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Possible side effect from some oil based flavourings

disclaimer: this is conjecture based on rapid development of various health issues within 2 years of trying a food additive flavoured ecig just couple times. I was 31 at the time of trying it with sedentary lifestyle. As I don't have exercise routine and am indoors as much as some hospitalized people, I breath very very casually so anything that would effect oxygen delivery in permanent way would be noticeable. I'd guesstimate there is 'good' odds that these issues would have developed anyway, I simply suspect the ecig lowered the oxygen intake ability during slow casual breathing just past a "tipping point" where as result there was acceleration in the onset of various health issues that may have been already on the way anyway due to lack of exercise etc and sitting on computer.

After trying ecig for only couple times, and not changing my daily routines in the following years I had a bunch of very subtle health issues develop that I have finally tracked down to the body regulating blood circulation to too low levels because of lack of oxygen. I would say that I was already "pre-compromised" due to sitting all day on computer so anything that would decrease the oxygen intake further was a tipping point. A bunch of mysterious issues developed with seemingly no connection because this lack of oxygen in circulation effects everything. Brittle nails, cold extremities, poor concentration - though because I also had some sort of stroke where I passed out about 1 year from trying the cig.

First paragraph of the lede

In the recent past the construction page had a cleanup and c/e. Since the first paragraph of the lede is based on construction I propose this version with a better function description for the first paragraph of the lede.

An electronic cigarette is a battery-powered vaporizer which simulates the feeling of smoking by vaporizing a liquid into an inhalable aerosol. The primary parts that make up an e-cigarette are a mouthpiece, a cartridge (tank), a heating element/atomizer, a microprocessor, a battery, and possibly a LED light on the end. An atomizer comprises a small heating element that vaporizes e-liquid and wicking material that draws liquid onto the coil. When the user pushes a button. or inhales a pressure sensor activates the heating element that atomizes the liquid solution; The e-liquid reaches a temperature of roughly 100-250 °C within a chamber to create an aerosolized vapor. The user inhales the aerosol, commonly called vapor, rather than cigarette smoke. The aerosol provides a flavor and feel similar to tobacco smoking, but without tobacco. Their use is commonly called "vaping". The three main types of e-cigarettes are cigalikes, eGos, and MODs. These devices are also categorized as first, second, third, and fourth generation devices. Most are reusable but there are disposable versions of first generation devices also called cigalikes. E-liquids usually contain propylene glycol, glycerin, nicotine, and flavorings.

Edit 2/2/16 incorporated TMCk's suggestion. AlbinoFerret 16:12, 2 January 2016 (UTC)

The wording, claims, and references are already in the article. The full version with references can be found in this sandbox.User:AlbinoFerret/sandbox/ecig AlbinoFerret 22:42, 31 December 2015 (UTC)

This is not an improvement—not until sentence 7 does it actually explain the purpose—something that is in the current first sentence. CFCF 💌 📧 11:29, 2 January 2016 (UTC)

What it does , is shows how it works. Which is drastically missing in the lede. AlbinoFerret 13:26, 2 January 2016 (UTC)

Just add something like the following (bold):
An electronic cigarette is a battery-powered vaporizer which simulates the feeling of smoking by vaporizing a liquid into an aerosol to inhale.
Alternative: by transforming a liquid into an aerosol to inhale.
Note: Say what it does not what it doesn't (as in the current lede).--TMCk (talk) 14:37, 2 January 2016 (UTC)

Done, swapped a couple of words around, but its the same meaning. Removed the line further down that had the same info from the same source. AlbinoFerret 16:12, 2 January 2016 (UTC)

Don't you think this gives unnecessary detail in the lede for something that isn't essential to the topic? The construction is of secondary importance to the primary purpose. I find that the theme of the current lede is clearer. CFCF 💌 📧 10:39, 9 January 2016 (UTC)

The inserted information isnt construction its function. AlbinoFerret 14:05, 9 January 2016 (UTC)

Is this the text you intend to replace?

