Talk:Positions of medical organizations on electronic cigarettes/Archive 1

Archive 1

Statement by UK Office of National Statistics

This should probably be discussed both here and in the main article Usage Section. Mihaister (talk) 19:23, 25 November 2014 (UTC)

This isn't a position statement by a medical organization, but material published by a medical organization (much like CDC MMWR are published). This material isn't appropriate here. Yobol (talk) 19:32, 25 November 2014 (UTC)

Report by California Department of Public Health

The California Department of Public Health is the lead agency in California for detection, treatment, prevention and surveillance of public health and environmental issues. $3.5 billion budget. Provides public health services, evaluation, and research. The Department recently issued a report on e-cigarettes:

url=http://cdph.ca.gov/programs/tobacco/Documents/Media/State%20Health-e-cig%20report.pdf | title=State Health Officer’s Report on E-Cigarettes: A Community Health Threat | publisher = California Department of Public Health, California Tobacco Control Program | date = January 2015 | accessdate=30 January 2015

Would this be most suitable as a position statement here, or on the related e-cigarette pages? Thanks! Cloudjpk (talk) 22:51, 31 January 2015 (UTC)

It is neither a position statement, nor is it really from a medical organization - but rather from a political office. It may or may not be the Californian position, in which case it may influence the Californian law, and then belong on the legal page. But it doesn't belong here. --Kim D. Petersen 23:12, 31 January 2015 (UTC)

I'm inclined to agree that it's not a position statement. However it's hardly from a political office, nor the California position. It is a public health evaluation from a major public health department.

Where it belongs is the question. I'm interested in editors' views. Cloudjpk (talk) 23:24, 31 January 2015 (UTC)

Looks fine to me. "California Department of Public Health" is a medical organization. Doc James (talk · contribs · email) 00:01, 1 February 2015 (UTC)

@Doc James: So we are not doing scientific positions? But also political positions? Have you read/seen the "report"? It just amazes me what constitutes "medical science" these days, if it matches up with accepted views. --Kim D. Petersen 11:46, 1 February 2015 (UTC)

Sad indeed. Before being fired for gross incompetence and causing the biggest US measles outbreak this century, Ron Chapman blasts off a disturbing evidence-free diatribe against vaping and you call it "position from illustrious medical organization" [1] Mihaister (talk) 08:05, 4 February 2015 (UTC)

Extremely one-sided

This article is extremely biased, and does NOT represent all medical organizations. I recommend that the article be more balanced, as well as have statements of funding sources for authors as well as a declaration of possible conflict of interest. This whole article screams of ANTZ (Anti-Nicotine and Tobacco Zealots). Considering that there is an organization of medical professionals in FAVOR of electronic cigarettes as a harm reduction device, this article as it stands is extremely biased. — Preceding unsigned comment added by Gbaughma (talk • contribs) 15:38, 2 March 2015 (UTC)

The article applies our guideline on neutral point of view appropriately; we do not give equal validity to both sides of an argument, rather we give due WP:WEIGHT to those based on reliable sources. In this case, most sources (especially those outside the UK) are skeptical right now about e-cigarettes, so that is why most of the article is presents a skeptical outlook. Yobol (talk) 18:24, 2 March 2015 (UTC)

I disagree. According to the NPOV, "all of the significant views that have been published by reliable sources on a topic.", and I have links to HUNDREDS of positive peer-reviewed studies, and belong to an organization of hundreds of medical professionals in support of electronic cigarettes. Considering that there are lives in the balance (by scaring would-be quitters into still smoking), it's our civic duty to present both sides. — Preceding unsigned comment added by Gbaughma (talk • contribs) 11:19, 3 March 2015 (UTC)

This is an article discussing the position of medical organizations. If the vast majority of medical organizations, especially the most prominent ones, are skeptical of e-cigarettes, so will this article. We don't change our rules because of one editor's feelings about "civic duty". Yobol (talk) 16:08, 3 March 2015 (UTC)

