of a nearly thirty-year old study indicating that pipe smoking not harmful. Surely, there is newer studies out there. Ideas? 66.191.19.217 (talk) 22:35, 3 August 2008 (UTC)

Move Tobacco and health → Health effects of tobacco

This article was originally named Health effects of tobacco smoking and Health effects of smoking. However, naming it Tobacco and health is unnatural in that it identifies tobacco as something of an equivalent to health. Instead, Health effects of tobacco yields the most natural title in that it does not specifically identifies smoking as the subject of the article. ChyranandChloe (talk) 06:38, 16 August 2008 (UTC)

I didn't have strong views on the rename, but I am curious as to whether any attempt was made to obtain WP:Consensus before making this move? It does seem disruptive to have it shuttling back and forwards between two equivalent names, and I am not at all convinced by your explanation above. Nmg20 (talk) 12:13, 18 August 2008 (UTC)

No pair of "Health effects of tobacco", "Health effects of tobacco smoking", or "Health and tobacco" are equivalent. The current title (Health effects of tobacco) is the best title of the three — smoking is not the only way to take in tobacco (others include: snuff, dermal patch, gum), and "Health and tobacco" is imprecise (is it about health, as well as about tobacco, or is it about the effect tobacco has on health?). — Twas Now ( talk • contribs • e-mail ) 21:12, 25 August 2008 (UTC)

Voice effects?

Have cigarettes been proven as being a cause of certain people's "raspy" voices, and if so, is that considered a health effect, even if it's merely a side effect? I only ask because it seems it's something I never hear about in any long explanations of smoking risks, even though you always hear about singers and others whose voices are usually described as "ravaged by years of smoking" or something similar. I'm just wondering, what's the actual evidence behind this. Is it just a result of people's being unable to move more air? I don't know if this addressed more eloquently (or rather, encyclopedically) in the article, but I was looking for info on this, did a Ctrl + F search for "voice" and only had one match, so I'm wondering if this merits more lengthy explanation in the article, and where to go for information on it. Thank you reading the first chapter of my book, "Uhm, Excuse Me: The Science of Amateurish Wikipedia Requests". 24.3.14.157 (talk) 04:54, 14 September 2008 (UTC)

A voice effect, that's something that usually flies below the radar. This articles primarily contains information about significant "health effects" from tobacco, rather than "effects of tobacco". Nevertheless, if you have a good understanding of this topic, start an article titled Effects of tobacco. ChyranandChloe (talk) 02:07, 15 September 2008 (UTC)

Allergies

Maurice Carbonaro (talk · contribs) added that smoking is to blame for an "insurgence in allergies". Yet in many countries smoking rates are going down yet allergy rates are going up. No persuasive reference is provided. I have temporarily removed the addition in question; for further context see our discussion on Talk:Allergy. JFW | T@lk 19:23, 15 September 2008 (UTC)

References... pretty please ?

Thank you JFW,

xkcd "wikipedian protester" comic.

but... could you please provide us references to what you are pontificating?
In particular:

("(...) in many countries smoking rates are going down yet allergy rates are going up (...)")

Thank you very much and please keep up the good work!
Maurice Carbonaro (talk) 16:21, 17 September 2008 (UTC)

Don't reverse the argument please. I asked you for a reference for your addition. It is well known that less people are smoking more in many countries. JFW | T@lk 16:28, 17 September 2008 (UTC)

Killing time

Tobacco kills about 5 million people every year.
23 hours have passed since the "temporary removal" of my addition where I contributed stating:

"(...)smoking as being a major risk factor for the insurgence of allergies(...)".

About 13,700 people died since yesterday because of tobacco related illnesses... and here, in this talk page...
This makes you think, huh?
No wonder this Health effects of tobacco article is rated as a B-class medicine one...
It seems like we have people here that like to create "arguments".
Maurice Carbonaro (talk) 16:51, 17 September 2008 (UTC)

Cleanup

I've cleaned up the WikiCode (seriously, when our severs won't correctly convert the WikiCode to HTML, it's time for some code cleanup) by removing spaces after titles, between paragraphs and so on. I've also added the {{Tobacco}} template (the fomer images are moved to Epidemiology), added WP:MOS optional spaces between the titles and their syntax to better distinguish the two. ChyranandChloe (talk) 03:22, 23 September 2008 (UTC)

I've commented out the 1905 image and the image of the man smoking, on the grounds of NPOV and relevance. The 1905 advertisement is unncessary and contains little relevance to the Health effects of tobacco as it also only represents the negative views of the author. The image of the man smoking is also uncessay, as a statement that nicotine causes dependence is needed. ChyranandChloe (talk) 03:15, 24 September 2008 (UTC)

Removed

I removed this:

The health risks of occasional tobacco use has been studied far less that the impact of habitual use. There are many people who use tobacco on rare or infrequent occasions without becoming addicted. This group of people is typically neglected in scientific studies, and the conclusions of such studies will use phrases like "smoking causes" without defining a threshold of whether such health risks are caused by smoking two cigars per month or two packs of cigarettes each day.

If terminology were better defined so that "excessive smoking" would refer to smoking to the extent of incurring a negative health impact, and "occasional smoking" would refer to usage below that threshold, then by such definition occasional smoking would have no associated health risk.

The obvious problem here is that it's unsourced and probably original research, but there is a much more insidious problem. Smoke contains radioactive and radiomimetic carcinogens. For radiological damage, the linear no-threshold model is used. Thus, it is reasonable to assume that tobacco smoke is carcinogenic without threshold. However, there is an alternative theory to linear no-threshold, radiation hormesis. This issue appears to be contested (I'm not an epidemiologist). To what degree does occasional tobacco smoking fall within the range of hormesis, or does hormesis work for tobacco, or does it even exist - that's all nontrivial, and should be discussed in the article. Although right now I don't have the time to dig up references that definitively prove that all exposure to tobacco smoke is carcinogenic. ... And also optimism bias is not mentioned in the article, although that's an important part of the epidemiology. --Vuo (talk) 21:39, 20 November 2008 (UTC)

2008-2009 Copyedit

Sections

I've reorganized the article to: contain more concise and direct section titles, to be more focused on the topic they are discussing, and to be more concise over all. This would be the section major reorganization to my knowledge, the original can be found here [1], following the first major reorganization here [2], the current reorganization can be found as it is. This is, of course, in my opinion.

Of the remaining tasks as of this post: (1) there are several sections which duplicate information ("Prognosis" and "Primary Risks"), (2) it may be better to move "Epidemiology" to a better location, (3) it may be better to move and rename "Beneficial effects" to a better location, and (4) "Indirect effects" is somewhat divergent of the focus of the articles which discusses "Heath effects". ChyranandChloe (talk) 05:58, 30 December 2008 (UTC)

After giving more thought, and as a side note, here is the break down for the article:

• "Epidemiology" will provide a good introduction to the article from which
  • "Prevalence" will introduce the reader to who is affected
  • "Prognosis" I am unsure what to do with this subsection, there is good information but a lot of its duplication
• "Primary risks" (possible rename) will move the reader from who is affect to how they are affected
  • In addition to keeping the current subsections, I believe it is possible to combine "Beneficial effects"
• "Risk type" seems to be an odd ball section, it may be possible to merge this section will the one discussed above, currently "Primary risk"
• "Carcinogens" (possible rename) will discuss the active substances which are either related to risk type through association (linked to) or causation (causes ailment).
• "Indirect effects" at this point I really don't know what to do with this section; it is related to the subject somewhat, but is too divergent in my opinion to be included. We might need to find a new home for it.