Electronic cigarettes are battery-powered vaporizers that simulate the feeling of smoking, but without tobacco. Their use is commonly called "vaping". The user activates the e-cigarette by taking a puff or pressing a button. Some look like traditional cigarettes, but they come in many variations. Most are reusable but there are also disposable versions called first generation cigalikes. There are also second, third, and fourth generation devices. Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution known as e-liquid. E-liquids usually contain propylene glycol, glycerin, nicotine, and flavorings.

References

1. Caponnetto, Pasquale; Campagna, Davide; Papale, Gabriella; Russo, Cristina; Polosa, Riccardo (2012). "The emerging phenomenon of electronic cigarettes". Expert Review of Respiratory Medicine. 6 (1): 63–74. doi:10.1586/ers.11.92. ISSN 1747-6348. PMID 22283580.
2. ^ Cite error: The named reference Orellana-Barrios2015 was invoked but never defined (see the help page).
3. "Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues". Tob Induc Dis. 12 (1): 21. 2014. doi:10.1186/1617-9625-12-21. PMC 4350653. PMID 25745382. {{cite journal}}: Unknown parameter |authors= ignored (help)CS1 maint: unflagged free DOI (link)
4. Grana, R; Benowitz, N; Glantz, SA (13 May 2014). "E-cigarettes: a scientific review". Circulation. 129 (19): 1972–86. doi:10.1161/circulationaha.114.007667. PMC 4018182. PMID 24821826.
5. Cite error: The named reference Pepper2013 was invoked but never defined (see the help page).
6. Cite error: The named reference Bhatnagar2014 was invoked but never defined (see the help page).
7. Cite error: The named reference McRobbie2014 was invoked but never defined (see the help page).
8. Cite error: The named reference Farsalinos2014 was invoked but never defined (see the help page).
9. Cite error: The named reference Farsalinos2015 was invoked but never defined (see the help page).
10. Cheng, T. (2014). "Chemical evaluation of electronic cigarettes". Tobacco Control. 23 (Supplement 2): ii11 – ii17. doi:10.1136/tobaccocontrol-2013-051482. ISSN 0964-4563. PMC 3995255. PMID 24732157.
11. Weaver, Michael; Breland, Alison; Spindle, Tory; Eissenberg, Thomas (2014). "Electronic Cigarettes". Journal of Addiction Medicine. 8 (4): 234–240. doi:10.1097/ADM.0000000000000043. ISSN 1932-0620. PMID 25089953.
12. Cite error: The named reference Cooke2015 was invoked but never defined (see the help page).
13. Cite error: The named reference Kacker2014 was invoked but never defined (see the help page).
14. Cite error: The named reference Brandon2015 was invoked but never defined (see the help page).
15. Cite error: The named reference Cochrane2014 was invoked but never defined (see the help page).

If it is, the current iteration is simply better and more precise in every way. CFCF 💌 📧 21:34, 11 January 2016 (UTC)

Smoking cessation

I present a partial restore from the archives:-

I'm still hoping to make progress with this idea and would welcome additional commentary.—S Marshall T/C 21:38, 10 January 2016 (UTC)

It's a huge improvement over the current text. There are other changes I'd like to see, but I won't stand in the way of this one. P Walford (talk) 12:10, 11 January 2016 (UTC)

• I think this may be something like the 6th time I find myself repeating myself: we should not be mentioning PHE by name if we don't mention Cochrane or the WHO, both of which carry more authoritative opinions. Ping Doc James who commented on these proposed changes with similar concerns further up on the page. CFCF 💌 📧 13:05, 11 January 2016 (UTC)
• Looks good. AlbinoFerret 14:25, 11 January 2016 (UTC)

What about the concerns that it skews coverage and gives undue mention of a single positive report? This isn't an issue for you? May I remind you that you had issues with the text yourself . CFCF 💌 📧 15:39, 11 January 2016 (UTC)