Actually there is evidence that a) the wind is changing here, and b) there is something of a trans-Atlantic divide, with the UK notably less sceptical that US organizations. For example I have had to revise what is said about the US "Smokefree.gov, a website run by the Tobacco Control Research Branch of the National Cancer Institute to provide information to help quit smoking, stated that e-cigarettes have not been shown to be effective in helping people quit smoking... because the bit in italics no longer appears on the site, though the rest of the sentence does. Presumably it was correctly quoted and referenced before, so that is a change since last November. This is a fast-moving field, and there is a need to date all statements, and review them every so often. There are also statements by specialist medical associations that should be quoted here - they are typically faster to react than government ones. Johnbod (talk) 16:52, 6 March 2015 (UTC)

Notice

The behavior of some editors of this article is being considered at AN/I. BMK (talk) 01:49, 13 March 2015 (UTC)

• Notification. I started an ArbCom discussion. See Wikipedia:Arbitration/Requests/Case#Battleground on e-cig articles. QuackGuru (talk) 22:37, 15 March 2015 (UTC)

New position by smoking cessation manager in the UK

I think this qualifies for inclusion in this article: [2] --Mihaister (talk) 19:21, 25 November 2014 (UTC)

Which major medical organization's position statement are you proposing to add? Yobol (talk) 19:32, 25 November 2014 (UTC)

As discussed in the linked article: Leicester Stop Smoking Service, Cancer Research UK, Action on Smoking and Health (UK). Mihaister (talk) 23:07, 25 November 2014 (UTC)

I see no indication that Leicester Stop Smoking Service is a major medical organization that deserves to be mentioned. Cancer Research UK's position is already noted in the article. If we include ASH (borderline in my view), we'd have to use official position statements rather than white papers produced for ASH, and include both UK and US versions as there appears to be a difference in empahsis from positions statements released by both. Yobol (talk) 04:59, 26 November 2014 (UTC)

I don't see that service qualifying as a significant medical organization. And we'd need a better source than a letter to the editor from a pharmacist who attended a conference anyway. Zad68 05:10, 26 November 2014 (UTC)

NB, the US & UK ASHs are AFAIK unrelated except by name & mission. Johnbod (talk) 11:16, 18 March 2015 (UTC)

New source

QuackGuru (talk) 07:33, 21 March 2015 (UTC)

Outdated WHO Statement(s)

Why are we using an unofficial link to a WHO statement that was withdrawn sometime ago and replaced with this one before being replaced with this report? You have to wonder whether the 2012 statement is also now outdated and should also be removed. To clarify, we have three two different position statements from the WHO and only one of them appears to be up to date.Levelledout (talk) 15:15, 21 March 2015 (UTC)

"Why are we using" it? Probably because no one has noticed & updated it. See my comments in a section above. We should only use the latest, unless we want to cover the direction of travel, which is interesting. Johnbod (talk) 15:18, 21 March 2015 (UTC)

Interesting from our point of view perhaps, I doubt that the average reader is that interested in the direction of travel of opinion over successive statements. I definitely don't think we should be using an unofficial link to a statement that has been withdrawn, not very verifiable apart from anything else. The citation of the 2012 statement says effectively the same thing as the latest one so not sure I see any point in keeping that either.Levelledout (talk) 15:35, 21 March 2015 (UTC)

2013 is not old. WHO is one of the most authoritative sources. The WMA is from 2013. That is recent. QuackGuru (talk) 18:13, 21 March 2015 (UTC)

A statement that has been replaced by a later, and much more comprehensive, statement from the same body should not be used, whatever the date, except to show an evolving position. I have clarified the relation between the two, & I think on this basis it is worth keeping both. Johnbod (talk) 21:04, 21 March 2015 (UTC)