ChyranandChloe (talk) 03:55, 31 December 2008 (UTC)

I believe the new layout scheme is finally stabilizing. Most of the article is derived from Epidemiological findings, however I've narrowed its definition to discussion only one section; in this section the article will discussion who is affected (Prevalence) and what (specifically products) are affecting them (Vectors). The last subsection in "Epidemiology" is "Studies", it contains perhaps new findings or interesting findings, right now it's like a "Trivia" section. My plans are to expand it to discuss the processes from which the findings were made. The next section is "Effects" (possible rename), it would discussion what the effects are, rather straight forward it perhaps needs a better narrative to help guide the reader in understanding the statistics. The next section is "Factors" it will discussion how the active substances in tobacco have an effect, this would include the carcinogens, active substances, and so forth. "Indirect effects" is still seems oddball. A "History" section is possible, but there isn't enough content yet. ChyranandChloe (talk) 22:59, 31 December 2008 (UTC)

“

• "Smoking and health: physician responsibility. A statement of the Joint Committee on Smoking and Health. American College of Chest Physicians. American Thoracic Society. Asia Pacific Society of Respirology. Canadian Thoracic Society. European Respiratory Society, and International Union Against Tuberculosis and Lung Disease". Chest. 108 (4): 1118–21. 1995. PMID 7555125. {{cite journal}}: Unknown parameter |month= ignored (help)
• Boffetta P, Agudo A, Ahrens W; et al. (1998). "Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe". J. Natl. Cancer Inst. 90 (19): 1440–50. PMID 9776409. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

• Tobacco Smoke and Involuntary Smoking, Summary of Data Reported and Evaluation 2004 by IARC.
• UCSF Tobacco Industry Videos Collection

”

Dropping the External links and the Further reading as unncessary—should be used in direct verification; currently: Bibliography and Notes subsection accomplish this, and it also brings the reader closer to the source. ChyranandChloe (talk) 09:28, 15 February 2009 (UTC)

Prose

• As of this post there are two locations which require attention. The first is the the prose directly following "Primary risks", this was originally derived from a list [3], and it may be of interest to dissolve several of the paragraphs into the appropriate subsection and to provide a summery of what the section is about in the lead of the section. The second area is the lead, and when we are finished with the rest of the article.

What remains is improving the subsection "Chewing" in "Risk type", which can be done later. Afterwards, compacting and improving the prose may be of interest. ChyranandChloe (talk) 05:58, 30 December 2008 (UTC)

• The next tasks that remains is to dissolve the previously "Benefits" subsection, now contained in the "Psychological" subsection, into the rest of the section (currently "Effects"). The prose needs a sort of narrative which would allow the article to be more than just a conglomeration of statics. ChyranandChloe (talk) 06:46, 31 December 2008 (UTC)
• Reorganization has effectively been complete, and the major prose rewrite and expastion has begun. One of the interesting things that have occured to me is how much epidemiological information is available. This could easily become an an article of its own, and then some. The World Health Organization provides perhaps one of the easier to understand information (it also helps aid WP:CSB): [4] provides context to global diseases as a whole, [5] outlines the WHO's plan while providing useful statics for the control and prevalence of tobacco usage, and [6][7][8] are even easier on the gradient of difficult to understand with the statics placed into simple bulleted list. I would imageine the CDC would provide similar information pertaining to the United States, and PMED for the more up to date research. Google book search yields [9] which I would imagine would be a good introduction. ChyranandChloe (talk) 07:42, 1 January 2009 (UTC)
• The list in the "Vectors" subsection is essentially complete, however some areas are unreferenced or are poorly written. Most of the information was taken from the World Health Organization's MPOWER, which then defers the citations to several other sources. ChyranandChloe (talk) 03:14, 28 January 2009 (UTC)

Neutrality

This article suffers from a number of neutrality issues, and I'll enumerate them at a later time. ChyranandChloe (talk) 05:58, 30 December 2008 (UTC)

OK, good luck - this article has been a bit unloved, so hopefully you can shape it up. My only comment is that I'd like to see the lead a bit longer and more detailed, per WP:LEAD - I kinda like the old lead better, because it summarizes more of the relevant article content: smoking prevalence, major effects (e.g. on lifespan), and so forth. MastCell ^Talk 06:12, 30 December 2008 (UTC)

“ [...]as seen in the news coverage of the tobacco-related cancers of two American presidents; Ulysses S. Grant died in 1885 at age sixty-three after a long and painful public battle with throat cancer which was widely assumed at the time to be the result of his lifelong cigar habit, and Grover Cleveland was diagnosed in 1893 with cancer of the left jaw, which was frequently remarked upon by the press and public as the side where he usually had a cigar clamped. Similarly, cancer of the mouth and jaw is also a risk for chewing tobacco. ”

(ec) I have removed the above from the subsection Cardiovascular. This text is non-essential to the point of the subsection, that is health effects of tobacco on the cardiovascular system. This text also lacks sufficient citation linking the deaths of the two presidents with the hypothesis. If sufficient citations was provided, and a context concerning how tobacco became viewed as it is; a "History" section may be formed.

I went over a longer lead above in #Prose. I was planning on doing this at a later time when the rest of the article has completed its course of copy-editing. This makes deriving a lead easier, and follows the idea of trickle-up. ChyranandChloe (talk) 06:47, 30 December 2008 (UTC)

OK, no problem. MastCell ^Talk 06:55, 30 December 2008 (UTC)

Yeah, this is a pretty hard article—written incrementally by at least half a dozen editors. Figuring out what they want to say, and the direction of the section as a whole can be a real challenge. This makes me miss articles like Jane Austen where only one person really wrote it and what they're trying to get across a simple matter.

I'm looking at "Primary risks" right now; trying to get a summery out of its subsections; and looking for the omissions. In neutrality, I'm also looking for a better name since this "Primary risks" seems to have a negative connotation and does not describe its subsections as a whole. ChyranandChloe (talk) 07:08, 30 December 2008 (UTC)

“ Cigar and pipe smokers tend to inhale less smoke than cigarette smokers, so their risk of lung cancer is lower but is still several times higher than the risk for nonsmokers. Pipe and cigar smokers are also at risk for cancers of the oral cavity, larynx (voice box), or esophagus, a risk which was widely hypothesized before any link between smoking and cancer was scientifically proved. The benefits of smoking cessation are immediate: blood pressure, heart rate, and temperature return to normal range; heart attack risk decreases; ability to smell and taste is enhanced; circulation improves.

It is generally assumed that the major motivational factor behind smoking is the nicotine it contains. However, the practice of ingesting the smoke from a smoldering leaf generates an enormous number of active chemical compounds, loosely lumped together as 'tar', many of which are biologically reactive and potential health dangers. (Chewing tobacco is also carcinogenic, likely because similar compounds are generated in the practice of curing it; the Nordic snus, which is steam cured and therefore does not generate these compounds, is much less carcinogenic.)