CFCF My concerns were to the first proposal that boiled it down to one paragraph, it has been expanded. AlbinoFerret 19:42, 11 January 2016 (UTC)

CFCF did indeed point this out in the past and I've failed to amend the proposed text in response to his concerns. I don't take those concerns seriously; the contention that the proposed text "skews coverage", or is unduly favourable to electronic cigarettes, is not one that I need to waste any of my time answering. But although it's silly, it's also easily countered without substantive changes, thus:-

Heading

The amendments are given in bold.—S Marshall T/C 19:07, 11 January 2016 (UTC)

— CFCF 💌 📧 19:52, 11 January 2016 (UTC)

• It isn't much use looking at these without the refs. I'm rather suspicious that some of the wording is sufficiently precise. Eg, are there really "2015 reviews from the United States which conclude that e-cigarettes are ... not associated with quitting", or not associated with better rates of quitting than other methods? Johnbod (talk) 20:38, 11 January 2016 (UTC)

Yes the pre Cochrane,and PHE staement sources from the US do argue that there are no sources that prove they help people quit. AlbinoFerret 21:28, 11 January 2016 (UTC)

Obviously there are sources that show ecigs as "associated with quitting" - not in itself a large claim. All the sources I can remember discuss how this "association" looks compared to conventional NRT, cold turkey, etc. What is "PHE staement sources from the US"? Johnbod (talk) 03:31, 13 January 2016 (UTC)

• I think "the pre Cochrane,and PHE statement sources from the US" should be parsed as:- "the pre-Cochrane and pre-PHE statement sources from the US".—S Marshall T/C 13:13, 13 January 2016 (UTC)

• Well, I didn't check that QuackGuru's claims were backed up by his sources. I simply assumed that he didn't go so far as to lie. If he did, then really, we need to nuke this whole article and start again from scratch.—S Marshall T/C 21:58, 11 January 2016 (UTC)

I seem to remember checking those sources, its basically a known unknown at the time the sources were written. It might be a good idea to add the sources now to final chacking can be done before inclusion as CFCF gave a thumbs up. AlbinoFerret 22:01, 11 January 2016 (UTC)

The WHO and Cochrane are more respected or at least more well known than PHE. So yes this version is an improvement over the prior version that was proposed. But what happpened to the USPSTF? Doc James (talk · contribs · email) 23:16, 11 January 2016 (UTC)

I think it represents a significant improvement and is clear. SPACKlick (talk) 11:41, 13 January 2016 (UTC)

• I think we've reached a rough consensus that this trimming is appropriate in principle, subject as always to a careful comparison of the detail with the sources.—S Marshall T/C 13:10, 13 January 2016 (UTC)

• Any discussion of smoking cessation and e-cigarettes that doesn't even mention dual use is missing a key point. Our sources find high levels of dual use, say that's a major part of what's happening in the real world. I suggest citing a source or two on this. Without it I think the trimming has cut meat along with the fat. Cloudjpk (talk) 18:53, 13 January 2016 (UTC)

Agree with that - it wasn't very well covered before either. Johnbod (talk) 19:07, 13 January 2016 (UTC)

Amazingly the PHE report also addresses dual use. The pages 26-29, and the summery on page 29 is quite interesting. AlbinoFerret 21:19, 13 January 2016 (UTC)

• This section is entitled smoking cessation, and someone who's dual-using is by definition not ceasing their smoking. I think that's why QuackGuru's text doesn't substantially mention it. (I'm not cutting any meat: it was never in this section in the first place.) There's clearly an appetite for discussing dual use, though, and I agree that in a well-written version of this article it would be discussed here. I propose that I draft a separate section entitled "smoking reduction" about dual use, to be placed immediately after the smoking cessation section, and begin a discussion about it here, once we have an agreed text for the smoking cessation part.—S Marshall T/C 22:38, 13 January 2016 (UTC)

