Talk:Heated tobacco product/Archive 8

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Older versions or expanded version

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


Should we support the expanded version (proposed draft) or go back to the January 9, 2019 or the December 26, 2018 version or current version? QuackGuru (talk) 21:57, 12 January 2019 (UTC)

  • I favour a slightly earlier Jan 9th version, as last edited by Carl Fredrik (differs by an image-alignment sock edit and the removal of this image, which QuackGuru later replaced with a more promotional image supplied by Phillip Morris). A diff of the QuackGuru version and the above version is here.(outdated) I have been continuing to add content to the article, some of which QG has modified and added to QG's draft.

Still discussing and editing the article. QG, can you explain why you called an RfC without doing any of this discussion first? You could integrate content from the draft into the article using normal processes; I just objected to you completely replacing the article with no discussion.

I think that while some of the content of QuackGuru's version should be integrated, QuackGuru's version has suffered by being written by a single contributor working alone in draftspace. QuackGuru's version minimizes and omits some information critical of the article subject (for instance, the reasons that independent researchers consider "heat-not-burn" and "smoke-free" to be inaccurate). QG's idiosyncratic insistence that each statement be one sentence with one citation also leads to a very choppy, repetitive, long-winded, and sometimes contradictory writing style. For instance, the section on health effects is much longer and less legible; the first sentence defines the subject as having battery-powered heating systems, citing the WHO, a good source; but the rest of the article mentions charcoal-, butane- and mains-powered devices. More detailed criticism in comments section below. HLHJ (talk) 04:09, 13 January 2019 (UTC)
The content about "independent researchers consider "heat-not-burn" and "smoke-free" to be inaccurate" is misleading content and uses popular press media rather than MEDRS compliant sources. I restored a high quality image that was removed without consensus. This image is low quality. The expanded version does not minimize or omit any information critical of the article subject that was well sourced. It omits negative information cited to sources that are MEDRS violations. Stating "They may or may not generate smoke.[10]" is neutral. Stating they produce "smoke" throughout the article is clearly not neutral. QuackGuru (talk) 05:05, 13 January 2019 (UTC)
Is this your position?
  • if Phillip Morris and competitors say "heat-not-burn" and "smoke-free", those are not medical claims, and do not require MEDRS (and may be said in Wikipedia's voice)
  • if independent researchers say that these terms are misleading, quoting them is a medical claim, and requires MEDRS
I replied to an earlier version of the previous post in the comments section, below; this is a reply to QG's update of Jan 15th. HLHJ (talk) 05:53, 16 January 2019 (UTC)
It depends on the specific claim whether they are or are not MEDRS violations.
See "However, independent researchers who tested a common "heat-not-burn" device explicitly disagreed with the claim that they are smokeless,[1][2] arguing that the emitted aerosol is smoke, as it contains pyrolysis products.[3] Independent researchers studying the aerosols produced by heat-not-burn products commonly call those aerosols "smoke".[4]

References

  1. ^ Wan, William (2017-08-11). "Big Tobacco's new cigarette is sleek, smokeless — but is it any better for you?". Washington Post. ISSN 0190-8286. Retrieved 2018-05-27.
  2. ^ "FDA Panel Gives Qualified Support To Claims For 'Safer' Smoking Device". NPR.org. Retrieved 2018-06-04.
  3. ^ Auer, Reto; Cornuz, Jacques; Berthet, Aurélie (2017). "Perplexing Conclusions Concerning Heat-Not-Burn Tobacco Cigarettes—Reply". JAMA Internal Medicine. 177 (11): 1699–1700. doi:10.1001/jamainternmed.2017.5861. PMID 29114801.
  4. ^ Mallock, Nadja; Böss, Lisa; Burk, Robert; Danziger, Martin; Welsch, Tanja; Hahn, Harald; Trieu, Hai-Linh; Hahn, Jürgen; Pieper, Elke; Henkler-Stephani, Frank; Hutzler, Christoph; Luch, Andreas (2018). "Levels of selected analytes in the emissions of "heat not burn" tobacco products that are relevant to assess human health risks". Archives of Toxicology. 92 (6): 2145–2149. doi:10.1007/s00204-018-2215-y. ISSN 0340-5761. PMC 6002459. PMID 29730817., and sources therein
The content about smoke-free was rewritten to be more accurate without any MEDRS claims. See "The IQOS is marketed as a "smoke-free" alternative to traditional cigarettes, and promoted as a way to lower risk from smoking.[84]Talk:Heat-not-burn_tobacco_product/Proposed_draft#cite_ref-NZH2017_85-0 It was specifically about IQOS. Making general or vague claims is misleading or inaccurate. Again, the source about "smoke-free" was about PMI's IQOS. In the draft it is in the IQOS section.
The content about "independent researchers consider "heat-not-burn" to be inaccurate" contains marketing as well as MEDRS claims. If any part of the sentence is a MEDRS claim then it requires better sourcing than a news article or primary MEDRS source for critical content.
The part "...claim that they are smokeless" requires a MEDRS compliant source for critical content. The content is cited to Washington Post and NPR.org.
The part "arguing that the emitted aerosol is smoke, as it contains pyrolysis products." requires a MEDRS compliant source for critical content. It is cited to a reply article that is not MEDRS compliant titled Perplexing Conclusions Concerning Heat-Not-Burn Tobacco Cigarettes-Reply.
The content "Independent researchers studying the aerosols produced by heat-not-burn products commonly call those aerosols "smoke"." requires a MEDRS compliant source for critical content. It is cited to an article called iQOS: evidence of pyrolysis and release of a toxicant from plastic. It is an article about IQOS rather than heat-not-burn products in general and is a MEDRS violation.
There are other MEDRS violations. See "HnB products vary, but can heat to these charring temperatures.[23][2][1]" The first two citations ([23][2]) used are about IQOS and are MEDRS violations. The third citation ([1]) does not even mention charring.
The "Nature and function" is badly written and disorganized. I reorganized it and rewritten the content and moved some content to a section under Marketing. The section under marketing contains much more critical content and is neutrally written.
Multiple editors have stated they have concerns regarding the MEDRS violations among other issues for quite some time. I was the first editor who attempted to cleanup the mess. Instead of reverting back to an older version before the MEDRS violations were introduced I thought it would be a better idea to tackle the problems others brought up and expand the article.
The post on "08:19, 13 January 2019 (UTC)" below also discusses specific content that are MEDRS violations. So far you have not acknowledged the content that I believe are MEDRS violations in this discussion or the discussion below. Checking the edit history of the article I have not seen you remove sources that you added that I or others stated are MEDRS violations. If you have removed a MEDRS violation you added please provide a WP:DIFF.
The expanded version states among other things: The IQOS is marketed as a "smoke-free" alternative to traditional cigarettes, and promoted as a way to lower risk from smoking.[84]Talk:Heat-not-burn_tobacco_product/Proposed_draft#cite_ref-NZH2017_85-0 See Marketing: The term "heat-not-burn" refers to tobacco heated (at ~350 °C) by an electrically-powered element or carbon, not combusted (at ~800 °C).[11] Terms used in marketing of cigarette-like products that "heat rather than burn" are referring to the product as "reduced risk" and "innovative."[63] Marketing slogans like "heat-not-burn" cannot be a substitute for science.[88] Heat-not-burn tobacco products are not typically marketed as a harmless substitute to smoking.[26] QuackGuru (talk) 16:16, 16 January 2019 (UTC)
You said "It depends on the specific claim whether they are or are not MEDRS violations". I asked about two specific claims. Was your answer "Yes, that's my position: describing claims made by tobacco companies does not need MEDRS, but describing claims made by independent scientist does"? I'm not sure you've read my previous answers to my other points. HLHJ (talk) 04:16, 20 January 2019 (UTC)
I cited specific content in the article above that are MEDRS violations IMO. You have not acknowledged there is an issue with the sourcing in this thread. I assume you think there is not a serious problem with the sourcing in the current article. Correct me if I am wrong. Your questions are overgeneralizing the dispute. It is not a simple yes or no answer. This is done on a case-per-case basis. I would have to review each claim and source. That is what I did above. QuackGuru (talk) 18:18, 20 January 2019 (UTC)

@QuackGuru: can you implement the changes between your version and the current version in this article, undo the edit, and link to the diff of your changes? It's very hard to follow what the proposal is asking without linking a diff with proposed changes with respect to the current revision.

Also, I think the discussion of whether or not these products generate some smoke or whether or not "heat-not-burn" is an accurate label is a red herring. If some of these products happen to generate some smoke as a result of overheating its content, just explicitly state this in the article and cite it to a MEDRS-quality source. The title of the article shouldn't be changed merely to reflect the fact that some or all of these products happen to burn content or generate smoke when that is not their WP:COMMONNAME though.

Anchored statement: Any claim in the article about how these products function should be cited to a reliable medical source given that their function impacts the health of the user (e.g., if you say "the device can explode" or "the device generates toxic particulate matter", then the statement you've written carries a clear implication that operating the device carries a risk of burning the user or causing exposure to toxicants; both sets of statements unequivocally require MEDRS). This should not be a terribly difficult constraint to adhere to given the amount of medical sources that exist about these devices.