”

The above have been temporarily removed from the "Cardiovascular" subsection, it is entirely uncited and makes several assertions that in my opinion do not provide sufficient dept into the subject matter. In other news, I've found a good source to expand this article and a potential splinter article [10]. ChyranandChloe (talk) 03:43, 31 December 2008 (UTC)

“ A 1979 United States Surgeon General report on smoking indicated that exclusive pipe smokers smoking less than five pipe bowls a day had a lower mortality rate than non-smokers. The report also indicated a higher mortality rates for pipe smokers smoking more than four pipe bowls per day compared to non-smokers, but still below that of cigarette and cigar smokers. ”

Removed from subsection "Oral"; check sources, as interesting and counter-intuitive that could be, I can't find it in the reference provided. ChyranandChloe (talk) 06:05, 31 December 2008 (UTC)

“ Cataracts that may cause blindness ”

Removed from "Other areas" subsection; check source, from my understanding it discusses the risk factors of cataract complications with age; smoking was discussed a potential "confounder". It would be interesting, but the verification I believe should be more direct. ChyranandChloe (talk) 22:41, 31 December 2008 (UTC)

“ and 100 million deaths over the course of the 20th century. ”

Removed from "Prevalence" subsection; check source, it would be interesting, but I can't find it in the citation provided. ChyranandChloe (talk) 01:20, 1 January 2009 (UTC)

“ Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide." ”

Removed from "Preventions" subsection. (1) check source, the source provided does not provide the quotation cited. (2) Non-essential to the article, only promotes the rhetoric. ChyranandChloe (talk) 07:22, 1 January 2009 (UTC)

• I've added a large among of information to the "Prevalence" subsection, however one issue that has arised is the increase of synthesis and extrapolation. For example is used three times in order to give context to the assertions, and therefore it may be challenged with both WP:OR and WP:SYNTH. It is also a(n extremely) poor practice in the field of statics to use individual cases (as each example describes) to generalized to a larger population from which the individual cases are not random samples of the latter. In short the examples provided should only be used in their own context, and not generalized to the population as a whole. The remedy would be to provide studies that describe the population as a whole rather than in the individual countries. Furthermore, the countries enumerated in the examples describe the situation in a slightly exaggerated context as they were used by WHO to promote the position of the rising health crisis. They however, are useful in that the studies exemplify where the change in rates of usage of tobacco occur. That would perhaps be the next step in this article. ChyranandChloe (talk) 09:20, 1 January 2009 (UTC)

“ Tobacco related illnesses kill approximately 438,000 United States citizens per year, about 1,200 per day, making it the leading cause of preventable death in the U.S. The World Health Organization has stated that tobacco is set to kill a billion people this century.

In the UK, the impact of smoking is felt most keenly by the lower social classes, which are known to have lower life expectancy than those in wealthier classes. Half the difference in survival to age 70 between social classes I and V is estimated to be due to the higher smoking prevalence in the lower class group.

As of 2000, smoking is practiced by 1.1 billion people, and up to 1⁄3 of the adult population.

As the gender gap among adolescents declines so the does the gender gap among the population. In South Korea in the first year following the lift of the ban towards the importation of American tobacco in 1980s, smoking rates among the adolence popualation double, from 18% to 30%; however, among the female rates rose five times from 1.6% to 8.7%. As a result between 1989 and 1996 the rates increased from 3.9% to 6.7% among women.

”

In the first paragraph the first static is good, however I removed it until it can be better meshed into the section, the second part of the paragraph with the 1 billion is a poor extrapolation and is out of context. In the second paragraph, the information is good, however due to space constraints it has been removed. The third paragraph has been removed since better numbers have been provided. Fourth paragraph have been removed since for under WP:OR an WP:SYNTH, it should also be implied and unnecessary to the overall subsection ("Prevalence"). ChyranandChloe (talk) 06:30, 2 January 2009 (UTC)

Objection! Well, anyway. There should be no "space constraints" on this page, since this is the specialized subpage, where we can explain pretty much everything starting from reaction mechanisms (see Organic carcinogens). Rather, in the main article, Tobacco smoking there are.—Preceding unsigned comment added by Vuo (talk • contribs) 21:18, 2 January 2009

This page is not a "specialized subpage" (WP:NC); it is an independent article used to discuss the Health effects of tobacco. Because this, WP:SIZE applies. My point is not to constrain what can or cannot be discussed; my point is that if we can gather enough information on a specific section or subsection we can split it into its own article (WP:SPINOUT) and use a summary in its place (WP:SS). The above was largely removed from the "Prevalence" subsection, most of it was because better information was found which gave a world view, or it may be misleading or unverified or both. I am unsure what you mean by "Organic carcinogens" (Chemical carcinogens), nothing was removed from that subsection. ChyranandChloe (talk) 21:43, 2 January 2009 (UTC)

“ Diseases caused by tobacco smoking are significant hazards to public health. According to the Canadian Lung Association, tobacco kills between 40,000–45,000 Canadians per year, more than the total number of deaths from AIDS, traffic accidents, suicide, murder, fires and accidental poisoning. The United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide."

To reduce cancer risk but to deliver nicotine, there are tobacco products such as the electronic cigarette where the tobacco is not pyrolysed, but the nicotine is vaporized with solvent such as glycerol. However, such products have not become popular.

After a ban on smoking in all enclosed public places was introduced in Scotland in March 2006, there was a 17 percent reduction in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers.

”

The first paragraph was not be incorporated during the migration from Tobacco smoking to Health effects of tobacco because of relevance and because it does not provide a world view, perhaps Prevalence of tobacco consumption may be more appropriate. The second paragraph is unsourced. Third paragraph also does not provide a world view, however may be applicable, if notable, in the History section. ChyranandChloe (talk) 05:34, 21 February 2009 (UTC)

This cannot be removed, because it asserts its notability effectively: the single most important preventable risk ... --Vuo (talk) 22:10, 21 February 2009 (UTC)

The quotations lacks: verification (direct citations, but that shouldn't be hard to find), and location (where do we put it). Additionally, I believe we can do better than "the single most preventable risk of death in developed countries". For example, "death" is very ambiguous. Does it mean that people who smoke immediately die afterward? What about the confounder that people die inevitably? Most likely, in surgeon general's 2004 report (it's in the Bibliography), they go over it this as YPLL or years of potential life lost [11]. ChyranandChloe (talk) 09:47, 22 February 2009 (UTC)

Talk page complement to expand

OK, so I added (diff) a politics section, because it is also a political issue. Although personally I had little to add, there are some suggestions:

• Anti-smoking propaganda. Does it work — are there any studies on this?
• Effect of tobacco companies on the research. There is a fascinating history to this.

--Vuo (talk) 20:37, 4 January 2009 (UTC)

I like it, it gives good background information; however I've moved it under "Studies" (see #Sections). There are two reasons for this: (1) the focus of this subsection appears to be discussing how establishing causation is such a challenge (and as mention it is in effect not possible by definition), and how it was through epidemiology that regulations which control the spread of tobacco usage came to be (2) "Politics" is not the focus of this article, it may be discussed, but only in the context of health effects; the title "Politics" itself runs against the statement above. My thoughts are to either begin a History section or mesh it with the Epidemiology section. In addressing anti-smoking rhetoric and its complement, I believe it is possible to include it in Epidemiology to help give context. ChyranandChloe (talk) 22:55, 4 January 2009 (UTC)

Diagram of tobacco relate diseases

I have reverted the wide image attribute to Madhero88's mind map showing a summary of tobacco related diseases. The older version can be found here [12]. No hard feelings, but the large image is:

1. distracting to the reader consuming more space than some sections
2. to enlarge the image could be as simple as clicking on it

ChyranandChloe (talk) 03:28, 12 January 2009 (UTC)

Studies

I've removed a sentence at the end of the "studies" section that says various companies have suppressed research. This is true, but it was also completely un-sourced ;) 82.41.11.155 (talk) 00:47, 17 January 2009 (UTC)