Yes the WHO is one of the most authoritative medical sources. However the statement has been withdrawn completely from the WHO's web site and replaced with an updated one. Likewise the 2012 statement is outdated not due to age, but because it's not the most up to date information. (striking text, sorry didn't realise one of the statements was from the WMA, not the WHO) Why would we want to cite information that the WHO themselves have decided to withdraw from public access and/or replaced with newer information?Levelledout (talk) 21:56, 21 March 2015 (UTC)

Because it is the most one of the most authoritative and it provides additional information for the reader. When there is regulation in the future the source (along with other sources) will be outdated and replaced with newer sources. There's no rush. QuackGuru (talk) 03:35, 22 March 2015 (UTC)

It isn't "authoritative" now it is withdrawn. The 2014 report is far longer and more detailed. Johnbod (talk) 04:50, 22 March 2015 (UTC)

Correct, how can an old outdated report that has been withdrawn and replaced with updated information provide useful information to the reader? It doesn't and if it was intended to then the WHO wouldn't have withdrawn it themselves. They withdrew the report and replaced it with this interim statement clearly indicating that the information was outdated and therefore irrelevant.Levelledout (talk) 14:00, 22 March 2015 (UTC)

This page says "The World Health Organization (WHO) is currently reviewing the existing evidence around ENDS and preparing a paper for submission to the meeting of the Parties of the WHO Framework Convention on Tobacco Control, which occurs later this year" [3]

Thus we are also using the prior one. It does not appear they have come out with a new statement based on the 2014 paper yet.

Might occur soon as they meet Mar 21st 2015 [4] Doc James (talk · contribs · email) 00:57, 26 March 2015 (UTC)

Arbitration committee discussion

(Notice cross posted to: Electronic cigarette, Safety of electronic cigarettes, Legal status of electronic cigarettes, Positions of medical organizations regarding electronic cigarettes, Electronic cigarette aerosol, Cloud-chasing & vape shop. Please focus any discussion on the main page

There is an ArbCom case pending related to this family of topics. SPACKlick (talk) 11:36, 31 July 2015 (UTC)

Public Health England Report August 2015

I saw the PHE report today, don't have time to add it but it's relevant. SPACKlick (talk) 10:26, 19 August 2015 (UTC)

Link copied from the the main EC talk: E-cigs estimated to be "95% less harmful to health than tobacco products". Press release, with links to the review [5] Little pob (talk) 09:56, 19 August 2015 (UTC) - indeed this is important, but it's 111 pages! The key findings are at the start. Johnbod (talk) 12:23, 19 August 2015 (UTC)

There are a couple of recent round-ups of UK statements at here and here - both Guardian. Johnbod (talk) 14:24, 19 August 2015 (UTC)

"In 2015 Public Health England released a report stating that e-cigarettes are estimated to be 95 per cent safer than smoking."

Editors can add it to this page. For the main page the current evidence has not changed among reviews. QuackGuru (talk) 18:55, 19 August 2015 (UTC)

The source does verify this

"Over the past few months, however, several reports have suggested that EC may pose more risks than previously thought."[6] See page 76. The source does verify this. QuackGuru (talk) 21:23, 20 August 2015 (UTC)

Read on - the report then criticises them one by one, and says they do not alter the 2014 95% figure as the best current estimate. But the 95% figure is certainly an estimate, and to use it obviously conveys that there is some remaining risk - the 5% left. I don't really think this needs spelling out. Johnbod (talk) 21:37, 20 August 2015 (UTC)

Archiving

The archiving of this page has been far too sudden. Blanking the page is not normal on WP. Please ask on the talk page before doing this again, QG. Clearing out the page just encourages people to raise the same issues again and again. Johnbod (talk) 03:33, 10 September 2015 (UTC)

The UK National Health Service

[7][8] I think it should be restored. If there is an update then we can use an updated source. QuackGuru (talk) 19:24, 26 August 2015 (UTC)

The 2014 NHS statement is outdated and now irrelevant due to the report by PHE. When the NHS issues a new statement, then it should be included. Please be advised that the NHS is ran by PHE so the PHE report will be what the NHS will eventually follow anyways.JoLincoln (talk) 20:50, 26 August 2015 (UTC)