Lastly, as for marketing claims about a health-related effect, the general consensus from the discussions at the FACs for β-hydroxy β-methylbutyric acid is that marketing claims should not be stated in an article without citing a reliable medical source which supports its use as such. A statement like "X is marketed as Y" – where "X is Y" would be construed as a medical claim – needs to be removed from the article unless one of the cited sources is a reliable medical source that covers evidence supporting the statement "X is Y". Otherwise, this would violate WP:NOTADVERTISING. Seppi333 (Insert ) 07:14, 23 January 2019 (UTC)

@Seppi333: the proposal is replacing the current version with the proposed draft. See proposed draft. Anything that was worth integrating from the older version is already part of the draft. See diff for the proposal. QuackGuru (talk) 10:30, 23 January 2019 (UTC)
Noting a previous RfC, which discussed how content in the form "X is marketed as Y" can be included and critiqued: "We should prefer sources which directly refer to the marketing claims, though sources that address the same health claims as a marketing claim can be used sparingly if no direct critique is available and an alternative source is needed to accord due weight."
QG, I had already addressed your individual claims of MEDRS violations individually below, but from your post above I don't think I can have made myself understood. I do not understand your interpretation of criteria for when MEDRS are needed. Is it your position that describing claims made by tobacco companies does not need MEDRS, but describing claims made by independent scientists does, even if the one claim is a negation of the other? HLHJ (talk) 19:20, 27 January 2019 (UTC)
Why exactly are marketing claims even being covered in this article to begin with? Including those in an article like this seems like an indiscriminate collection of facts about product marketing given that this article encompasses a number of different brands. Considering how much discussion has taken place on this issue, including these is clearly a can of worms, so why not just delete the claims altogether and state the actual evidence?
Writing something like "Product is marketed as XYZ, but evidence suggests ABC" or "Product is marketed as XYZ, which is supported by evidence" is just verbose and unnecessary when you could just say "Evidence suggests ABC/XYZ about Product". Seppi333 (Insert ) 03:51, 28 January 2019 (UTC)
My understanding is that these products produce smoke under correct use conditions; it is what they are designed to do. I think due weight will probably require, at a minimum, coverage of the marketing names of these products (as marketing claims, not as facts), and their accuracy. One of the products, IQOS, is strikingly dominant in market share and in coverage by reliable sources, and the article reflects that. There's sources like an entire four-part Reuters investigation, largely covering marketing efforts, broadly construed[1]; one of the sections is called "How Philip Morris is selling regulators on its hot new smoking device", so the balance of reliable sources may require more extensive coverage of marketing, but this is a separate issue. HLHJ (talk) 02:25, 30 January 2019 (UTC)
  • support there are so many problems with the main article that it is a bit shameful WP allows work like this to remain. —Atcovi (Talk - Contribs) 19:01, 12 February 2019 (UTC)
    • Atcovi, could you please specify any remaining problems, so that I can fix them? HLHJ (talk) 07:22, 22 February 2019 (UTC)
  • Support change to Draft:Electric smoking system. There are maybe 100 individual points under contention here and it is not possible to debate them all. If the arguments are to be ongoing then maybe there can be resolution by routine large jumps to particular versions. In that scheme, maybe there could be debate for 6 months on individual points, then about every 6 months whoever wants to nominate an entire revision can do so and there can be discussion on selecting that revision.
In this case the current version is about 17k and the proposed version is 50k. In general, I favor keeping more well-referenced information in Wikipedia. I try to avoid Wikipedia:Removal of Wikipedia articles on notable topics, and am in favor of having more content in Wikipedia. Popular articles like this one (16k/month, which I think is top 0.1% by popularity) should be solid in the 30-50k range if possible per Wikipedia:Article size. If it gets much longer then probably some aspect of this could be subdivided, but the content should have a home somewhere in Wikipedia.
Since the advent of these devices all related articles have continually been among the most contentious in Wikipedia. Overall, I like the debates and I think WP:WikiProject Medicine does also, which I identify as the community most concerned with the content. I do worry that the debates are too nuanced for causal contribution and wish there was an obvious way to get more editors here. This is not a good place for new editors, but I do wish experienced editors who were new to this topic could better engage.
I do not think that there has ever been a WP:Status quo here so I see no reason to avoid sweeping changes. I agree with HLHJ that Quackguru's proposal is not concise or easy to read. However, I would say that about most articles in this category. My !vote is for revolution and seeing what can come next after I have seen over the years a series of blocks in article development. Good luck with this. Blue Rasberry (talk) 01:40, 13 February 2019 (UTC)
  • Support agree with Blue Rasberry Cloudjpk (talk) 20:23, 22 February 2019 (UTC)

Comments on older versions or expanded version

See previous discussion. There was no consensus for the charred pizza image. Others also disagreed with including the image. I and others disagreed with other content. Also, there was another problem. The section called Nature and function is heavily based on primary sources and popular press articles against WP:MEDRS. See "Another probablematic aspect of this whole section in the article is that it is based almost entirely on either primary WP:MEDRS sources (such as the St.Helen at al(2018) one), or non-MEDRS articles in popular media. Both of which should be unacceptable for Wikipedia sections within this realm (science/medical info)."[2] I did my best to merge any content that was sourced and neutral rather than revert back to an older version. Adding multiples sources after each claim in order to try to verify the claim is a SYN violation or original research.

The expanded version is much more neutral. For example, see "As it starts to heat the tobacco, it generates an aerosol that contains nicotine and other chemicals, that is inhaled.[4] They may or may not generate smoke.[10]" A lot of the older content was not supported by the sources and was blatantly bias. The expanded version does explain it may emit smoke in a neutral way. Articles on Wikipedia should be neutral and supported by the citation given. QuackGuru (talk) 21:57, 12 January 2019 (UTC)

As I said above, a major problem I have with QGs's version is that it is hard to read and not very succinct. While it contains some additional sources, it does not convey information as well as the multi-editor versions.
 
This pizza was baked for four hours. Like the tobacco in these products, it has charred, and it has released pyrolysis products and particulate matter, but most of the carbon has not oxidized and it has not been reduced to ash (see carbonization).
My comments from the charred pizza discussion stand:

The pizza is charred. The image itself is a sufficient source for that statement, as it is not in the least extraordinary and readily verifiable by anyone looking at the image. I have RS saying that the function of the article topic also involves charring. I therefore use the pizza as an illustration of charring, linking the somewhat abtruse functioning of a piece of new tech to an experience most people will have had.

The accompanying section covered debate on whether charred tobacco is to be considered "heated" or "burned", and whether it emits "smoke" during the process, describing statements made by marketers and public health researchers. Nicotine company marketing has included a lot of complicated sciencey-sounding statements around this question, so I think it's important that Wikipedia provide a clear illustration of the technical concepts.
On popular media sources, I quote myself from the earlier discussion:

The popular media sources are only used for statements about what marketing messages are used and who argued about them; I think these are suitable statements to support with journalistic sources, as they are not biomedical.

As I recall, I improved the research article sources in response to criticism by KimDabelsteinPetersen (which you quoted). In the previous discussion, I went over where I thought MEDRS were needed and where I thought they were not in some detail. I also went over the image's policy compliance point-by point. I am happy to address any new counterarguments more detailed than "disagree".
I do not agree that the QuackGuru version is more neutral. For instance, QG replaced "smoke" with "aerosol" throughout. Carl Frederik stated in an earlier discussion that there was a consensus to use "smoke". When independent researchers in the field explicitly discuss the question of whether there is smoke (as opposed to using tobacco-industry terms in passing, because there are no other common terms), they say it's smoke. In the aforementioned earlier discussion, Sarah at PMI (Phillip Morris International) argued that "aerosol" is more neutral because smoke is definitely an aerosol, so no-one disputes that the emissions are an aerosol. It is not, however, the case that neutral, accurate content is content that no-one disputes. I favour the term which is
  1. supported by independent, expert sources
  1. disputed by the tobacco industry (their independence and reputation for accuracy in such debates is nil)
  1. more specific
  1. a common, non-technical English word (how often is the non-technical term more specific? here we can have both!)
Some of the text also seems a bit weasel-wordy. For instance, "There is a lack of evidence on the possible effects of second-hand exposure. There is anticipated to be a reduced risk to bystanders where smokers were using heat-not-burn tobacco products instead of smoking" replaces "The effects of second-hand exposure are unknown".
While I support having a "marketing" section, QG's proposed section is seems to be a longer re-write of the "Nature and function" section, with the criticism of the accuracy of tobacco marketing messages and the information on how the products actually function removed. This information is essential to a neutral coverage of a topic on which many have strong incentives to provide misinformation. A marketing section could include new information, relying on sources such as this Reuters investigation (which QG found, and it's excellent). HLHJ (talk) 04:09, 13 January 2019 (UTC)
Criticism of the accuracy of tobacco marketing messages and the information on how the products actually function was removed because the sources did not verify the claims. A lot of content does fail verification and are using non-compliant sources against MEDRS. Editors can tag the content. I chose to remove the content that misrepresents the sources. I think it is a good idea to omit content that misrepresents sources. For example, the WHO source states "Heated tobacco products are tobacco products that produce aerosols containing nicotine and other chemicals, which are inhaled by users, through the mouth."[3] It does not verify smoke. Another example of misleading content is the following: "HnB products vary, but can heat to these charring temperatures.[23][2][1]"[4] The WHO source does not verify the claim. So far no source has been presented that connected an overcooked pizza image with this topic. QuackGuru (talk) 05:24, 13 January 2019 (UTC)
Quoting myself from the charred pizza discussion again:

I therefore use the pizza as an illustration of charring, linking the somewhat abtruse functioning of a piece of new tech to an experience most people will have had. I think this is a good illustration, as it will promote understanding of the article's topic. I do not think I need a source that says that each image is related to the article's topic. Many illustrations on Wikipedia have no such source. If you are arguing that all illustrations need such a source, please provide a link to the policy that says so.