Well, it could be sourced quite easily, starting with the World Health Organization inquiry, the 2006 Surgeon General's report, USA v. Philip Morris et al., or the industry's own internal memos. But I don't know that it needs to be hammered on in this article, necessarily. MastCell ^Talk 01:05, 17 January 2009 (UTC)

I think a little more explanation on how they suppressed the findings would be better than a statement that they did. Nice sources though. ChyranandChloe (talk) 21:46, 17 January 2009 (UTC)

Yeah I know there should be something better than a Hesari review of Cigarette Century, but that's the cause — and solution — of all the problems in doing things the Wiki way. That is, worse is better, and right now is more important than perfect. Wiki is best in the cases when someone knows practically nothing and wants to get into actually researching the topic. --Vuo (talk) 22:33, 17 January 2009 (UTC)

Cancer section missing

There should be a list which cancers tobacco smoking and chewing cause, and the severity of the risk. [13] --Vuo (talk) 14:38, 17 January 2009 (UTC)

Becareful about how you use the language, most of the research is not through causation but association; and the difference goes beyond mere semantics. The "Cancers" section is not missing, it's compiled along with other diseases in the section "Effects". ChyranandChloe (talk) 21:41, 17 January 2009 (UTC)

No, no, and no. That's about as clear I can make myself. The "Effects" section includes a short summary of cancers, and the Factors section goes into the chemical mechanisms. This is not an adequate synthesis, especially in light of the references I added to the main article, Tobacco smoking, where for example for pipe smoking, every kind of cancer and the associated increase of risk was listed. See [14]. In contrast, there is a "Cardiovascular" and even a very long "Reproductive" section, although this section includes for example ulcerative colitis (which is reproductive how?). Secondly, the language I am using is perfectly appropriate: tobacco smoking causes cancer. It is known definitively that DNA alkylating agents are produced in pyrolysis of tobacco, and these very same carcinogens have been demonstrated to reliably produce cancers pathologically identical to cancers found in tobacco smokers. Additionally, there is statistical evidence with lifetime-long time span for the carcinogenic effect. These facts are independent and both support the claim that tobacco smoking causes cancer. For stochastic effects, this is just as strong evidence as you can get. However, it is known that humans are able to accept a level of risk, and cancer is the disease that ultimately kills about one third of us anyway, because of another carcinogen we like to inhale — oxygen. Thus, it is an elementary point for the article to explain what is the expectation value for cancer when smoking tobacco. Propagandizing either way or lawyering/explaining away is perhaps the worst thing that could be done. The important thing is that the article is correct information-wise (thus, for example, making informed decisions possible). --Vuo (talk) 22:29, 17 January 2009 (UTC)

Your first comment was rather terse and left a lot of implication, thanks for clarifying. The source you provided is very helpful, and I'm looking froward to it. There are several question I have in mind. The list discusses only cancers, and excludes other diseases; are you suggesting that we redivide the article into potentially "Cancers", and then "other diseases"? How are we doing this exactly? In reproductive, the divisions are rather rough, and we can fix them as we go; right now I've divided Cardiovascular to into Pulmonary and the latter. ChyranandChloe (talk) 23:13, 17 January 2009 (UTC)

Lead

We're finally to the lead. I've removed "are significant, including increased mortality and lung dysfunction." from the first sentence for three reasons: (1) under WP:LEAD the first sentence defines the article, the sentence does not, (2) the sentence is ambiguous and covers only a very small portion of the total effects discussed in this article, it lacks context and depth, and (3) starting the article with regularly propagandized remark borderlines with neutrality and feels like we're paying platitude, it's not necessary and the second paragraph is there for a reason.

I've reworded the second sentence in the first paragraph, it's suppose to parallel the first paragraph in the subsection "Prevalence"; to better explain it, "present indicator" is referring to availability of data, there is good statical data on the prevalence of smokeless tobacco, but none that would effectively give a world view. I like the third paragraph, though it needs more on the mechanics (e.g. concisely define the carcinogens). Vuo, you seem to have the best understanding of this. ChyranandChloe (talk) 03:57, 21 January 2009 (UTC)

Only one point I'm addressing now, and let's not Wikilawyer. The health effects of tobacco are the effects of tobacco consumption on human health. This contains zero information. --Vuo (talk) 18:08, 21 January 2009 (UTC)

I see your point, but the purpose of the first sentence is to define the topic; and not necessarily to start them out with the many facts we want to go over. I tried to be as short and simple as possible, that is by essentially telling the reader: this article is focuses on the health effects from consuming tobacco. We would assume that they would understand that from reading the title (that is we're not introducing anything new), so the point is that this solidifies it. ChyranandChloe (talk) 03:32, 22 January 2009 (UTC)

I think we need to go over the first sentence it's better as there's more substance, but I think we need to concentrate on defining the article. Repeating the title isn't a problem, in fact it is encouraged to use the title as the subject of the first sentence (see WP:LS). For example, "The health effects of tobacco" and then the definition of what the article is about, I am currently defining it a as the associated factors and effects of tobacco consumption on human health; this is as concise, unambiguous, and definitive as I can get it. Another effect that arises when the article is defined it is that it establish the boundaries of the article, this keeps the article relevant to the subject. Also "depending on the way it is consumed" doesn't give the full picture, there are more factors than simply "the way it is consumed". ChyranandChloe (talk) 03:43, 23 January 2009 (UTC)

Random Spam Removed

Found random spam at the bottom of the bibliography ("Hi...") and removed it. 99.13.70.165 (talk) 22:50, 24 March 2009 (UTC) you dont ever want to smoke cause you can die from it and you won't have a nice family. if you smoke you will regret you did nd by smoking that little bit it will still harm you for the reast of your life and ,evaery body knows you want a nice life. once my sister was smoking and she was only 10 years old and ever sence she has been smokimg. —Preceding unsigned comment added by 66.182.117.146 (talk) 00:28, 15 April 2009 (UTC)

whole article clearly written from offices at tobacco companies

it's obvious the whole article has been written from inside offices at tobacco companies. I can't blame anyone, I myself don't have much motivation to try to work on the article -- who cares. I just thought I should point the fact out. 79.122.41.137 (talk) 19:12, 2 May 2009 (UTC)

External links

Deathclock.com are you serious? I am supposed to take that serious?????That was a website for s***'s and giggles back in middle school. Go to Britannica if you want FACTUAL information. —Preceding unsigned comment added by 96.255.134.245 (talk) 15:29, 23 May 2009 (UTC)

Where did you find the link? The "External links" section doesn't exist. ChyranandChloe (talk) 16:03, 23 May 2009 (UTC)

Found it, the edit was by User:Eldudarino [15]. ChyranandChloe (talk) 21:22, 23 May 2009 (UTC)

ChryandChloe's deletion from lead

ChryandChloe started this thread to give reasons for deleting the following bold:

“ The current view on cancer is that carcinogenicity is a stochastic effect, where various environmental factors trigger the development of cancer. While exposure to a carcinogen increases the probability of cancer, the process remains random. For example, smoking tobacco is known to cause cancer in humans, but not all people who smoke necessarily develop smoking-related cancer. In studies on humans, the large number of confounding variables makes it challenging to statistically distinguish their effects. In spite of these challenges, many health organizations worldwide remain unequivocal about tobacco's deleterious effects: the World Health Organization estimated in 2002 that in developed countries, 26% of male deaths and 9% of female deaths were attributable to smoking. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide." ”

Provided by 79.122.70.79 and 94.27.220.95 in the following diffs [16] [17]. Removed under check source, verifiability (WP:V).