PHE's point is that the many people who plan to "cut down cigarettes gradually" by dual use usually fail to do so; a complete switch is far more likely to be effective. Like so much in PHE, this is an old theme of the Smoking Toolkit surveys (http://www.smokinginengland.info/latest-statistics/ - latest update out this week I see). Johnbod (talk) 04:27, 14 January 2016 (UTC)

I think it should be added to this section rather than in a section of its own although it could likely stand to be a separate paragraph. We'd need to bear in mind that there are dual users who intend it, dual users who do it to reduce the number of cigarettes they smoke, those who intend to quit and fail and so continue dual using and those who successfully use dual use to quit, each of which is discussed, sometimes in combination, in different sources. 82.111.139.27 (talk) 13:13, 14 January 2016 (UTC) That was me SPACKlick (talk) 13:22, 14 January 2016 (UTC)

I'm fine with a separate section, linked from here. I'm fine with adding it here. I guess the relevance here is that dual use is not cessation and that e-cigarette use does not assume cessation. I guess the argument for its own section is high levels of dual use are a large part of the e-cigarette phenomenon. Cloudjpk (talk) 18:36, 14 January 2016 (UTC)

• I was surprised by the proposed content's description of the Cochrane review's findings of ECs being "as effective as nicotine patches for quitting smoking over the short term" - the flat definitiveness of that statement is not something I would think authors in the Cochrane group would say as the evidence is still so thin. And indeed, the review says: "There is evidence from one trial that ECs may lead to similar quit rates at six months as NRT, but the confidence interval is wide." That is very different. Jytdog (talk) 18:04, 14 January 2016 (UTC)

and what are the reviews discussed in this part again with a very flat statement of superiority to NRT? "Reviews in 2014 and 2015 found that e-cigarette users had 20% higher cessation rates than users of nicotine replacement products." Thanks Jytdog (talk) 18:21, 14 January 2016 (UTC)

• That's a small section of my proposed text taken out of context in such a way to make it look ridiculously extreme. Putting it back in the intended context, the first sentence of the proposed text reads: The available research on the safety and efficacy of e-cigarette use for smoking cessation is limited and the evidence is contradictory. I have said that front and centre, right at the start, and I do not think it is a good idea to repeat it in every paragraph afterwards.—S Marshall T/C 22:51, 14 January 2016 (UTC)

Thanks for replying, but I am not taking anything out of context. Any given source may or may not acknowledge the incompleteness of the picture currently, and the draft makes it seem like the Cochrane source is way more definitive than it is - which misrepresents it. Also what are the two sources I mentioned in the 2nd bullet? It is impossible to know if the sentence is accurate or not, without that information. Jytdog (talk) 23:25, 14 January 2016 (UTC)

• But, you see, that leads to the problem your buddy QuackGuru had, where he said the same thing again and again in every paragraph. That's exactly the problem that I'm trying to solve with this edit. I could address your concern by making the sentence read: Insofar as it is possible to draw conclusions based on the limited evidence available, the Cochrane Collaboration found... But it would be extremely poor editorial judgement to do that. It's true that my text misrepresents Cochrane in the mind of any reader who's forgotten how I began the first paragraph by the time they read the second sentence of the second one. But such a reader really does not have the capacity to understand this article in the first place.

  As for where the sources are --- I haven't checked them. I've simply assumed that despite QuackGuru's behavioural problems, he didn't go so far as to lie. I would suggest you read the source that QuackGuru gave when he made this claim (which is this one). If you do check the sources and find that QuackGuru lied, please do say so, as I will then have good grounds to propose that he's site-banned, and this article is nuked and restarted from scratch, which will make my life a great deal simpler. But I think he was telling the truth.—S Marshall T/C 20:35, 15 January 2016 (UTC)

i understand you are frustrated but we cannot discuss proposed content without sources. As for the problem you are describing about repeating things, here is my take on that. There are two ways to build a Misplaced Pages article. The normal way is to read what the relevant sources say, summarize them, and cite the sources. The other way, which often happens in highly contested articles like this one and is very sub-optimal, is to name the source in the actual content - to attribute in-text - and describe what that source says. We have gone down that route. if we are doing that, we have to accurately describe what each source says and we cannot elide. To do so misrepresents the source. If you want to simplify things, I would recommend proposing content that summarizes what the sources say and provide that, with the sources. Jytdog (talk) 20:46, 15 January 2016 (UTC)