Another self-quote from previous discussion, this one on verification of the word "smoke":

My understanding is that a consensus to use a consistent term overrides the term used in a specific source, as it has at the e-cigarettes article. Independent and non-independent, or technical and non-technical sources, may well use different terms, while the Wikipedia article uses a single consistent one. As long as it is clear that we are talking about the same thing, and are thus still accurately representing the source, I don't see this as a verification problem.

The WHO source gives a temperature in degrees which is within the range of charring temperatures given in the source cited right next to it. The source giving the range also says that a specific product falls within that range; the WHO source says that other products run at similar temperatures. Figuring out if a number is within a range of other numbers is a trivial calculation, not original research. HLHJ (talk) 06:43, 13 January 2019 (UTC)
User:KimDabelsteinPetersen explained "another problem: Based entirely on primary MEDRS sources, and non-MEDRS sources."[5] KimDabelsteinPetersen also stated "Disagree entirely. The image provides a POV (personal view) not expressed by the majority of sources on this topic, and as far as i can tell entirely unsupported by reliable sources."[6] The issues brought up by KimDabelsteinPetersen about the poor quality sources have not been fixed by removing the poor quality sources from the Nature and function section from the shorter version. The section called Nature and function is disputed and never gained consensus. I initially made an effort to address the concerns brought up by KimDabelsteinPetersen by rewriting and improving the section. After you made bold edits others have disputed the content. For example, User:Sennen goroshi reverted back the changes including changing the word from smoke to aerosol in the body of the article. Sennen goroshi stated "Hi, HLHJ - I think the general tone of the article was very biased. Lots of weasel words and implications. While other content was obviously misleading. "Surveys have found that about half of users have never smoked conventional cigarettes" Is blatantly misleading."[7] Adding negative content using poor sources is not a neutral coverage of the topic. Content such as "There is anticipated to be a reduced risk to bystanders where smokers were using heat-not-burn tobacco products instead of smoking."[8] is sourced to the Committee on Toxicity. It is MEDRS compliant and accurate according to the source. This kind of content brings balance to the article. Adding highly negative content using popular press articles for MEDRS claims and primary sources that are MEDRS violations is not going to make a better article. For example, the content "However, independent researchers who tested a common "heat-not-burn" device explicitly disagreed with the claim that they are smokeless,[30][31] arguing that the emitted aerosol is smoke, as it contains pyrolysis products.[32]" is using sources that are not MEDRS compliant. This is negative content. This is the kind of problem KimDabelsteinPetersen brought up about the poor sources. These are not new arguments I am making. The poor sources were brought up in previous discussions. For example, User:LeadSongDog stated "On a related point, there seems to be less than due care with regard to wp:MEDRS vetting of sources both here and at some of the ecig related articles."[9] User:Ozzie10aaaa agreed.[10] A concern with the shorter version is that it contains little information from recent MEDRS compliant sources. I attempted to address the issues with the poor sources and the lack of MEDRS sources by removing poor sources and citing many MEDRS compliant sources. For example, the content "Independent researchers studying the aerosols produced by heat-not-burn products commonly call those aerosols "smoke".[33] Independent research has also disputed the claim that the products are "heat-not-burn" devices.[2][34]" fails to comply with MEDRS. New content such as "A 2018 Public Health England (PHE) report found "Compared with cigarettes, heated tobacco products are likely to expose users and bystanders to lower levels of particulate matter and harmful and potentially harmful compounds (HPHC). The extent of the reduction found varies between studies."[25]" adheres to MEDRS.
I do see it as a problem when the WHO does not verify "smoke". The WHO source verifies aerosol. That's the reason the content fails verification.
The WHO source does not verify "charring temperatures". The WHO source does not state it is within the range of charring temperatures. The other sources do not verify the broad claim "HnB products vary, but can heat to these charring temperatures.[23]".[11][12] The other sources discuss a specific brand not HnB products in general for the claim. IQOS does not translate into HnB products. Therefore, all three citations fail verification. QuackGuru (talk) 08:19, 13 January 2019 (UTC)
As you say, these are not new arguments you are making; some are over four months old, older than any of the versions of the article we are discussing here. Both the sourcing and the content have changed since. I think I have replied to all of the criticisms you quoted above. Some of the criticisms were specific and well-justified; I acknowledged and fixed some content and citing. The changes I made also addressed the more general criticisms, though where I did not get responses I cannot tell if I have entirely resolved those concerns. I made efforts to get feedback; for instance, I posted to Sennen goroshi's talk page. Some editors posted support of the content, which you have not quoted. I do not intend to quote the entirety of these past discussions; you can read through them at post-rename Archive 4, Archive 1, Archive 2, and Archive 3. I am not in the least opposed to making further efforts in response to further criticisms, nor am I stating that your new version contains no new useful content or sources.
I mentioned the need for consistent terminology in articles referencing diverse sources using inconsistent terminology. Can you tell me what you did not understand about my comment?
On the content on charring temperatures, let's use an analogy. Suppose we have two sources; one says "The Crazy District is located between 3rd and 7th Avenue downtown; Hotel Alpha is in the Crazy District, on 5th Avenue" and the other says "Many hotels are located downtown on 4th and 5th Avenues". A sentence citing both could say "The Crazy District, between 3rd and 7th Avenues downtown, contains many hotels". The synthesis is limited to a trivial assessment that the range 3 to 7 encompasses 4 and 5. See Wikipedia:No original research#Routine calculations.
I would point out that no product in this category comes anywhere near matching the sales of IQOS, so almost all the sources are on IQOS. Combining detailed information from sources about the functioning of IQOS with general information from sources saying that its competitors function in the same way on specific, quantifiable parameters like operating temperature seems a good way to deal with this situation. HLHJ (talk) 23:00, 13 January 2019 (UTC)
User:Jytdog stated in part on 14:09, 17 August 2018: "You will need MEDRS sources for such content. I say that generally, but if you are not aware, please do be aware that there are DS on e-cigs as our pages on ecigs are contentious, and health claims sourced to non-MEDRS sources get shot down quickly on those pages."[13]
You stated in part on 03:05, 18 August 2018‎: "There are plenty of good medical sources on nicotine use; detailed sources on nicotine promotion are actually harder to find. I would definitely never use this as a MEDRS, but thanks for the warning."[14]
It seems you understood back in August 2018 for biomedical information (health-related content) WP:MEDRS sources are usually required. However, editors have been complaining about the popular media and primary MEDRS sources in this article and in the Nature and function section.
As a compromise, I did include "The IQOS HeatSticks do not generate a flame, they are charred following use.[38]" in the proposed draft. The source is not a very high quality source but I did want to include something about charring because I know you want that included in the article. I'd rather the content be accurate rather than make vague or broader claims than the source is making. That's why the content states "The IQOS HeatSticks..". rather than HnB products in general. I did mention the MEDRS violations above. You have not directly stated whether you think the content I quoted above are MEDRS violations in this thread. They are still in the Nature and function section. The proposed draft makes an effort to fix the concerns. Citation clutter decreases readability. Adding one citation per claim for the proposed draft increases ease of reading for our readers. See WP:CITATIONBLOAT, WP:Citation overkill, and WP:BOMBARD. QuackGuru (talk) 18:33, 17 January 2019 (UTC)
Jytdog was not talking about content in this article, but about content in a source I'd brought to the reliable sources noticeboard, for use in a completely different article; the source is not cited here. I must have told you half a dozen times that I disagree with your idea that one citation per sentence always makes text clearer. Looking over the article content, statements about the health effects of the products are cited to systematic reviews, WHO guidelines, and similar high-quality sources; statements about who said what are cited to popular media sources; and a few studies are referenced individually ("according to a small survey done in Italy"... "In one manufacturer-led study", both citing secondary sources, though not systematic reviews), as WP:MEDRS recommends:

If conclusions are worth mentioning (such as large randomized clinical trials with surprising results), they should be described appropriately as from a single study:[example omitted]... Given time a review will be published, and the primary sources should preferably be replaced with the review. Using secondary sources then allows facts to be stated with greater reliability:[example omitted]... If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed.

So the citing seems appropriate to me. I'm concerned that some of your content is misleading and inaccurate; for instance "There is no information available on potential impact of maternal inhalation of heat-not-burn tobacco emissions during pregnancy on fetal outcomes", when we have extensive MEDRS saying that these products contain nicotine and maternal nicotine use seriously harms the child, seems to fall short.
Of late, QG, I've spent more time arguing with you here than writing content, and I don't think we are getting anywhere, or will reach a consensus. Let's spend our time on more productive things. HLHJ (talk) 04:16, 20 January 2019 (UTC)
The proposed draft removes many popular press articles and primary MEDRS sources that were making MEDRS claims IMO.
The article states "There is no information on the effects of smoking HnB devices during pregnancy, as of 2018.[18]"
The draft states "There is no information available on potential impact of maternal inhalation of heat-not-burn tobacco emissions during pregnancy on fetal outcomes, as of 2018.[11]"
The sentence in the proposed draft is more accurate than what the article currently states.
See "Neither is there information on the potential impact of maternal inhalation of heat-not-burn tobacco smoke during pregnancy on fetal outcomes, all of which require urgent attention."[15] The content is accurate, according to the source. There is very limited research on this topic. Research on maternal inhalation of heat-not-burn tobacco is currently unavailable. Sources that do not mention heat-not-burn tobacco products are off-topic and undue weight. I expanded the pregnancy section using two sources that were already in the draft.
The draft now contains more critical information on pregnancy than the current article states.
See Electric smoking system#Pregnancy.
See Draft:Electric smoking system#Pregnancy. QuackGuru (talk) 05:15, 20 January 2019 (UTC)
Given that the diff literally doubles the size of the article and modifies most of the existing text, I'm going to need a few days to go through that. Seppi333 (Insert ) 12:13, 23 January 2019 (UTC)
 
This pizza was baked for four hours. Like the tobacco in these products, it has charred, and it has released pyrolysis products and particulate matter, but most of the carbon has not oxidized and it has not been reduced to ash (see carbonization).