1. This is a scientific article, the positions of major health organizations is based off of scientific evidence as to political positions. The report from WHO is a synthesis report, taking those scientific sources and placing them in context for policy makers. This article provides how these conclusions are reached through scientific analysis, not through political positions. Political positions are deferred to the main article Tobacco politics.

This is not a "scientific article." That would be Original Research. Wikipedia has a policy of providing a neutral point of view. This contrasts with a scientific article which comes to a single conclusion. 79.122.9.209 (talk) 10:57, 24 May 2009 (UTC)

1. "26% of male deaths and 9% of female deaths" is not with in either of the two sources provided. Likewise this statistics is already provided in the last paragraph in the subsection "Prevalence" with "[...] [in 2004] 5.4 million are tobacco-attributed, and 4.9 million as of 2007".[18](page 23),[19]
2. The quotation from the CDC is not within the source.

You pretend that the sentences mention statistics, instead of health organizations' stances. This is not the case. 79.122.9.209 (talk)

For these reasons, edits made by said anons have been removed. They may not be added under WP:CON until a consensus may be achieved; failure to abstain after the third revert (WP:3RR), or failure to engage in civil discussion whiling engaging in reverts(WP:EW) will result in a block. ChyranandChloe (talk) 01:54, 24 May 2009 (UTC)

Wikipedia has a policy of a Neutral Point of View. As I have pointed out, you work for a tobacco company directly or indirectly, and so you automatically represent their POV. There is no issue of "consensus". You are the only one pushing this POV here. Stop. You also lie about "reverts" as your revert history summary here you write "revert:1" -- however it is the second time you reverted the article by deleting the same content, the first time was here. Stop making POV deletions to push your POV agenda and stop abusing Wikipedia policies by lying about circumstances. Wikipedia is not your marketing material. 79.122.9.209 (talk) 10:57, 24 May 2009 (UTC)

The sources do not check out, if the quotation or statistics were actually in it, then you would have qualified verifiability; and I would not have opposed it. I understand neutral point of view (WP:NPOV), your persistent poisoning the well does not adhere to it. Address my central point. I considered my first edit a revise as I moved the content down to the subsection "studies"; since the content was removed from the lead, I do not challenge your assertion, this makes my second edit the third revert and yours the fourth. Because of the dynamic nature of your ip-address, you have been adequately warned on this talk page. ChyranandChloe (talk) 20:12, 24 May 2009 (UTC)

First of all, identifying a huge conflict of interest (your working for tobacco companies directly or indirectly) is not the same as poisoning the well. The difference is obvious. If not read the two articles. There's nothing wrong with having a built-in conflict of interest, but it is customary not to delete material which is counter to it. Likewise, you should understand that it is your job to put your POV in the best possible light WITHOUT removing other POV's which are also significant (such as the WHO's). The fact that you work for a tobacco company, directly or indirectly, means you do not have the right to delete positions of the Center for Disease Control and of the World Health Organizations. The deletions you are making are simply POV pushing at the expense of other very authoritative POV's. Also, you are lying that your first revert was a "move" as you moved it to a completely inappropriate section (under 'studies', even though they were stances from health organizations -- not studies) so it would be deleted. In fact, despite this ploy it was a simple revert (#1) subsequent to which you made the same deletion again (#2, which you called #1). As for verifiability, it took me about five seconds to get from the references to "Worldwide, it is estimated that tobacco causes about 8.8% of deaths (4.9 million) and 4.1% of DALYs (59.1 million) [...] for example, attributable mortality is greater in males (13.3%) than females (3.8%)." on this page, which is in the reference linked. I'm sure you can find the exact quote for industrial countries, except oh wait, you're not actually interested in the reference, you're only interested in burying it. Seriously, read the conflict of interest article. 94.27.176.34 (talk) 21:20, 24 May 2009 (UTC)

also, not that either of us is a policy freak, but the three-revert rule would mean you could revert three times and I could revert three times, meaning the addition would stay -- until the next day. But who wants a pointless edit war. If you want to improve the references, by all means. And if you want a section in the article for major health organizations' policies and stances, feel free to add that as well. But trying to make it sound like there is no definite stance from health organizations (since it is statistically "challenging") is misleading at the very best. In fact criminally so. 94.27.176.34 (talk) 21:25, 24 May 2009 (UTC)

Wikipedia actually has a more direct article for Conflict of Interest (WP:COI). Let's go over the edit:

1. The first sentence is from the WHO, I would prefer a quotation from them as to a synthesis from it (WP:SYNTH).
2. The statistic "26% of male deaths and 9% of female deaths" is not wihin the source, you need to provide a page number if it is. Furthermore this statistic is already provided in the last paragraph in "Prevalence" and likewise in the source you've provided. The content need to reflect the source.
3. The quotation from the CDC is not within the source provided.[20]

I do not work for a tobacco company directly or indirectly. You're claims are irrelevant, unjustified, and unverified. WP:CIVIL guides this. ChyranandChloe (talk) 23:03, 24 May 2009 (UTC)

Verifiability is Wikipedia's criteria of inclusion (WP:V); perhaps removing the second paragraph would make things clearer. For example, "the large number of confounding variables makes it challenging to statistically distinguish their effects"—I do not agree with this premise, the lack of randomization of treatments prevents causal inferences from being easily made[21]. I don't like playing gate keeper, but we need to watch what's going into this article. ChyranandChloe (talk) 05:44, 25 May 2009 (UTC)

NOTE: Rest of the discussion moved from ChyranandChloe's talk page [22] ChyranandChloe (talk) 21:12, 6 June 2009 (UTC)

the new lead is OK by me as it doesn't contain the ridiculous idea that tobacco effects are too "challenging" to study statistically, as though there weren't clear evidence either way. The truth is all health organizations worldwide condemn tobacco use strongly.

I think the stances of leading health organizations ought to go in the article. Try to put it in your draft if you can.

Finally, I would appreciate your reply with a few sentences about your personal studies and funding, as for me the type of interest you show in the tobacco articles would most easily be explained by studying as a research assistant for someone taking grants from tobacco companies. However I am open to the idea that you're just a huge fan of tobacco, though this is bizarre. Also my concern is not unwarranted given the article "Tobacco Company Wikipedia Edits Revealed".

I look forward to your fair lead (and body of article) which does not trivialize or neglect the strong positions of leading health organizations. 79.122.104.255 (talk) 06:34, 26 May 2009 (UTC)

Hi; a note. I agree with your thoughts about the article. I hope you understand that User:ChyranandChloe was probably taken aback at your initial accusations, and has no reason to need to answer you; the content of the edits is all that should matter. That being said, from the user page, it would seem that User:ChyranandChloe is an undergraduate student. Awickert (talk) 09:11, 26 May 2009 (UTC)

That doesn't make sense. Scientific-minded undergraduates are not usually huge fans of tobacco. ChyranandChloe was not taken aback by the accusation, indeed tacitly admited it by calling it "poisoning the well" rather than saying "actually I'm just a huge fan of tobacco". ChyranandChloe's not divulging their reasons for being such a fan makes it more than clear whose interests they have at heart, and I would just like the financial reasons for this to be put forward honestly. No one is that big of a tobacco fan. 94.27.152.196 (talk) 18:01, 26 May 2009 (UTC)

Is it within your imagination that I do not affiliate myself with the advocacy of tobacco? This is certainly within your capacity as you've arrogantly written my back story without any regard for consent, accuracy, or verifiability. I have a user page. I am interested in epidemiology, virology, and to a smaller extent pathogenesis. "Funding" is called scholarships. And they come from legitimate sources. I do not support tobacco consumption, your accusations are entirely speculation, and to an even larger extent, a fabrication.