It is not clear to me that PHE directly oversees/regulates the NHS; rather, what limited information I could find suggests they work together but have different functions in the government. Do you have any sources that unambiguously state that PHE policies override NHS decisions/policies? Yobol (talk) 21:10, 26 August 2015 (UTC)

No they don't, but they do generally work pretty closely together. I agree the existing text should be restored pending a new statement, but I expect there will be a new statement somewhere down the line. The NHS's patient information blog, and a blog by the Cabinet Secretary (Head of the civil service) have both covered it in a way that suggested they were all on the same page. Actual prescription may be politically difficult though, I'm guessing. Johnbod (talk) 01:12, 27 August 2015 (UTC)

That NHS page[9] isn't a position statement. Why are we linking to some random stop smoking page here? That page might not even be updated if the NHS has a different position. I thought this was about position statements? The NHS seems to rely on that page on ASH's opinion, and not their own. I'm curious if the NHS even has positions/position statements since it (afaik) is a warm hands service and not a research service. --Kim D. Petersen 22:01, 18 September 2015 (UTC)

They won't I think be slow in updating the page when they reach a new conclusion. They are not a research service, and NICE generally draw the conclusions from research for them, but the NHS run the smoking cessation services, & if e-cigs are ever to be prescribed in the UK, as the PHE report suggested, they will be the ones doing that for most UK patients. The NHS changed their position last year to be supportive of ceasing smokers (?) using e-cigs, rather than discouraging, but still don't recommend or prescribe them. It's interesting that they link to the ASH 14 page PDF, which is far more bullish about e-cigs - no "may be safer" than cigarettes. Johnbod (talk) 03:24, 19 September 2015 (UTC)

12 english health organizations make a statement

Several english health organizations have put out a joint position statement. They are: Public Health England, Action on Smoking and Health (ASH), Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Public Health Action (PHA), Royal College of Physicians, Royal Society for Public Health, Tobacco Free Futures, UK Centre for Tobacco and Alcohol Studies, UK Health Forum. Seems to be a rather important piece to add. --Kim D. Petersen 22:04, 18 September 2015 (UTC)

Yes, we should. Johnbod (talk) 03:32, 19 September 2015 (UTC)

I did add the joint UK statement to this page and the electronic cigarette page. QuackGuru (talk) 22:37, 19 September 2015 (UTC)

And (puff!) disappeared the 5% of the risk into a negative....

We now state the NHS' position as if it was a negative[10], instead of presenting a clear picture of what they are really saying: Which is that e-cigs carry much less risk than cigs, and that the risk is ~5% compared to cigs. Did anyone notice? The reason for its disappearence? Apparently it is repetitive.. despite the NHS not being quoted for this anywhere. --Kim D. Petersen 08:39, 3 November 2015 (UTC)

A summary of how the British and American policies differ and why

A new article, available online in full view, is: Green, Sharon H.; Ronald Bayer; Amy Fairchild (7 April 2016). "Evidence, Policy, and E-Cigarettes — Will England Reframe the Debate?". The New England Journal of Medicine. 374 (14): 1301–1303. doi:10.1056/NEJMp1601154. StarryGrandma (talk) 06:05, 16 April 2016 (UTC)

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Use of Some in lede

The source does not support the weasel word "Some".[11] You removed the tag without removing the unsupported claim "Some". Per WP:V policy, the source does not indicate "some".[12] See WP:WEASEL: "Weasel words are words and phrases aimed at creating an impression that something specific and meaningful has been said, when in fact only a vague or ambiguous claim has been communicated." The previous text as well as the source did not indicate "some" or "all". QuackGuru (talk) 20:36, 26 August 2016 (UTC)

Moved this from my talk page to the appropriate page. The previous text indicates all by its phrasing. "Doctors say running is good for cardiovascular health" indicates, unanimity or majority consensus. The source indicates that a portion have hesitated in recommending but not that it is the vast consensus and so presenting it as consensus misrepresents the source. It is not weasel words it is a more accurate paraphrasing of the content of the source. SPACKlick (talk) 21:19, 26 August 2016 (UTC)