I haven't read this entire thread, but my gut reaction to seeing this image in an article on a topic other than one on charring or pizza would be to remove it; in this context, it's being used to liken tobacco burning to a burnt pizza as an analogy, which is really not encyclopedic. It would be appropriate to show an image of burnt tobacco and discuss charred residue and its pyrolysis products in the image caption; if desired, adding an appropriate image and captioning it in this manner can be used as a replacement. As for the moment, I'm going to remove the pizza image because I think it detracts from the article for the aforementioned reason. Seppi333 (Insert ) 05:46, 23 January 2019 (UTC)

An image showing one of these charring cigarettes, used, and split open to show the charring, would be a useful addition to the article, but we don't have such an image.
This image serves a different purpose. I'm likening charring tobacco to charring pizza, as an analogy to illustrate charring. The charring process is generally common to organic matter. I think most readers will be familiar with charring food, but will not immediately think of it when they hear "char", so I think the analogy will increase comprehension. I take it from Seppi333's revert comment ("this isn't encyclopedic coverage of the topic: cover it directly, not through an analogy") that it is analogy itself that is considered unencyclopedic. I don't understand this, and I'm willing to hear arguments to that effect. HLHJ (talk) 19:49, 27 January 2019 (UTC)
You're missing the point: how does this article topic have anything to do with pizza?
FWIW, I'd never immediately associate "char" with food given that I've never been dumb enough to leave something in a high-temperature oven until it's incinerated. I associated that term with this, which is probably the most common form of charring an individual encounters in daily life. But again, burnt firewood is not burnt tobacco, so that is not a suitable image for this article. Read the first two paragraphs of MOS:IMAGERELEVANCE and it should be clear as to why that is the case. Seppi333 (Insert ) 04:09, 28 January 2019 (UTC)
 
There are some superficial spots of charring on this marshmallow, but it's a bit hard to imagine it producing smoke, as it was probably being held over a fire that produced a lot more smoke
Hello, Seppi333, and sorry I misunderstood. I agree that the article has nothing to do with pizza; so I didn't go looking for pizza images, but images of charring. I didn't look for an image of firewood, because that generally first chars and then burns oxidatively, releasing the carbon; not the process I was trying to illustrate. I may be unrepresentatively bad. I've charred food lots of times: burnt it to the bottom of a pot, left it too long in the fire or oven, you name it. I've never baked anything until it was quite as badly charred as that pizza, but I can easily imagine the process, including, critically, the aerosols it would produce. Can other people also imagine this? Is there some other image that would bring these ideas more vividly to mind?
There are not as many photos of charred anything on Commons as I expected, and I was glad to find this one, as flatbread (and more modernly pizza) is a fairly widespread food. I think it meets those two paragraphs; it is an "illustrative aid to understanding" charring, and while the photo does not look much like pizza (I would not illustrate the pizza article with it), it does look like a charred thing. The sample photo at MOS:IMAGERELEVANCE is a poor illustration of a helicopter and the Sydney Opera House, but a good illustration of an image that fails to show its putative subjects (avoiding Russell's paradox here). I'm open to suggestions of other images that would communicate the idea "charring". I would support the inclusion of any images showing these products in use or used, as I think this is a major omission in the article, but obviously I don't know, sight unseen, if such an image would illustrate charring as well. Do you have suggestions for how we should illustrate charring, given the images we currently have? HLHJ (talk) 02:07, 30 January 2019 (UTC)
@HLHJ: Have you considered just buying some loose tobacco, burning it, taking a photo, and uploading the image to commons? Seppi333 (Insert ) 03:26, 30 January 2019 (UTC)
@Seppi333: I did think about finding and taking photos of the low-T cigarettes, if they are available locally, though I haven't ever uploaded photos to Commons; not really my thing. If I used leaves, then unless I was very careful to just char it (by excluding oxygen? by adding humectants and large amounts of water, as these products do?), the photo would show oxidative combustion. Showing charring of a dark-brown substance would be difficult. Also, the dominant product here is filled with a dried film of tobacco slurry with some additives, rather than leaves. I'm not sure such a photo is the clearest way to bring a solid impression of charring to the minds of readers. I don't object to removing the image if we agree on a more vivid one to replace it, but I think it better than the lack of image we currently have. Charring is a very visual thing and I think we should show it. HLHJ (talk) 03:59, 30 January 2019 (UTC)
@HLHJ: I can't image that it would be illegal in your jurisdiction to just buy an unadultered tobacco leaf via an online vendor. Using the same "additives" that these devices mix in with it should not be hard to duplicate. Also, uploading an image to commons is extremely straightforward and only takes like 30-60 seconds: you add a license (use the default one: CC-BY-SA-4.0), the date the image was produced, and a file description... and you're done. Seppi333 (Insert ) 04:21, 30 January 2019 (UTC)
I was doubting whether I could readily find people using these devices, not the legality of tobacco leaves. I'm sorry, but I am not willing to order tobacco leaves online, simplify a list of dozens of ingredients down to the ones I think essential, source them via a chemical supply, mix them, burn them, take a photo which I don't think will show the subject well, and upload it. It sounds time-consuming. I know these are personal judgments, but it would not be fun, and I don't believe it would be very useful (which makes me mildly uneasy about the ethics), and I don't want to spend time and money on it. I don't have any objection to others suggesting, or even creating and suggesting, more suitable images. HLHJ (talk) 04:46, 30 January 2019 (UTC)
@HLHJ: This took all of 2 minutes to find on google images - that's licensed under {{CC-BY-2.0}}. Upload it to Commons, select that copyright license, credit "vaping360.com/iqos-phillip-morris/ (Vaping360)" as the original author, and specify https://www.flickr.com/photos/vaping360/31014691033 as the source of the image. Also, that does not look charred, so I'm wondering why you're suggesting that these devices burn tobacco anywhere close to the extent of that pizza. Seppi333 (Insert ) 06:53, 30 January 2019 (UTC)
The image was added to the draft without stating it was charring. That would not be neutral or verifiable. See Draft:Electric_smoking_system#Construction. QuackGuru (talk) 16:22, 30 January 2019 (UTC)
Thank you, Seppi333, that's a really good find. The heating element impales the tobacco and heats it from the center, so most of the charring is in the interior. This image from the same photoshoot[16], in which the tobacco is broken apart, shows it much better; the good outdoor light helps make the charring visible. Like the Flicker page you linked to, the source page says "free to use only when crediting image", but unlike the Flicker page, it does not seem to explicitly provide a license. I think a crop of this image would work for this section, if the photographer is willing to license it. How do others feel? HLHJ (talk) 02:15, 31 January 2019 (UTC)
It looks like someone broke apart the tobacco stick after use. It does not look natural. I would not use it. QuackGuru (talk) 23:52, 31 January 2019 (UTC)
That looks charred. Seppi333 (Insert ) 08:19, 31 January 2019 (UTC)
Despite the fact that I think the focus should rather be on the contents of the aerosol the users inhale, I do think these two photos are much more on-topic than a four-hour overbaked pizza. Thanks both of you for finding these. Cheers, Sarah at PMI (talk) 15:35, 1 February 2019 (UTC)
I'm having difficulty contacting the source page authors and asking them to include a legal CC-BY license as well as a colloquial-english permission; if someone who is on a social media platforms they use could do so, I'd be grateful, and if they do and you ping me, I'll upload it. HLHJ (talk) 23:56, 3 February 2019 (UTC)
Sorry, that's not something the {{helpme}} template is meant for. The website does have a contact form, though. If that doesn't work, then I doubt contacting them on social media would work. Huon (talk) 00:20, 4 February 2019 (UTC)
They are not responding by e-mail. Would someone please poke them on social media? HLHJ (talk) 07:21, 18 February 2019 (UTC)
Please don't add that poor image to this article. The draft has a better image. QuackGuru (talk) 21:30, 18 February 2019 (UTC)

End of pizza image discussion; break added for ease of editing

@Bluerasberry:, I have respect for principles over partisanship, and I'm all in favour of avoiding ossification of articles. I'm also in favour of expansion. If there are specific bits of information you feel should be added to the article, please let me know. I'm trying to get around to it. I'd be really happy if others would contribute. Looking through the edit history of the page, I've been making most of the green content-expansion edits for the past year...