The whole purpose of this section is get off of what we have been doing and move to a more summery style, your comments so far reflect keeping things as they are. This is just the start of that process, and other sections will follow. So to enforce how its been is not helpful. There is consensus so far that this article is not the best and written badly. Do you disagree with that? AlbinoFerret 21:14, 15 January 2016 (UTC)

There is "consensus so far that this article is not the best and written badly", but not that the way out of this involves reducing the length of sections by >50%, which generally I don't like. Johnbod (talk) 23:43, 15 January 2016 (UTC)

No, I am responding to the actual draft, which still says "a review published in 2014 says X". If a sentence says that, the sentence has to actually tell you what the attributed source said or else it misrepresents the attributed source. If the notion is to move away from in-text attribution that is great. The draft doesn't do that. Jytdog (talk) 22:48, 15 January 2016 (UTC)

• Did you check whether it does say that? I've linked the source QG used.—S Marshall T/C 23:24, 15 January 2016 (UTC)

again S Marshall what are the reviews you are mentioning in "Reviews in 2014 and 2015 found that e-cigarette users had 20% higher cessation rates than users of nicotine replacement products. " I am not being obtuse, I really don't know which ones you mean. Thanks. Jytdog (talk) 00:03, 16 January 2016 (UTC)

• I mean the source that QuackGuru has already placed in the article and linked to this statement when he made it. So as to help you find this source, I also linked it for you yesterday in the edit I made at 20:35. I will link it yet again: here. I don't think you're paying attention.—S Marshall T/C 16:57, 16 January 2016 (UTC)

Description of Cochrane findings in current article

I just cut this from the article and put it here.

• In terms of reduction in cigarette consumption, nicotine-containing ECs were more effective than placebo ECs and also significantly more effective than nicotine patches in helping people achieve 50% or greater reduction in smoking.(ref name=Cochrane2014)

That is a pretty dramatic distortion of the Cochrane author's findings. How can this be more accurately summarized? Jytdog (talk) 18:55, 14 January 2016 (UTC)

Page 18 "In terms of reduction in cigarette consumption, nicotine-containing ECs were significantly more effective than placebo ECs and also significantly more effective than nicotine patches in helping people achieve 50% or greater reduction in smoking." Looks like someone inserted a copyvio, but its in there. AlbinoFerret 19:03, 14 January 2016 (UTC)

ack, yes. That is about reduction. What threw me is that it is mixed in with a bunch of stuff about cessation and the section is called "Smoking cessation". Where does content about reduction fit - in this section or in the following "Harm reduction" section? I would think the latter... Jytdog (talk) 19:27, 14 January 2016 (UTC)

Thats a good question because some editors I am sure would qualify that as dual use which has been part of the smoking cessation section. Personally I think it more harm reduction, but lets let a few more editors chime in. AlbinoFerret 19:37, 14 January 2016 (UTC)

Reduction is unfortunately used both for smoking fewer cigarettes and for reducing harm caused by smoking, which are hardly the same thing. It would improve the article if we chose unambiguous terms and used them consistently. Perhaps "cutting down" and "harm reduction". Cloudjpk (talk) 22:32, 14 January 2016 (UTC)

Smoking fewer cigarettes is harm reduction. Each cigarette not smoked reduces the harm. Some have questioned if smoking fewer cigarettes is really quitting calling it dual use if the goal is quitting. The focus should be what the source is talking about. In the paragraph on page 18 the focus appears to be smoking reduction not quitting, the the paragraph says

"In terms of reduction in cigarette consumption, nicotine-containing ECs were significantly more effective than placebo ECs and also significantly more effective than nicotine patches in helping people achieve 50% or greater reduction in smoking. The finding is tempered by lack of biochemical confirmation of the reduction.Future studies should include such measures. There was evidence from intervention cohort studies that dual use may promote smoking reduction, and no evidence that dual use undermined smoking cessation.