The source states "Public health experts are concerned about emerging research showing that e-cigarettes could renormalize and undermine tobacco control and smoking cessation efforts."[13] The source does not claim it was "some" public health experts. The previous text did not indicate all because the word all was not used. The source makes other claims but that is not what is being sourced. Verification was not provided for "Some" public health experts. The part about the recommendations from the Heart and Stroke Foundation is not relevant to the current text in question because that is not what is being verified. If you think "some" public health experts is sourced then please provide the exact quote from the source to verify the claim. QuackGuru (talk) 21:31, 26 August 2016 (UTC)

The tag was removed without providing verification. The edit summary "Source is example of one without indicating unanimous consent. Verified."[14] does not verify the claim. QuackGuru (talk) 05:44, 28 August 2016 (UTC)

Removed from context and in its location in the article the lack of modifier implies a unanimous or overwhelming position. The original source doesn't. It talks about growing fears suggesting a developing position. Reading comprehension isn't your thing Quack, leave the fine details of the wording to people who can read English. SPACKlick (talk) 06:16, 28 August 2016 (UTC)

The part about fears is not about the sentence in question. I specifically asked for verification. Please provide an exact quote from the source to verify the claim. QuackGuru (talk) 06:33, 28 August 2016 (UTC)

That's not how english works Quack. The meaning is taken from the whole. The source says "There is also growing fear that e-cigarettes could renormalize smoking, and those with nicotine could promote dual usage and perpetuate nicotine addiction instead of encouraging full cessation, thus undermining tobacco control efforts." Among the rest of what it is saying it is clear it is not aiming for a unanimous claim. SPACKlick (talk) 06:36, 28 August 2016 (UTC)

We are verifying the claim specifically for "public health experts".

We are verifying: "Public health experts are concerned about emerging research showing that e-cigarettes could renormalize and undermine tobacco control and smoking cessation efforts."[15]

The source says "There is also growing fear", but that is not about the "public health experts". We cannot confound different claims together per WP:SYN policy. QuackGuru (talk) 06:50, 28 August 2016 (UTC)

That section is discussing the opinions of the health community Quack. Stop being obtuse. Also, look around at other sources to see if this is a contentious claim. Hey look, a 3 second google finds sources showing public health experts who don't think renormalisation is an issue here. Now, what about the word some do you feel is misleading regarding the source? SPACKlick (talk) 06:53, 28 August 2016 (UTC)

We are not talking about a section. We are about only one sentence that is only about the "public health experts". Other content from the source did not verify the claim. Looking around at other sources do not verify the claim. QuackGuru (talk) 07:07, 28 August 2016 (UTC)

My comment clearly referred to SECTION OF THE SOURCE. You have repeatedly failed to comprehend basic English this evening Quack so there's no point discussing with you further. You cannot use the existing source to make a claim of universal concern or even consensus concern about renormalisation. It can only be used to make a claim for some experts concern. SPACKlick (talk) 07:11, 28 August 2016 (UTC)

The section of the source about the fear is not explicitly about the "public health experts". There is one sentence from the source that is clearly relevant to this discussion. See "Public health experts are concerned about emerging research showing that e-cigarettes could renormalize and undermine tobacco control and smoking cessation efforts."[16] There is no mention of "some".

The source also says "There is also growing fear that e-cigarettes could renormalize smoking, and those with nicotine could promote dual usage and perpetuate nicotine addiction instead of encouraging full cessation, thus undermining tobacco control efforts."[17] The phrase "There is also growing fear" is not the opinion of the "public health experts" and even if it were the opinion of the "public health experts" it still does not verify the word "some".