I'm not sure how long QuackGuru has been working on the draft, but it is longer than the page history of the page posted here, as I first saw it, by chance, in late December. I should really have raised the issue then. The draft looks like a lot of work, and I'm surprised and somewhat upset that QG never mentioned it in our discussions of this article. I'm also not happy that the article was replaced by an earlier version of the draft, without discussion, in early January, just before a surge of media coverage of the article topic, and a surge in page views. I like debates, but this does not feel like one. It lacks substantive interaction.(apology below)

I'm not sure that having an RfC on drafts twice a year would have the effect you are looking for. I think it might tend to look less like consensus and more like Duverger's law, with increasing polarization. It would also raise the bar to entry very high; you'd have to write an entire draft, then argue for it. I don't think many part-time editors would have the time to do this well. Also, old editors, like new editors, generally want to see that their edits have some effect; putting in a huge amount of work and then having it all rejected, an inevitable outcome of a Battle of the Drafts, would be extremely discouraging, and seems likely to decrease editor engagement with the topic. Having all informal consensus overturned every six months would mean that the only way to bring about lasting changes to the article would be to put effort into RfCs on article content, rather than article content; I'm doing far too much of that for my taste already.  Any suggestions on how to get around these problems? HLHJ (talk) 07:21, 18 February 2019 (UTC)

I have looked at every edit. Anything that was worth adding to the draft is already in the draft. The POV and other misleading content was left out of the draft. Who added mass MEDRS violations and other problems to this article? Almost all the new content added to this article is a problem. The article contains mass vague and ambiguous content. The draft contains detailed accurate content. The current article has an activist tone. The current article is also littered with mass failed verification content. Even the first sentence fails verification. Once those problems are not repeated there will be no more problems.
There is way too many problems with the current version. For example, there is original research and failed verification content and misleading content. This article is in very poor shape. For example, every sentence in "Nature and function" is complete junk.
You mentioned in another thread that the E-cigarette marketing is currently in poor shape. How about you redirect the page and let me fix the problems with that page? It would take me about 1 or 2 weeks to fix all the problems and create a massive article. QuackGuru (talk) 12:48, 18 February 2019 (UTC)
QuackGuru, first, my apologies. My comment above was written when I was feeling frustrated and generally annoyed; I should have waited, and discussed my problems with you directly.
There's an number of things about our interactions that I'm finding difficult. I'm going to go through some of them, with specific requests for resolution; please feel free to propose other resolutions.
You regularly tag large numbers of sentences as failed-verification. I generally respond by adding verifying quotes from the sources, which I think is what the quote parameter is for. This takes a lot of effort, especially if I have to translate the quotes and type up the translations. I've spent hours over it. When you then remove the quotes, it's really frustrating. I feel like I've done a lot of work for nothing. Could you please not remove quotes?
I also find the sheer number of tags that you add to articles stressful. They feel like demands to fix things, which is difficult when I can't figure out why you've tagged something. If you could fill out the "reason=" parameter in the tags, it would help a lot.
You have maintained drafts of several articles in the draft space for months without mentioning them in ongoing discussion of article content. I've come across them now and then while searching for topic-related material, and when another editor mentioned one. Your drafts are often under titles that give no clue as to their contents; I vaguely remember seeing one whose title contained a schwa. You've moved this content from draftspace to draftspace and from draftspace to article without referring to where it came from, thus breaking off the edit history. Could you please, when you transfer content between pages, note that you are doing so in the edit comment, and when you revert pages to earlier version, note the version you are reverting to?
It feels as if you are trying to hide the really substantial work you do it the draftspace, which is turn feels like a reaction to a hostile environment. Is this why you don't edit in the mainspace? I'd really rather not have a hostile editing environment, and am willing to put effort into it.
It also makes it difficult for me; when you replaced this entire article with your draft, you did it in a handful of edits over the holidays. This made the change much more abrupt than if you'd done the incremental work in the mainspace. While I was willing to retain some content, I asked you to revert your article replacement and let us start again incrementally from there. I expected that you would add content incrementally. Now, with the RfC, I feel as though I have to integrate all the additional information from your draft into the main article at once, which is an overwhelming amount of work to do in a short time. It's also work you could have done automatically by editing in the new information incrementally as your wrote it. I can understand that you might not want me editing in your draftspace, but could you please consider editing in the article space in future? I'd be happy to have help integrating information into the article, and I'd be happy to see you do it and collaborate with you in the mainspace. If you really feel you need to write in a draft, could you please post to the article talk page and let everyone know that you are working on a draft, and why?
I try not to hide my editing activity from you. I have not been perfect in the past; I should have waited for further feedback from you on the move of this page. May I ask that you not nix my suggestions without giving substantive reasons? Sometimes I feel as if you are not putting effort into the discussion, or remembering previous discussions, because you raise the same complaints repeatedly without substantively engaging in my replies; sometimes I'm not even sure that you've read my response.
Just now, I reverted to an earlier version in order to restore source quotes you'd removed, and was then working on fixing the tags, after which I was going to restore the non-quote-removing edits you had made. I said all this in the edit comment. While I was doing it, you removed the content I was working on, in a series of rapid bold edits; you also made some minor phrasing changes, which I mostly do not object to, apart from minor grammar quibbles. I've been trying to get around to some of this for weeks; it's really frustrating to have the content pulled out from under my feet just as I set to work on it. I do not want to create another parallel draft. I am going to restore the removed content, fixing it as I go; I hope you will not object. This will take a while, especially since I'm going to have to copy over each citation individually from an earlier draft, and until I've done it, I won't be able to vote for the finished version in this RfC. I won't be able to do much today at this point. I do not have as much editing time as you do. When you edit in a way that makes it more work for me to fix things, or make substantial talk-page demands of me, it seriously cuts into my productivity, and reduces my ability to address the problems you raise with the articles. HLHJ (talk) 01:53, 21 February 2019 (UTC)
See Wikipedia:Non-free content. Adding a bunch of quotes may not be allowed. QuackGuru (talk) 01:58, 21 February 2019 (UTC)
Adding a quote in the "quote" field of a reference template to help verify content, especially in the case WP:PAYWALL sources, is perfectly fine. If you doubt that, and/or rather think there is a limit to it, then make your case at Wikipedia talk:Non-free content. I've decided not to get involved with some of your other faulty rationales at this article and the related electric smoking system articles. Flyer22 Reborn (talk) 04:25, 21 February 2019 (UTC)
I've tried to fix all the tagged things, but where I wasn't sure what the problem was, I've left some of the inline tags in place; please remove them if you feel they are no longer needed. I would appreciate a fuller reply to my post above when you have time. HLHJ (talk) 07:40, 21 February 2019 (UTC)
You restored similar disputed content or citations including Pyrolysis is a process causing charring,[22][unreliable medical source?] and char is a solid pyrolysis product;[23][unreliable medical source?]
See "Tobacco companies claim these products are less harmful to consumers than[4] other types of cigarettes,[2] but "there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products", according the to the World Health Organization.[2][5]" That is confusing and the first part of the claim uses a primary source.
The drafts says "A 2016 World Health Organization report found no compelling evidence has been presented for the claims of lowered risk or health benefits compared with traditional cigarettes, which are based on industry-funded research for these products.[23]" That is better written than the current wording in this article. The draft uses the WHO source in the lede without the primary source.
See "There is not thought to be any possibility of harm reduction among these dual users.[13][clarification needed]" That's vague content. The draft says "In this regard, the IQOS is more a gateway to traditional cigarette use (20% of users) than quitting (11% of users).[10] Further, it is not anticipated a lowered risk among the dual users who make up the remaining 69%.[10]" That is accurate content.
See "Tests of smokers switching to the most common HTP products show that they take deeper, longer puffs at shorter intervals.[14]:99" That is not what the quote verifies. See the draft for verified content.
See "86% of conventional smokers using the product did not stop using regular cigarettes; they used both.[13]" The draft is more detailed and not vague. The draft says "These products did not satisfy 86% of users, and they did not quit using traditional cigarettes; they used both, according to a 2017 survey in Japan.[10]"
See "one survey found that half of those interested in the product were never-smokers.[13]" That is inaccurate and does not state what product. The draft says "The same survey found 51% of those interested in the IQOS product were never-smokers.[10]"
See "Nicotine harms brain development, in the fetus[19][not in citation given]" The source does not assert it "harms" the brain. See the draft for accurate content.
See "Users experience a sudden, sharp peak in blood nicotine levels; levels rise just as abruptly, and just as high," The quote does not verify this part. See the draft for accurate content.
See "while the World Health Organization calls them "cigarettes".[2]" That is misleading content. The draft says "Some use product-specific customized cigarettes.[7]" That's accurate content.
See "One brand's tobacco powder comes packed in aluminum capsules.[32]" That's duplication. See "The capsules are aluminum.[13]"
See "It has also advertised[26] and marketed them as "smoke-free".[27]" That is misleading and vague content. Part of it is also duplication. See Electric smoking system#Marketing. The draft says "The IQOS product has been advertised as emitting "no smoke."[139] These products are marketed as a "smoke-free" alternative to traditional cigarettes, and promoted as a way to lower risk from smoking.[16]" That's accurate content.
See "tar is liquid at high temperatures, but may be more solid once cooled.[24]" That's off-topic content from another article.
There are too many problems to list them all. The draft fixes all of them.
Please verify "This has caused concern that the products could worsen public health risks." QuackGuru (talk) 17:44, 21 February 2019 (UTC)
I have no objection in principle to your inserting this sort of detailed commentary into "reason" parameters of tags.
  • Generic statements about what technical terminology like "pyrolysis" means does not have to be cited to a MEDRS source that mentions these products. Such a restriction will make it impossible to describe how these products work, as MEDRS sources use, without explanation, technical terms which the encyclopedia reader cannot be expected to understand without explanation.
  • "Tobacco companies claim X,[RS] but the WHO says not-X[MEDRS]" is acceptable; we had a RfC on this.
  • "Further, it is not anticipated a lowered risk among the dual users who make up the remaining 69%" is not grammatical nor, in my view, as clear as ""There is not thought to be any possibility of harm reduction among these dual users." (immediately following a description of what dual use is)
  • What, exactly, is unverified in ""Tests of smokers switching to the most common HTP products show that they take deeper, longer puffs at shorter intervals"?
  • "These products did not satisfy 86% of users" is not supported by the source. That's the percentage of dual users; not the percentage giving that reason for dual use.
  • Do you think that "half" and "51%" are ifferentiable at the accuracy of a small poll? Why?
  • "harm" is a reasonable way to say "have adverse effects on", which is the source, verbatim.
  • "Users experience a sudden, sharp peak in blood nicotine levels; levels rise just as abruptly, and just as high," is verified; the peak comes just as soon, and a trivial comparison of the magnitude of the peak numbers given shows the numbers given for the one flank the number given for the other, and are thus "just as high".
  • I'm not sure why it is misleading to say that the WHO called them "cigarettes". They did. I'm contrasting this to a marketing claim, so it matters who said what.
  • "tar is liquid at high temperatures, but may be more solid once cooled." is background necessary to understand the rest of the content, which discusses the tar levels in these products. You cannot expect MEDRS written for experts in teh field to define all their terms before starting.
  • "This has caused concern that the products could worsen public health risks." is verified by the abstract and the "essential points" at the end of the conclusions. I have noted this in article per your request.
Answering these points has taken a fair amount of time which I could otherwise have used to work on the article.
Your draft repeats itself in places, and often buries a section's most important points in FRIN statements about what is not yet known, or low-information statements about people finding it hard to quit. Could you please edit to express points clearly and succinctly, and removed repetition? Your draft uses the same sources you have challenged and removed as non-MEDRS in the main article, for content topics that you considered biomedical in the main article, such as product functioning. It is thus unsurprising that the draft has more content on these subjects, as you removed parallel content from the article mainspace. There are a some factual errors, such as "These products have a time limit, so that the user inhales the nicotine within 3.5 minutes to 10 minutes.[10] This makes it possible to sustain elevated levels of blood nicotine". It does not; it makes it harder to sustain elevated, or stable, levels of blood nicotine, by causing nicotine levels to oscillate more. I think the article makes it clear why this increases addictiveness. The draft makes statements that only apply to IQOS as though they applied to all such products, which should be fixed. Could you please also ensure that all medical claims made in marketing materials (e.g. "smoke-free") are juxtaposed with the MEDRS view, to accord due weight? HLHJ (talk) 07:08, 22 February 2019 (UTC)
"This has caused concern that the products could worsen public health risks." is not verified by the abstract. No mention of cause for concern. The part about "..the promotion of the products..."[17] is about marketing and there is a section about marketing. The draft fixes this other problems with this article. What, exactly, is unverified in ""Tests of smokers switching to the most common HTP products show that they take deeper, longer puffs at shorter intervals"? The quote used in the article does not verify the claim. The WHO did not say they are simply "cigarettes". WHO said "and some make use of specifically designed cigarettes to contain the tobacco for heating."[18] That's not a regular cigarette. These products did not satisfy 86% of users..." is supported by the source. See "ces produits n’apportent pas pleine satisfaction au fumeur qui, dans 86% des cas, n’abandonne pas la cigarette conventionnelle mais utilize les deux produits, rendant très improbable une reduction du risqué pour le fumeur"[19] See "This heated-tobacco operating pattern permits the maintenance of peaks of nicotine, and upregulation of the nicotine receptors, which, in multiplying and becoming less sensitive, maintain a very high level of nicotine dependence."[20] This quote does not verify the current wording. The factual errors is with the current article. I made a small adjustment to the wording in the draft. The draft makes statements that only apply to IQOS because that is what is verifiable. That does not need to be fixed. You have not acknowledged any problems with the current article. Others can review your comments and mine and make a decision which they think is best. QuackGuru (talk) 11:10, 22 February 2019 (UTC)
  • I invite anyone to compare the differences with the current article and draft. There are lot more problems with the current article that I have not mentioned. I will give one good example for others to review. It should not be this hard to remove failed verification content from the article. That is the reason for the RfC. I can't fix the problems when the problems are not being acknowledged. No editor should have to wait weeks or months to fix obvious problems in any article.
  • "This has caused concern that the products could worsen public health risks." fails verification. The abstract does not verify the claim currently in the article. So what does the abstract say? See "On the other hand, the worsening of the global tobacco risk related to the promotion of the products by the TI is anticipated, justifying that the authorities take the appropriate measures to control the promotion of heated tobacco."[21]
  • See "It is expected that the promotion associated with these products may worsen the worldwide tobacco risk.[10]" This content is in the draft. The content is related to marketing. Therefore, it belongs in the marketing section. See Draft:Electric smoking system#Marketing. QuackGuru (talk) 16:47, 22 February 2019 (UTC)
There are currently two "failed verification" tags in the article. I do not understand why one of them is there; if you will fill out the "reason=" parameter, it might help me understand. I think the last one is a semantic quibble, but I will change it if third parties disagree. I've changed the phrasing on the sentence you complain of. The source sentence you quote is about health risk and marketing; try "Thus, the available scientific evidence shows that at the population scale, heated tobacco products worsen the risk of tobaccoism to society" (I've added the verifying quote and a translation to the article).
You were right about the puffs, good catch. The puffs are shorter, and I mistakenly wrote "longer". Fixed. Please, say these things explicitly, it will save time for us both!
I have a few suggestions for the draft. Firstly, I mentioned editing edit the draft to reduce the repetition; as an example, the content about flavourings and additives and smoker satisfaction, and the content about loose-leaf products.