To me it does mention quitting in the end but the focus is more on smoking reduction than quitting, even so the last sentence (in bold) isnt in the article and should be in any dual use section we have. AlbinoFerret 22:58, 14 January 2016 (UTC)

I agree that if the focus is cutting down, that's not cessation and probably should be in a different section.

As to terms, I'm fine with "cutting down" and "harm reduction". The sources say they're not one and the same. cutting down exposes the user to nearly the same cardiovascular risks as heavy smoking cutting down by more than 50% has no effect on risk of premature death I will respect the sources and not use the terms interchangeably. I think that would improve the article. Cloudjpk (talk) 23:25, 14 January 2016 (UTC)

That is contrary to the the last paragraph of the "Why it is important to do this review" section on page 7 of this Cochrane review, which says there are benefits from smoking reduction as harm reduction. and the views of a 2010 review that doesnt even mention e-cigs and a study from 2006 that doesnt mention e-cigs either, cant negate the findings of a 2014 Cochrane review. AlbinoFerret 23:48, 14 January 2016 (UTC)

It doesn't say they're the same thing :)

The sources are not actually in conflict. There is hope that cutting down may contribute to harm reduction. That does not make them one and the same. We might also hope that vaccination may contribute to disease prevention, but that does not mean the two are one and the same. I think clear and consistent terms will improve the article. Cloudjpk (talk) 00:27, 15 January 2016 (UTC)

Yes it does "owever, there is also an opportunity to investigate if the EC has potential to aid reduction in cigarette consumption in those smokers who cannot or do not want to stop smoking altogether." thats harm reduction. In any event the weight of newer sources say there is a benefit from even dual use, small but existent, including the WHO in 2014 "dual use will have much smaller beneficial effects on overall survival compared with quitting smoking completely." So there are some benefits not "hopes". AlbinoFerret 00:47, 15 January 2016 (UTC)

I'm fine with that, and I think it furnishes a good illustration of use of terms: quitting delivers harm reduction, cutting down delivers much smaller harm reduction.

BTW I see some sources use "cutting back" or "reducing consumption" but "cutting down" seems to be most used in the sources. Any preferences? Cloudjpk (talk) 00:58, 15 January 2016 (UTC)

Cutting down is ok, but in the harm reduction I think reduce smoking is a little better to differentiate between HR and dual use in cessation. I have rewritten the claim

A review found e-cigs to be much more effective than patches or placebos to help people reduce cigarette smoking by 50% or more. Further study will be needed with biomedical evidence to support these findings.

Thoughts? AlbinoFerret 14:26, 16 January 2016 (UTC)

• OKsounds like the two of you are good with putting this into the harm reduction section. I think we just need to add the Cochrane authors' caveats around it and we are good to... Jytdog (talk) 01:03, 15 January 2016 (UTC)

Semi-protected edit request on 16 January 2016

This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.

Laika19 (talk) 06:24, 16 January 2016 (UTC)

Recently, a meta-analysis was published showing that e-cigs might actually make it harder to quit smoking. The new analysis suggests that e-cigs make people 28 percent less likely to quit smoking. Source: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00521-4/abstract

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. --allthefoxes 13:39, 16 January 2016 (UTC)

Interesting abstract, but "Odds of smoking cessation among smokers using e-cigarettes compared with smokers not using e-cigarettes were assessed " - this appears to be about dual-use. Johnbod (talk) 13:47, 16 January 2016 (UTC)

I also have concerns about one of the authors Stanton Glantz a known anti tobacco activist. More than just an abstract is needed and this is behind a paywall. It is also not pubmed indexed. AlbinoFerret 13:56, 16 January 2016 (UTC)