Taken aback is an euphemism. Poisoning the well is a logical fallacy. It was directed at you. You argument began by attacking the character of the opposing party with little respect for objective facts. I became your opposing party when I checked to see if the content added was consistent with the sources. There is nothing tacit or subtle about pointing out your fallacy. There is nothing non-neutral about checking your sources.

If you begin with the presumption by attacking my character, there is no trust, and no means by which I can say to you: I do not support tobacco. Alas, I do not support tobacco. I believe in presenting the content as an articulated analysis of the objective facts, similar to that from the independent firms cited within the Surgeon General. Paragraph two in the lead was by Vuo[23], I originally summarized paragraph one of "Prognosis" and refitted for the lead. I've let it slide. I was busy finishing "Prevalence" and "Factors" (which is now "Prognosis"). If you're looking for a fight, go to Talk:Passive smoking. You have good intentions, but a terrible way of showing it. This is good faith (WP:AGF). Remember that I am in a position to revoke it. ChyranandChloe (talk) 04:36, 27 May 2009 (UTC)

Paragraph 2, lede

A semi-requested comment from a noncommittal observer: I don't like the 2nd paragraph. The first half of it is outsourced, a little wishy-washy, and (AFAIK) although cancer may be "stochastic" on-average, itis linked to very specific actions of cancer within specific people with specific genetic makeups. I think this first half could be shortened down to a sentence. It worries me that the second half doesn't match the sources. In my opinion, all the paragraph really has to say is something along the lines of, "Although factors such as [genetic variability, etc.] preclude any 100% causal relationship (smoke-->cancer), there is (a) a strong correlation between smoking and certain types of cancer and (b) reason to believe causality because of studies of the lung, behavior of smoke, (others?)." It can be general because it is the lede; specific numbers can be in the body. Awickert (talk) 09:25, 25 May 2009 (UTC)

Relooked at paragraph two as a whole. The entire paragraph was unverified, or whose citations were inconsistent. Rewrote it to reflect section two in the body "Mechanisms". I'm leaving it short for now. Right now I'm drafting some content that could be added to the body, which would better explain how causality is established in tobacco consumption. When this new section is complete, a sentence or two can be derived for the lead. The draft is available here. Still working out the prose—it seems a little incoherent and weak. You can comment are accepted on my user talk.

Remember that leads are derived from the body of the article. It is a summary and an introduction defining the scope of the article and establishing how the article is notable. The direct guideline for this section is available at Wikipedia:Lead section. ChyranandChloe (talk) 02:53, 26 May 2009 (UTC)

OK - I'll check out what you're writing, and help if I think I can; I don't see how this doesn't jive with the body text, care to explain? Awickert (talk) 08:46, 26 May 2009 (UTC)

I like the change to the lede. Short and sweet. Awickert (talk) 09:02, 26 May 2009 (UTC)

Notable people who have died from smoking

I think there should be an article that is a list of famous people who have died from smoking-related illness. That'd be interesting to see. Kag427 (talk) 15:42, 3 June 2009 (UTC)

Same said on Talk:Tobacco smoking. I don't believe that this subject would be prudent to the main subject of the article, however you can start a new article title Notable deaths attributable to tobacco consumption, and it could be linked through either the infobox, footerbox, or as a {{See also}} navigational link in one of the sections. ChyranandChloe (talk) 16:20, 3 June 2009 (UTC)

Yeah, that's what I'm talking about: a new article called List of notable people who died from smoking-related complications. However, I don't have any information on the subject. I came to Wikipedia to find that list, but it's not here. I think it's worth having, but I just don't know how to do it! 64.195.0.117 (talk) 19:12, 3 June 2009 (UTC)

Centralizing discussion at Talk:Tobacco smoking. ChyranandChloe (talk) 19:34, 3 June 2009 (UTC)

New "Studies" section

In January of 2009 I proposed a new layout for this article which would break down the subject into three parts: Epidemiological findings, the Biologic processes (Mechanisms), and Prognosis. The first two section establish how the effects came to be, while the last one listed what they were. Finished the Studies section, started back in February 15 which would explain the "processes from which the findings were made", before then it was treated as a sort of trivia section.[24] The Old version of this section can be found in this old version[25]. Parts from the old "Studies" section may be moved down to History, and others moved here to the discussion for reintegration; remember that this article now exceeds 100kb and is applicable under WP:SIZE to be reduced, and specific sections spun off into new articles with a summary section in its place (WP:SPINOFF). Two new articles are possible: Effects of tobacco to cover those effects that are not directly tied with health, and possibly one from Epidemiology. ChyranandChloe (talk) 17:33, 3 June 2009 (UTC)

Introduction

The first part of the article, which is supposed to summarize all the facts presented in the article mentions(current version when I wrote this note):

• a definition of what is health effects
• that research is focused on smoking
• how many people are smoking and their demographical characteristics
• effects of tobacco in health (diseases only)
• existence of compounds that are carcinogenic in tobacco

In the first part of the article we should not focus on:

• definitions, necessary and adequate to be analyzed for the paragraphs which follow
• references for things which are more than adequately referenced in the parts of the article
• demographical characteristics

My opinion is that we need to focus on 'health effects of tobacco, which is what the article is about.

• diseases caused by tobacco
• effect on the population (deaths, decrease of life expectancy)

With these in mind, I intent to rewrite the introduction. Any comments to take into account are welcome.--FocalPoint (talk) 07:45, 6 June 2009 (UTC)

The large "Smoking kills" warning is inappropriate. It (1) does little to explain the full extent of the diseases, while (2) being obnoxiously large and (3) devoid of any depth in the topic. Do not put it in again. Let's go over the tree points in paragraph two of your comment:

• The purpose of the lead is to "unambiguously define the topic for the reader" (WP:LEAD). The definition is essential to what the article is going to be about, which I have defined to be the: "circumstances, mechanisms, and factors of consumption on human health."
• The lead is still subject to verifiability, and while it is generally written a greater level of generality, this does not exempt it from references; so far I've cited the first paragraph because that option was available, the second paragraph less so since it is designed to explore the mechanisms of consumption on health (WP:LEADCITE).
• The demographic characteristics lead to the discovery between tobacco consumption and disease. First noticed by Fritz Lickint between males and females. Males smoke more therefore acquired lung cancer at a greater rate than females[26]. These are the "circumstances" acknowledged in point one, the definition; and begins with a notable acknowledgement to (1) the foundation of pushing forth later findings, and (2) the historic background to the topic.

The "health effects" is not two-dimensional, getting there: how the effects came to be, is worthy of explanation. You can list the diseases caused by tobacco consumption in one to two paragraphs, the World Health Organization did it in two pretty pictures (page 17 of pdf [27]), which is what I'm working on right now. Effects on the population is measured in Years of Potential Life Loss, chapter 8 [28] of the Surgeon Generals 2004 report. That's next on my roster. I usually write the lead after the body is copy-edited, this makes it easier to see all the major points and determine which ones are the most notable. ChyranandChloe (talk) 21:07, 6 June 2009 (UTC)

Thank you for the answer.