This process still allows the user to sustain peaks of blood nicotine, resulting in an increased nicotine dependence.

This is an improvement, but the peaks cannot be sustained. The peaks are sharper, with quicker withdrawal afterwards, which is what causes the increased dependence; the rapid onset of the peak causes the addiction (because it means rapid relief of withdrawal). I think that the draft's re-ordering and removal of information in the "nicotine delivery" section obscures the logical progression through the information; these are not a series of unrelated facts. Oddly, though, it compares oral nicotine to inhaled nicotine, not HTP to regular cigarettes. I've added a comparison to NRT to the article.
I mentioned that your draft uses sources which you have demanded I remove from this article (St. Helen et al., for instance), supporting content types you said could not be supported by those sources. Could you please apply the same standards to content you wrote as to content I wrote? If you think this content is OK, please add it to the article.

As of December 2017, it is impossible to quantify the health risk from using these products.[1]

This seems a bit too modest. We know that they are harmful, and we have no evidence that they are less harmful than regular cigs. Burying the Cochrane review after a bunch of less-reliable sources seems undesirable; I think it should lead the section.

However, reduced exposure to harmful substances does not mean that health risks are equally reduced.[2] Even low exposure increases the risks for cancers, stroke, and other cardiovascular diseases compared to non-smokers.[2] It is still unclear to what extent the reduced levels lead to lowered health risks.[2]

Actually, reduced exposure to harmful substances does not mean that health risks are reduced at all. The dose-response curve may plateau, and we don't know what all the relevant harmful substances are. There is a lot of evidence on this from earlier modified risk products, which had lowered amounts of harmful substances and the same risks.
I think the "Health effects" section should not include information on proxy measures that are known not to correlate with health effects (despite looking to laypeople as if they ought to), such as concentrations of harmful substances in emissions. The large section on emissions concentrations also buries the section on addiction and quitting.
Statements beginning "there is limited information" or "it is not yet known", "more evidence is needed" and so forth should generally not come before concrete statements about what is known.

The limited data on heat-not-burn tobacco product users show that they take short puffs, and that the time between puffs is very short.[3] Experimental tests show that there is a higher volume of puffs at shorter intervals than with traditional cigarettes.[3] A 2018 clinical trial found that tests of smokers switching to a IQOS product showed a tendency to take more puffs at shorter intervals.[3]

I can't see why this is preferable to just "Tests of smokers switching to the most common HTP products show that they take shorter, much more frequent, and larger-volume puffs.[4]: 97, 99 "
This could be out of an industry publication:

Pregnant women who wish to quit smoking but are unable, are left with few options.[5] As nicotine replacement products is often ineffective for quitting smoking, pregnant women turn to alternatives such as heat-not-burn tobacco.[6] There is no information available on potential impact of maternal inhalation of heat-not-burn tobacco emissions during pregnancy on fetal outcomes, as of 2018.[6] The risk to the fetus from heat-not-burn tobacco products during pregnancy is hard to quantify.[1]