There's nothing much wrong with being "a known anti tobacco activist", though Glanze is also hardline anti-ecig, and a bit extreme I think. The article is free if you register (in the UK anyway), and just published online. No doubt it will be listed on PubMed in due course - The Lancet is certainly a top journal with an impact factor of 45 (and anti-ecig), though this is I think only a specialist sub-journal. Johnbod (talk) 14:23, 16 January 2016 (UTC)

Yes, and these biases will probably require accreditation if it comes in. Cant find the sub journals impact factor, might not be listed. AlbinoFerret 14:32, 16 January 2016 (UTC)

Having a position is not the same as bias: and this is an excellent journal and a top quality study. From what I can see it should definitely be added to our article and is very pertinent. The prior argument is a prime example of WP:BIAS — per the pertinent and recently debated section of WP:MEDRS:
        "Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, or conclusions."
Ping WhatamIdoing, who may have some insight as to the interpretation of that section. CFCF 💌 📧 15:50, 16 January 2016 (UTC)

Up until TMCk added the links below, my concerns were not to exclude the material but to add in text accreditation per WP:BIASED. AlbinoFerret 16:27, 16 January 2016 (UTC)

Reminds me of the formaldehyde scare or to a lesser degree the ambigoues propylene oxide claim (also Glantz) that remained in the article for far to long. Now we have this new review and (already) plenty of critical responses: "...not scientific."... , "...at best preliminary or at worst “grossly misleading...”, "...tentative and sometimes incorrect.”
So I'm wondering how much weight this flawed article deserves.--TMCk (talk) 15:54, 16 January 2016 (UTC)

You are aware that the Lancet and BMJ similarly criticized the PHE report? Or do we only find rebuttals when it suits us? Wired, The Guardian, BMJ.
To take it to the extreme, this article has a pretty decent title concerning criticism of the PHE report: E-cigarette ‘safety’ study was written by industry funded scientists, Lancet warns. CFCF 💌 📧 16:05, 16 January 2016 (UTC)

The PHE report wasnt written by a anti tobacco/anti ecig activist. Any use will have to be accredited to him. Though looking at the links above, its questionable what use it could have. AlbinoFerret 16:18, 16 January 2016 (UTC)

• I think it's pretty obvious that we need to include this source in the article. I propose that it belongs in the dual use section that we're discussing above, and the tricky issue will be how much weight to give it. Off the cuff, I would suggest that a controversial paper in The Lancet should get less weight than the Cochrane Collaboration and somewhat less than clinical practice guidelines from major Western democracies, but more than most other sources.—S Marshall T/C 17:18, 16 January 2016 (UTC)

It's not about dual use; it measures the effect of e-cigarette use on cessation of smoking. It does not break out users who were or were not dual users. So the Cessation section seems appropriate.

As to weight, it uses the same methods as Cochrane but includes more and newer studies than were available to Cochrane. Cloudjpk (talk) 22:55, 16 January 2016 (UTC)

• I think Johnbod's right and it's at least partly about dual use; the fact that it doesn't break out dual users from quitters is a design flaw. Simply put, the Cochrane Collaboration is the most reliable source in medicine, and the idea that a brand new just-published study proves Cochrane wrong is the sort of thing that we might normally see coming from an IP address on Talk:Homeopathy.—S Marshall T/C 09:56, 17 January 2016 (UTC)

I agree with you. The scientific writer in me wants to dismiss this paper for all the flaws in it. However by policy it must be included and I agree that it meets the criteria for inclusion and reasonable weight. I would also assess it for the same weighting as S Marshall. SPACKlick (talk) 20:24, 16 January 2016 (UTC)

S Marshall, TracyMcClark, and SPACKlick what is your opinion on in text accreditation per WP:BIASED? AlbinoFerret 20:48, 16 January 2016 (UTC)

I agree that by policy it should be included, flawed or not. It will be interesting though, to see the responses in the peer-reviewed press - since i find the criticism by Pf. Ann McNeill to be particularly damaging "This review is not scientific. The information included about two studies that I co-authored is either inaccurate or misleading. ...".