• The "Smoking kills" sign: I will make it smaller to suit better to your taste. This is the main health effect of smoking: death, loss of life. Shallow, but true. Because it does not matter how or what is the illness which makes people die. Smoking kills, this is the summary of what can fit in one or two paragraphs or two pretty pictures. A summary in two words. Think about it.
• The definition as you describe it "circumstances, mechanisms, and factors of consumption on human health." is excellent and short.
• The rest of the first paragraph is nice but out of place. If someone reads only the introduction, the information is lost in trivialities like historic background. I am therefore reverting your edits [29] of Dec 30th 2008, bringing back text which existed from the creation of the article until that time. Number of deaths. Preventable deaths, as quoted by WHO and CDC. Deaths are the most notable.
• Your logic of how the effects came to be is excellent and 100% adequate for the main body of the article.

--FocalPoint (talk) 23:28, 6 June 2009 (UTC)

Typical tobacco packaging warning message about the health effect of smoking tobacco

Well...here is the sign. You can size it to your liking.--FocalPoint (talk) 23:33, 6 June 2009 (UTC)

Too shallow. Smoking does not necessarily kill. Smoking causes disease, but fatalities resulting from the disease does not necessary result from smoking. When a conclusion is drawn combining those smoke and who have likewise died from a particular disease—from which the two posses a causal link—the logical fallacy of the undistributed middle emerges confounding most estimates over large populations. Determining how well you can say with certainty, while both attempting to measure and mitigating the effects of confounding, has lead both the Surgeon general and the World Health Organization use "attributable" instead of fallacious statement "smoking kills" within scientific writing. There is more depth, understanding, and insight into this topic than what the statement "smoking kills" can do justice.

Look, I understand what you want is simple and will evaluate to be true. However, there is no intellectual value in the statement, all it gets across is an already advertised statement, supported by advocacy groups and condemned by the like. The image is not valuable. This is an encycolopedia. Ask yourself would an encycolopedia place this in their articles? Britannica does not[30]. For these reasons I am challenging for its removal with: (1) The image is not notable nor pertinent to be included in an encyclopedic article concerning health science (WP:N), (2) the image is an advertisement oversimplifying scientific concepts to justify its inclusion, (3) the image contributes little intellectual value to justify its inclusion, and (4) the image is advocacy applicable under neutrality (WP:NPOV) and reliability (WP:RS). For these four central points, I do not believe that the image or similar object should be included. Address these four points. I will not revert until a consensus has been reached. If a consensus cannot be achieved I can ask an established editor or an administrator familiar with the subject to help mediate, contribute, or move to resolve our dispute. This discussion is now under WP:Dispute Resolution. ChyranandChloe (talk) 04:57, 7 June 2009 (UTC)

1. WP:N (Wikipedia:Notability) cannot be applied to a picture. I am copying from the guideline: "These notability guidelines only outline how suitable a topic is for its own article. They do not directly limit the content of articles.". Even so, there is a whole article about Tobacco packaging warning messages, where the phrase Tobacco kills is prominent. The image is pertinent, since it describes the effect of smoking on health.

2. The image is one of the phrases that are requested to be included on tobacco packaging by state authorities in many countries. It is not an advertisement, it is a requirement, an order by states. It describes facts. Deaths by smoking. I understand your opinion that this phrase oversimplifies facts. However, that this an opinion versus the fact that this phrase is used in packaging of tobacco around the world. It is well sourced as well. Britanica's article states "tobacco had become recognized as being highly addictive and one of the world’s most devastating causes of death and disease". WHO clearly states: (page 3) "In the 20th century, the tobacco epidemic killed 100 million people worldwide."

3. The image contributes the essence of the article: The effect of smoking on health is loss of lives. I have answered that already. The main health effect of smoking: death, loss of life.

4. I believe that I have answered also whether this image is acceptable for neutrality (WP:NPOV) and reliability (WP:RS), since state (countries) and international organizations (WHO) are both neutral and reliable, as also seen by other encyclopedic articles like Britannica's.

If these answers do not satisfy you, I suggest that we wait for others to comment. If nobody appears, we should then ask for opinion of others in relevant noticeboards. To this effect, I will refrain from answering further until next weekend, giving people time to appear and comment.

--FocalPoint (talk) 14:45, 7 June 2009 (UTC)

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Archived old discussion, and hid some of this one for accessibility: makes it easier for other people to see where the discussion is at without burdensome reading. On my roster to ask is MastCell, Nmg20, Peter Isotalo, and Vuo. These are people who have worked on this article or the articles in this series before. A Request for Comment (WP:RFC) is the notice board I'm looking at if we need one. I'll start asking for comments on June 10.

You're comments make sense and I appreciate them, we'll see what others think when they arrive; before then, working on something controversial seems to be in bad faith and I recommend not to edit the article until this is resolved. If you want to work on other items while we wait for this one to resolve, I have two active sandboxes specifically for this article: User:ChyranandChloe/Workshop 17 and User:ChyranandChloe/Workshop 15. When I do rewrites I do a whole section at a time for two reasons: (1) if it becomes controversial, it easier to discussion a holistic piece of writing rather than bits and pieces of smaller edits, and (2) for article stability and quality, this reduces the chances of edit wars and edit conflicts. Comment on my talk if you have questions—or—what's on your mind? It feels like you have something to say. ChyranandChloe (talk) 21:28, 7 June 2009 (UTC)

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I was notified by CandC about this, and I agree that this picture really has nothing to do with the article. This is about health effects, not anit-smoking campaigning. Warning labels have no direct connection to the article topic, and it really doesn't matter whether it's notable or not. It's quite simply unnecessary but still provides ample opportunity to accuse the article of neutrality issues. And quite frankly, the placement in the lead (and to the right no less) is really disharmonious.

Peter ^Isotalo 05:42, 9 June 2009 (UTC)

You mean "to the left" I suppose. I tried hard to put it on the right, but I could not manage to make the template to go under it. :) --FocalPoint (talk) 16:10, 12 June 2009 (UTC)

I was also notified of this discussion by CandC. My feeling is that a big graphic saying "Smoking kills" detracts from the article, which should cover the known harmful effects of smoking with a bit more depth and substance. There's a line between clearly stating the facts and beating the reader over the head with them, and I think this may cross it. MastCell ^Talk 06:07, 9 June 2009 (UTC)

Even if this article were to be used for advocacy (which it is not), one could argue that the ineffectiveness of "Smoking kills" as a campaign for public health is evidence that placing the same label on this article will effect the same result (i.e., no change in public behavior). That issue having been addressed, we are left with the matter of determining if this image contributes to the article. Because there is an entire article dedicated to these warnings, might a wikilink, rather than the least intellectually stimulating image from the page, be more palatable and useful to the reader? Antelan 06:21, 9 June 2009 (UTC)

FocalPoint. Do you have anything to add? I'm prepared to remove the image. ChyranandChloe (talk) 06:19, 11 June 2009 (UTC)

Hi ChyranandChloe. I will post a notice in a couple of noticeboards, so that other people may examine the issue of including this image in the summary. However, as I see that there is consensus among the people who were invited, I am removing it from the summary. If anyone is interested, they will always be able to see it here

I believe nevertheless that tobacco packaging warning messages are an important issue, connected with health effects of tobacco and therefore I will create (not today) a small paragraph somewhere, with one of the warnings as a picture. I hope that you will contribute to make it better.