It sort of has a tone, which I assume you did not intend, that it's terribly sweet of the tobacco companies to help the poor helpless pregnant women. Nor is there any evidence that "heat-not-burn" tobacco is an effective alternative for quitting smoking. There is information available on potential health impacts; it follows these sentences of statements that we know nothing. We know that all nicotine products studied, including pure nicotine products, cause harms. To me, "adolescent" does not immediately conjure up images of 24-year-olds; I'd suggest using the Surgeon General's precisely-defined age range, 10-25, as we discussion on WP:MED talk.
Do you want to include that long paragraph on the processes through which nicotine might cause harms in pregnancy? I think it's a bit off-topic, though I'd support listing more harms (I think I added them earlier, together with info on breastfeeding).
If industry calls something a "tobacco stick", and the WHO calls it a "cigarette", I think we should call it a "cigarette". Do you have a source for the "tobacco stick" term?
The idea that distillation, but not pyrolysis, occurs below 300 Celsius is obviously false. Put some leaves in an oven at 250 and watch them pyrolyse. They will blacken and smoke. Destructive distillation is an application of pyrolysis; it can't occur without pyrolysis. We need to distinguish it from normal distillation, which does not involve pyrolysis or other chemical changes, even if tobacco marketing materials do not distinguish.
Finally, QG, you started another RfC earlier on the inclusion of a table of emissions data. I commented that the RfC was moot as this one subsumed it. You disagreed and continued the discussion until Jojalozzo opposed the table, then closed the RfC, saying it was moot. Now you are proposing to add the same table. I don't think that a table of primary data on the chemistry of the smoke from one of these products belongs in the article. HLHJ (talk) 05:35, 23 February 2019 (UTC)
The part "the most common HTP products" fails verification. It was just the IQOS product.
See "This process still allows the user to sustain peaks of blood nicotine, resulting in an increased nicotine dependence." That is supported by the source. If you want me to change it I need a specific proposal based on verifiable content. This goes for all the other content you quoted from the draft.
See previous comment: "There is a new table sourced to a 2018 review added to the draft. See Draft:Electric_smoking_system#Comparison_to_mainstream_smoke_of_traditional_cigarettes. The new table makes this RfC moot. QuackGuru (talk) 18:15, 3 February 2019 (UTC)"
I am not proposing to add the same table. Did you ping an editor who disagreed with me to comment in this discussion? There is no table based on a primary source being proposed currently. The table is sourced to this review. I did not close the RfC. It is still open. QuackGuru (talk) 16:41, 23 February 2019 (UTC)

Comments on MEDRS

I tagged sources that are MEDRS violations. They are not reviews and thus fails MEDRS. See "another problem: Based entirely on primary MEDRS sources, and non-MEDRS sources."[22] The issues have not been resolved. Please read my comment posted on 08:19, 13 January 2019 (UTC) above. QuackGuru (talk) 04:39, 30 January 2019 (UTC)

I addressed these... below, I think. Could we please try to keep sections focussed on a single topic? This page is getting very confusing. (comment added when this was part of the discussion of the pizza image)HLHJ (talk) 05:54, 30 January 2019 (UTC)
Input requested. QuackGuru (talk) 02:53, 31 January 2019 (UTC)

Is the content tagged with [unreliable medical source?] in the "Nature and function" section and other sections WP:MEDRS violations. Thoughts? QuackGuru (talk) 02:44, 31 January 2019 (UTC)

I read the sentences cited by sources that were tagged with {{ums}} and looked at the publication types listing of those sources on pubmed. All of the sources are indeed primary; those sentences do need to be cited by a MEDRS-compliant secondary source per my #anchored statement about medical claims and product function claims that imply a health-modifying effect.
Also, regarding: While the nicotine is the main addictive component in tobacco, some pyrolysis products of tobacco are thought to reinforce addiction (such as acetaldehyde, norharman, and harman). Based upon the norharman and harman articles, those compounds don't appear to have any pharmacological targets relevant to addiction (the benzodiazepine receptor IS implicated in dependence though); acetaldehyde is sort of like ethanol in the sense that it borks the function of many proteins, including those expressed in the nucleus accumbens shell, so it's plausible that acetaldehyde is addictive. Nonetheless, it's very well-established that nicotine is the principal addictive agent in tobacco (per every source I've ever read about tobacco/nicotine addiction). Seppi333 (Insert ) 19:55, 31 January 2019 (UTC)
The McKelvey, Moazed, and St. Helen sources are reviews of different subsets of the multimillion-page no-idea-how-many-separate-studies IQOS application to the FDA. While PubMed does not classify them as systematic reviews, I believe that they are secondary sources within the meaning of WP:MEDRS ("A secondary source in medicine summarizes one or more primary or secondary sources, usually to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies"), as I've said somewhere else on this page at least once, as I recall... 
Another issue is the combination of MEDRS sources and non-MEDRS sources to support different parts of statements. For instance, where the article says :

However, independent researchers explicitly disagree with the claim that they are smokeless,[30][31][unreliable medical source?][32][33] arguing that[34] the emitted aerosol is smoke, as it contains pyrolysis products.[17]

Here, journalistic sources (the Washington Post and National Public Radio) are used to source the attribution of the dispute; who said what. I have also given MEDRS for the clause "the emitted aerosol is smoke, as it contains pyrolysis products". I think it is legitimate to include journalistic coverage of a dispute over a biomedical claim, though in this cas Wikipedia's voice does not actually state which view is supported by MEDRS, and perhaps it should. Similarly, in

Independent researchers studying the aerosols produced by heat-not-burn products commonly[35][unreliable medical source?][33] call those aerosols "smoke";[33]

Again, the non-medrs source is just used to show that this use of the word "smoke" is common; the MEDRS at the end states firmly that it is smoke. All of the independent sources which explicitly evaluate the smoke claim say it's smoke.
I would not in the least argue that nicotine is not the main addictive agent. I think "What do the pyrolysis products do then?" is relevant to this section, and would welcome better content and sourcing for it; Seppi333, you'd probably be better able to do this than I, if you have time.
Could we please keep all future discussions of a single topic in a single section? I would appreciate it, as it would save a lot of my time. HLHJ (talk) 23:29, 3 February 2019 (UTC)
Popular media is not MEDRS compliant. The content is also unencyclopedic. The emitted aerosol is not smoke They are different. The disputed content should be deleted IMO. QuackGuru (talk) 23:33, 3 February 2019 (UTC)
I agree that the Washington Post is not MEDRS, but not that there are biomedical statements not backed by MEDRS in the article; please name any you find. Why is the content unencyclopedic? We have a consensus that it's smoke. Disagree with deletion. HLHJ (talk) 23:48, 3 February 2019 (UTC)
See "However, independent researchers explicitly disagree with the claim that they are smokeless," That is a biomedical statement and it is essentially duplication of other content in the same section about smoke. We don't have a consensus that aerosol is smoke. They are completely different things. The source does not state aerosol is smoke. That is the reason it is unencyclopedic content. QuackGuru (talk) 16:16, 4 February 2019 (UTC)
The MEDRS Dauzenberg review says that the aerosol is smoke and the products are not smokeless. The Washington Post and other RS say that PMI claimed otherwise, and that the independent researchers explicitly disagree with PMI's claim. HLHJ (talk) 04:57, 5 February 2019 (UTC)
See under "Comments on tagged Dautzenberg French-language review". The MEDRS Dauzenberg review does not verify that the aerosol is smoke. An aerosol and smoke are completely different things. One is not the other. Smoke is not an aerosol. QuackGuru (talk) 21:18, 21 February 2019 (UTC)
The medical sources reviewing PMI's FDA application, which you challenged, are all summarized and briefly described in this source.[7] Do you consider these FDA-application-review sources secondary, QuackGuru? HLHJ (talk) 20:16, 10 February 2019 (UTC)

Comments on tagged Dautzenberg French-language review

You comment-tagged the French systematic review as failed-verification, QuackGuru; is it just a translation issue, or do you doubt the content's accuracy? HLHJ (talk) 04:27, 31 January 2019 (UTC)