The article says "Some public health experts are concerned that e-cigarettes could renormalize smoking, weaken measures to control tobacco,[2] and serve as a gateway for smoking among youth.[3]"

The other ref to verify the last part of the sentence says "Public health experts also are concerned that e-cigarettes will undo decades of progress in public health by re-normalizing smoking in public and act as a gateway to cigarette use among youth."[18] There is no mention of "some" to verify this specific part of the sentence. Both sources do not indicate whether it was some or all or most. Therefore, we should not indicate what the sources did not state. QuackGuru (talk) 10:42, 28 August 2016 (UTC)

I fully agree we shouldn't indicate things not in the source. Removing a modifier from that sentence implies a wider unanimity of consensus that the source does. Feel free to suggest a modifier more appropriate. SPACKlick (talk) 11:44, 28 August 2016 (UTC)

How about this phrasing? Sizeofint (talk) 21:59, 28 August 2016 (UTC)

It is better than the previous wording. QuackGuru (talk) 22:21, 28 August 2016 (UTC)

Yeah that works fine, better even. SPACKlick (talk) 08:58, 29 August 2016 (UTC)

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Source says "some"

The 2014 review says "some".[19] QuackGuru (talk) 20:11, 10 September 2016 (UTC)

International healthcare organizations

International healthcare organizations and national organizations outside the UK have generally been more skeptical of e-cigarettes, and have avoided endorsing or actively discouraged their use. I was unable to find a source to verify the claim.[20]

I replaced it with sourced content for the WP:LEDE. QuackGuru (talk) 01:53, 11 September 2016 (UTC)

Royal College of General Practitioners

Royal College of General Practitioners position [21] probably needs adding. --Kim D. Petersen 22:04, 25 November 2016 (UTC)

There is a statement that says "In April 2016, the Royal College of Physicians released a statement recommending that e-cigarettes..." I do not know what else specifically needs adding. QuackGuru (talk) 23:21, 25 November 2016 (UTC)

Those are different colleges QuackGuru - they are not the same. --Kim D. Petersen 08:36, 26 November 2016 (UTC)

There is also a statement that says "The Royal College of General Practitioners (RCGP) stated in 2016...". QuackGuru (talk) 22:43, 27 November 2016 (UTC)

I find it remarkable that the statement that you picked from the position paper isn't that e-cigarettes are encouraged by the RCGP as part of a cessation strategy. And instead picked a statement about uncertainty. I wonder if you've considered how your personal views influence your writings here? --Kim D. Petersen 06:48, 28 November 2016 (UTC)

I think the quotes in isolation actually distort the position of the royal college. There position is "although the long-term safety profile of EC use is still to be evaluated, it is accepted that vaping is an order of magnitude safer than conventional tobacco...Where a patient wants to quit smoking, and has not succeeded with other options, GPs should recommend and support the use of ENDS.". Also, it may be worth using their comments about children Use among children is rare, and in the small number who do use ENDSs, most who currently smoke are ex-smokers...New regulations around age of sale and restrictions on advertising are likely to reduce what is already an issue of low concern.. SPACKlick (talk) 11:02, 28 November 2016 (UTC)

Good call. Johnbod (talk) 13:15, 28 November 2016 (UTC)

Need to update official statements of scientific and medical organizations

This Wikipedia entry is important in the current debate over the precautionary principle, which leads to prohibitions, and tobacco harm reduction, which focuses on innovation and access to safer nicotine alternatives to smoking. As currently written, about half the entries are out of date.

Here is a list of more than two dozen recent official statements. This is, however, specifically and intentionally cherry-picked for positive statements on the relative safety of nicotine vaping products ("e-cigarettes") versus traditional cigarettes. The list includes over 27 organizations and governments. Each statement is hyperlinked to the original statement on these organization's web page. I am aware of numerous other official statements from other organizations recommending that e-cigarettes should be banned or severely regulated. But of course balance is important. This is a legitimate public health debate.

I hesitate to add any of these statements by editing the Wikipedia entry without permission from the moderators. Or you may feel free to examine the statements and add those you feel are appropriate.