Thank you for the civilized way of handling this discussion.--FocalPoint (talk) 16:06, 12 June 2009 (UTC)

That's good. The question that I am asking isn't whether or not it is an important issue, I certainly think it is; how and where that's what I was after in my first comment. The history section, although mostly about the medical developments, should either discuss or link to those pages you're talking about. Whether the "Smoking kills" image is justified there, I am not certain; I have one prepared from some of the old reports. ChyranandChloe (talk) 04:25, 13 June 2009 (UTC)

Merge old "Studies" section into "History"

This article is over 100kb and is applicable under WP:SIZE to be reduced. Johnfos restored the old "Studies" section, however many of the sources, and likewise the prose—place the topic in a historical context. At least the history of epidemiological developments of the health effects of tobacco. Therefore I've merged it into the history. ChyranandChloe (talk) 06:50, 20 June 2009 (UTC)

Johnfos, what's on your mind? I've reverted your entry to the last stable version where "Studies" was placed side by side with "Terminology". ChyranandChloe (talk) 21:19, 20 June 2009 (UTC)

I agree the article is too long, and have added a "very long" tag, and removed the section on causation again, as this is one of the least relevant sections in the article. Johnfos (talk) 00:49, 21 June 2009 (UTC)

I'm planning a rewrite. It doesn't make sense now, and I agree; however it goes with this.[31] Which should work with relative risk and YPLL. I'll take it into sandbox, thanks for clarifying. ChyranandChloe (talk) 01:03, 22 June 2009 (UTC)

Sections "Prognosis" and "Cancer"

I chose the section titled "Prognosis" for a reason. "Health effects" is redundant, used as the title of the article. For a period of time this article used "Effects", however I chose "Prognosis" on February 16[32][33] because it best reflected the contents of the section. What the statistical inferences lead up to is simply an attempt to determine and predict the diseases incurred through consumption. In your edit summery, Johnfos, you stated it "simplified" the heading. I disagree, "Prognosis" is not an extremely complicated term. In fact, under WP:MEDMOS#Diseases/disorders/syndromes, "Prognosis" is recommended as a possible section.

When I layed out the article, I actually decided not to have a "Cancer" section. Cancer is not the only disease, rather I chose to break it down by where the disease affected. If its lung cancer, put it in pulmonary, if its the larynx then put it in the oral subsection. ChyranandChloe (talk) 02:40, 26 June 2009 (UTC)

Ownership and POV

ChyranandChloe, listen to yourself...

• • "I chose the section titled "Prognosis" for a reason."
  • "I chose "Prognosis" ..."
  • "I layed out the article ..."
  • "I actually decided not to have a "Cancer" section ..."
  • "I chose to break it down ..."

There are HUGE WP:Ownership issues here which are adversely affecting the article. There appears to be opposition from you to almost any edit I make to the article. As soon as I've done a few edits I get a note on this talk page or on my user talk page debating what I've done.

To have an article called "Health effects of tobacco" and then not to have a section entitled "Health effects" in the article, and not to have a "Cancer" section in the article is simply ridiculous. It makes it looks like you are trying to hide something, confuse the issue with jargon, and not tell the whole story. As at least one archived Talk page comment suggests the article is POV and pro-tobacco. I'm amazed that there are no photos in the article of mouths or lungs that have been affected by tobacco smoking. Johnfos (talk) 05:19, 26 June 2009 (UTC)

I have raised the matter at Wikipedia:Wikiquette alerts#ChyranandChloe, because at this point I think there is no point in my continuing to try to edit and improve the article. Johnfos (talk) 05:50, 26 June 2009 (UTC)

Disagree with your assessment. I am asking about a content dispute, with a reasonable foundation, and the reply is ownership and PoV. I do not want to control the article. I want to improve it. In my last comment, stated explicitly, how your edit fails to improve the article. Your immediate response does not directly reply to the content dispute, but makes a personal attack to my character holding that because of wording and because of past actions, I am disenfranchised to oppose your edit. This is plain. This simple. This is objective. Reply to the central point, the content dispute. ChyranandChloe (talk) 19:49, 27 June 2009 (UTC)

The most serious and main effect on health of tobacco is cancer. It is obvious that there must be a section named cancer.--FocalPoint (talk) 20:36, 27 June 2009 (UTC)

Vectors

Since this edit, we seem, among other things, to have an incomprehensible title "Vectors", describing (and copying eventually a summary of) the content of the article Tobacco products, formerly named Tobacco consumption. Having a paragraph describing ways to consume tobacco here is clearly unrelated. Remember, we are looking for Health Effects in this article, not explaining Tobacco products. A simple link to the main article is enough. --FocalPoint (talk) 20:29, 28 June 2009 (UTC)

Introduction

I made a summary of the main points presented in the article in the introduction, therefore I removed the tag too-short-introduction. Furthermore I believe that the tag of too-long-article is not necessary. Unless there is indication that others agree, I sugest the removal of this tag.--FocalPoint (talk) 17:42, 5 July 2009 (UTC)

Carcinogens

Could someone (the original writer maybe) clarify what this means: "The damage a continuing smoker does to their lungs can take up to 20 years before its physical manifestation in lung cancer." - this seems to imply that lung cancer is guaranteed within 20 years of smoking. What gives? --ReturningTarzan (talk) 14:08, 18 September 2009 (UTC)

work for a tobacco company or just can't read? Up to 20 years means if you stop smoking at age 20 you won't suddenly get lung cancer at age 70 (fifty being more than the stated up to 20 yrs later) and have it somehow be because of all the smoking you did up to age 20. But the sentence says it COULD be because of your smokingbup to age 20 if you get cancer at age 39 (Which is "up to" 20 yrs later). It doesn't mean you will, just that you could.

Cigarette Tobacco Vs. Pure Tobacco

I'm not sure if I am going out of line here (first time using the talk page) so please bare with me. I am interested in more of the health effects of pure tobacco rather than tobacco in cigarettes, and there is nothing that I have found discussing this. I am not suggesting that the article be changed, just if it would be possible for the addition of health problems that pure tobacco has, as it is possible to purchase pure tobacco and make your own cigarettes out of them (thus having them free of all of the additives that are in a typical cigarette.) So it would seem to be relevant to have this information as well. 68.32.63.97 (talk) 09:35, 7 October 2009 (UTC)

This would be worth addressing I think. There is a widespread belief, unsupported by any evidence AFAIK, that the health risks of tobacco smoking are caused/increased by "additives". JQ (talk) 20:58, 11 October 2009 (UTC)

Fires

Fires started by tobacco could be mentioned, although admittedly not a health effect in the usual sense.

It's a hazard of burning objects, not particularly tobacco. It should not be mentioned here. Frotz (talk) 17:18, 22 December 2009 (UTC)

There is some evidence that smoking tobacco causes adolescent depression

Currently, the Psychological section of the article only mentions an association between depression and smoking tobacco. Based on reading the article alone, someone unfamiliar with the literature on smoking tobacco may get the impression that this association is due solely to depressed people tending to smoke more than nondepressed people (thus, negative mood influences the decision to smoke tobacco). However, there is some evidence for the other direction of influence as well: Adolescents who initiate tobacco smoking tend to become more depressed, and adolescent smokers who cease smoking tobacco tend to display an alleviation of depressive symptoms.

Here is one online reference:

http://www.ncbi.nlm.nih.gov/pubmed/15077744?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2

68.54.107.114 (talk) 20:41, 15 November 2009 (UTC)HopingtoCleartheSmokeSome