Please provide verification for "Independent researchers studying the aerosols produced by heat-not-burn products commonly[33][unreliable medical source?] call those aerosols "smoke";[18] Prior to 2016, Phillip Morris did the same.[18]".
The content about aerosols being called "smoke" does not make any sense because smoke and aerosol are not the same. The content is unencyclopedic and poorly written.
Please also provide verification for "However, independent researchers explicitly disagree with the claim that they are smokeless,[30][31][unreliable medical source?][18]" from the same review. The review should also verify the part "independent researchers" and the word "smokeless". This content is very similar to stating it is "smoke". There is no need to repeat the same thing twice in different words. It is essentially duplication.
Using the review that actually says more, which paragraph in the review you want to summarise? I did not find it yet. QuackGuru (talk) 10:55, 31 January 2019 (UTC)
The problems with the Nature and function section have not been fixed for quite some time. Disputed content about smoke in this article was added to another article. The same citation is repeated in multiple locations. QuackGuru (talk) 23:27, 3 February 2019 (UTC)
The same citation is repeated with different quote; sadly currently the only way to use multiple separate quotes from a source is to make separate citations, see this discussion. That content about smoke in the other article is sourced to this review, which seems a solid MEDRS; the content is equivalent to the bit of this article which goes "call those aerosols "smoke";[33] Prior to 2016, Phillip Morris did the same.[17]", which you have not tagged. If you are disputing it, could you please explain why? HLHJ (talk) 23:44, 3 February 2019 (UTC)
I requested verification for content above. Verification was not provided for the disputed content.
The following is more duplication: "call those aerosols "smoke";[33]". An aerosol is not smoke. The content is poorly written to claim an aerosol is smoke. QuackGuru (talk) 16:16, 4 February 2019 (UTC)
The Dauzenberg review explicitly evaluates the claim that the aerosol is not smoke, and states that it is smoke. I don't think it uses the word "smokeless", because it is in French. As I recall, it refers to a claim that the products are "« non-fumeur »". Smoke is a type of aerosol. The same review also calls Auer "un scientifique suisse indépendant" ("an independent Swiss scientist"), and carefully categorizes all the papers, with a summary count in Table 1; one column is "Universitaires et autres scientifiques indépendants" (university researchers and other independent scientists). The Washington Post calls all the Auer et al. authors "independent researchers". The COI statements of the papers using the word "smoke" also assert independence, if not using that exact word. I think that verifies the content about which you ask; please specify any other claims you want verified, but please check the quotes in the citations first. I've tried another format for the citations; if it works, I could use it for some of the others. HLHJ (talk) 04:43, 5 February 2019 (UTC)
See "Tableau 1. Les revues scientifiques ayant publié les 100 articles identifiés selon l’origine des auteurs"[23] and see "Universitaires et autres scientifiques indépendants"[24] That's not about smoke or aerosol. That's about the scientific journals. That does not verify the current claim in the article about smoke. See "À forte concentration (50 μg/L de nicotine dans l’aérosol de la THS2.2), les effets sont cependant mesurables sur tous les paramètres étudiés." That translates to "At high concentrations (50 μg/L of nicotine in the HRT 2.2 aerosol), however, the effects are measurable on all parameters studied."[25] I was only able to find the word aérosol mentioned once in the source and that does not verify the claim that the emitted aerosol is smoke. l’aérosol is about the THS2.2 device. That verifies it produces aerosol. These products produces both aerosol and smoke. The current wording makes no sense when it claims aerosol is smoke. QuackGuru (talk) 23:19, 5 February 2019 (UTC)
Original research and failed verification content along with other problematic content is still in the section. QuackGuru (talk) 20:10, 19 February 2019 (UTC)
There are too many problems with the content. I decided to clean it up. Also see Talk:Electric_smoking_system#Comments_on_MEDRS. We can't keep the problems in the article forever. QuackGuru (talk) 01:17, 21 February 2019 (UTC)
I've re-written the content with verifying quotes. The Dauzenberg review clearly verifies both that HTPs produce smoke and that independent researchers say so and manufacturers have disagreed. HLHJ (talk) 06:08, 22 February 2019 (UTC)
A Swiss independent scientist is singular. One person does not mean researchers and it is repeating what was said earlier about smoke. This could be too much detail. "There is debate over the terminology used for these products." is uncited. There are claims about marketing that don't belong in that section. The tobacco industry calls its tobacco refills "Heets" and "Neosticks",[31] does not belong in that section. It belongs in each section for each product. The draft fixes all of these issues. QuackGuru (talk) 11:52, 22 February 2019 (UTC)

Problems with the lede

Current sentence: An electrically-heated smoking system, also known as a heated tobacco product (HTP) or heat-not-burn tobacco product (HnB), uses an electric heating element to produce a smoke that contains nicotine, tar,[1] other chemicals, and particulates.[2]

The first sentence is a violation of Wikipedia:Leadsentence and it is not succinct.

The draft says A heat-not-burn tobacco product or heated tobacco product[notes 1] heats up tobacco using a battery-powered heating-system.[7] Later on it discusses smoke. The next two sentences in the draft says As it starts to heat the tobacco, it generates an aerosol that contains nicotine and other chemicals, that is inhaled.[7] They also generate smoke.[10]

See current wording These products may match some of the behavioral aspects of conventional smoking.[3] This is not succinct and the word "may" is misleading. The draft says "These products provide some of the behavioral aspects of smoking.[21]" That is succinct.

The current article has a lot of content missing from the lede. The draft has three sold paragraphs in the lede to summarise the body. See Draft:Electric smoking system. QuackGuru (talk) 02:31, 23 February 2019 (UTC)

See "...there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products", according the to the World Health Organization.[2][5] Adding a quote to the lede does not have an encyclopedic feel. QuackGuru (talk) 21:13, 23 February 2019 (UTC)

Sourced content in the lede was replaced with failed verification content. See "Products heating cigarettes using an external heat source[failed verification] first came to market in 1988, however they were not a commercial success.[4]" QuackGuru (talk) 21:26, 23 February 2019 (UTC)

Mass quotes

The citations contains quote after quote after quote. I can't think of a good reason for the mass quotes in the Reference section. See Wikipedia:Non-free content. Adding lengthy quotes may not be allowed. I don't recommend adding numerous quotes. QuackGuru (talk) 03:48, 23 February 2019 (UTC)

I added them because you tagged the sentences as "failed verification" when they were not there. Some sources are non-English-language and thus more in need of quotes, to allow editors who do not speak French and German to verify the content. HLHJ (talk) 19:55, 23 February 2019 (UTC)
Adding quotes to an article because of an editor does not seem to be about improving the article for the readers. QuackGuru (talk) 20:57, 23 February 2019 (UTC)

I think I will go ahead and deleted all the quotes. The mass wall of quotes in the References section is weird. QuackGuru (talk) 01:22, 15 March 2019 (UTC)

The mass quotes have been removed. Misleading content and failed verification content has also been removed. Repetitive content was also removed. QuackGuru (talk) 16:20, 23 April 2019 (UTC)

Misleading or vague content

See diff. It is about the IQOS. It is not about all products in general. QuackGuru (talk) 18:25, 23 February 2019 (UTC)

Confusing content

Tobacco companies have been contradictory in internal and external documents, saying that they both do and don't have evidence that heated tobacco products are safer than regular cigarettes.[10]

It is about PMI. The content is also not precise. QuackGuru (talk) 18:25, 23 February 2019 (UTC)

Violation of WP:Caption

See "There is a lack of independent research,[5] and the trustworthiness of internal industry research has been challenged.[8]" See WP:CAPTION. It appears the article is taking on an activist tone. QuackGuru (talk) 18:25, 23 February 2019 (UTC)

Draft

Content was copied from the draft before the RfC was closed and without a history merge. Please read this comment. QuackGuru (talk) 18:43, 23 February 2019 (UTC)

QG, I think Ivanvector was referring to wholesale replacements of the existing article with the draft, not to integrating content from the draft into the article. The latter does not make a mess of the edit history, and I did accredit it. As far as I know, no-one opposes having additional information in the draft integrated into the article; I objected only to wholesale replacement. I don't think that this RfC is about whether any content can be added from the draft. HLHJ (talk) 20:04, 23 February 2019 (UTC)
It's too far gone at this point. Please do attribute any content copied from the draft (per WP:CWW) and when you're done working with the draft it should be moved to a subpage of the article to save the contribution history. Let me know if I can help. Ivanvector (Talk/Edits) 13:38, 24 February 2019 (UTC)

Image

I removed the poor quality image but it has been restored to a different place in the article. QuackGuru (talk) 18:49, 23 February 2019 (UTC)

Off-topic

See "tar is liquid at high temperatures, but may be more solid once cooled.[25][relevant? – discuss]" The source is unrelated to the topic. QuackGuru (talk) 21:33, 23 February 2019 (UTC)

Wording in draft

The draft uses the wording "heat-not-burn tobacco products". I object to shortening it to HnB tobacco products. I also object to changing it to heated tobacco products or changing it to HTP products. QuackGuru (talk) 21:25, 20 March 2019 (UTC)

Request close

Ivanvector, only one editor objects to the draft. Where can I request a close? It would take only a couple of minutes for anyone to close it. Should there still be a history merge or just copy the content? QuackGuru (talk) 03:16, 7 April 2019 (UTC)

I second this request. I think the new draft is much stronger than the existing article. Also, it makes sense to implement that draft and work from there if editors would like to see certain changes to the text. That's better than carrying on with parallel versions of the same article as we are now. Best, Sarah at PMI (talk) 15:27, 24 April 2019 (UTC)

Ivanvector, you asked me to let you know when there is consensus.[26] Should there still be a history merge? QuackGuru (talk) 15:56, 24 April 2019 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
  1. ^ a b Cite error: The named reference COT2017 was invoked but never defined (see the help page).
  2. ^ a b c Cite error: The named reference PieperMallock2018 was invoked but never defined (see the help page).
  3. ^ a b c Cite error: The named reference DautzenbergDautzenberg2018 was invoked but never defined (see the help page).
  4. ^ : 99 Dautzenberg, B.; Dautzenberg, M.-D. (2019). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36 (1): 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Les quelques données sur la consommation montre queles fumeurs de tabac chauffé utilisent des bouffées de 60—65 mL, des bouffées courtes (1,8 s), que l'espace inter-puffs est très court et que les perforations des filtres ne sont pas obstruées. Il serait nécessaire d'établir un régime standard de fumage pour les tabacs chauffés :The evidence on consumption show that smokers of heated tobacco use puffs of 60-65 mL, that they use short puffs (1.8 seconds), that the spacing between puffs is very short, and that the filter perforations are not obscured. It will be necessary to establish a standard [machine] smooking regimen for heated tobacco"... Lors des tests avec le tabac chauffé, il existe un plus grand volume des bouffées et un espace inter-puffs plus court qu'avec les cigarettes conventionnelles. In tests with heated tobacco, the puff volume was larger and the interval between the puffs was shorter that with conventional cigarettes (Wikipedian's translation)
  5. ^ Cite error: The named reference LiuLugo2018 was invoked but never defined (see the help page).
  6. ^ a b Cite error: The named reference LiSaad2018 was invoked but never defined (see the help page).
  7. ^ Glantz, Stanton A. (1 November 2018). "Heated tobacco products: the example of IQOS". Tobacco Control. 27 (Suppl 1): s1–s6. doi:10.1136/tobaccocontrol-2018-054601. ISSN 0964-4563. Retrieved 10 February 2019.