I think this is one of the studies that we are going to have to keep an eye on, particular with regards to replies/commentaries if we are to take Pf McNeill's commentary seriously. --Kim D. Petersen 00:17, 17 January 2016 (UTC)

It took me a moment to figure out that AlbinoFerret meant WP:INTEXT attribution, when he (or his spilling chucker  ;-) typed "accreditation". I don't think this is necessary; you're never going to see "News flash: Professors of Medicine oppose tobacco!" in the headlines.

On the question of the MEDRS line above, it helps to read it in context. Don't replace a meta-analysis with primary sources because you personally believe that the author is "extreme" (or whatever your objection to him is). Of course, if you've got dozens of meta-analyses, then you should pick from among the best; you can't cite them all. And no matter what, you should accurately describe the actual results, e.g., "People who use both are no more likely to quit that people who use only one" rather than "Science proves that ecig users are incapable of quitting". WhatamIdoing (talk) 05:11, 17 January 2016 (UTC)

Thoughts about health section

It seems to me that the health section could be best structured by:
1) Naming the questions about health that are relevant - that everybody wishes we had very clear and definitive answers to
a) are they harmful on their own to users and people around them?
b) are they less harmful than cigarettes to users and people around them?
c) Do they help people quit smoking? How does their use compare with NRT for this purpose?
d) Do the they help people smoke less? How does their use compare with NRT for this purpose?
e) Do they increase the amount of people addicted to nicotine?
f) What recommendations should the public receive, about use of e-cigs?

2) Discussing the difficulties of answering those questions - why we don't have clear answers on many of the questions
a) e-cig technology is new, rapidly evolving, not standardized, and is customizable by users. This means that there is not that much published research on e-cig use at all (compared to cigarette use and NRT use, each of which have been around a long time), and that we cannot yet understand the consequences of long-term use. It also means that any single research study needs to be interpreted with care, and that any given study is difficult to generalize to the use of any e-cig device.
b) All scientific research is artificial. Generally a study will use one kind of e-cig device and liquid but in the real world, how much an individual likes to use a given device and liquid will strongly effect how much he or she uses it. This makes it hard (not impossible) to generalize the results when discussing the use of e-cigs in quitting smoking and reducing smoking.
c) There is a lot at stake in the results of the research and what recommendations are made based on it (tobacco money, NRT money, e-cig money, public health with regard to the stark known risks of cigarette use and with regard to the possible risks of e-cigs which are becoming widespread)
d) There is a growing body of published research on e-cig use. Researchers choose different populations to study, do different things with them, and ask different questions of them; every scientific study takes care to understand and takes care to apply to any general conclusions
e) There is a growing body of expert reviews of the research, done by scientists and by public health-oriented institutions. Those reviews have come to different conclusions about we know and have made contradictory recommendations about e-cigs. This is based on part on what questions the reviewers are asking, what criteria they use to include or exclude the published studies, and what is at stake for them.

3) Answers
3a) Summarize the answers to the questions in a brief section, simply. On a few of these questions I think there is consensus in the literature and we can say "yes or no". If there is not consensus in the literature, then we just say "Expert reviews come up with different answers on this question." Very simple and brief.
3b) Provide the details of reviews from the past two years or so on the questions, to support the summaries provided above. (this is the clutter that some people will just skip over, but that people who really want to know will read)

What do you think of this? Jytdog (talk) 17:33, 16 January 2016 (UTC)

One common complaint is this talk page moves to fast, and we have recently see it slow down a little. Please notice the number of archives. Adding sections to the page that already has other ongoing discussions will likely not help keep this page slowed down. But I am glad to see you recognise the problems pointed out in section #2. AlbinoFerret 18:12, 16 January 2016 (UTC)

Folks can respond or not as they please. There is no deadline. Jytdog (talk) 19:17, 16 January 2016 (UTC)

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