Talk:Electronic cigarette

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 January 2019 and 30 April 2019. Further details are available on the course page. Student editor(s): Sailorbo (article contribs). Peer reviewers: Skyguythor.

Claims are sourced

Entries

• Brain:

• Addiction

• Eyes:

• Eye irritation and blurry vision
• Corneoscleral lacerations or ocular burns after e-cigarette explosion

• Airways:

• Irritation and cough
• Increased airway resistance
• Irritation of the pharynx

• Stomach:

• Nausea and vomiting
• Abdominal pain

• Heart and circulation:

• Chest pain
• Increased blood pressure
• Increased heart rate

Mortality:

• Death after e-cigarette explosion (small risk)

References

Each claim for the adverse effects diagram which links to here is sourced using only MEDRS-compliant sources. There are multiple sources that verify each claim. QuackGuru (talk) 14:54, 25 July 2018 (UTC)

Since you seem not to understand why this is a WP:SYN, let me quote: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources". The picture is a stand-alone entry, as opposed to articles, and thus there is no possibility of explanation, and presenting a neutral discussion on the things it presents. And thus it is even more important that it presents a clear (pun unintended) picture of what it presents, and this one doesn't.

For original pictures, to wikipedia, such as this one. There is an out in WP:OI: Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments. But this image fails this, by presenting an overview that has not been published! --Kim D. Petersen 15:00, 27 July 2018 (UTC)

It even cites case-reports - which even fails WP:MEDRS, despite your claims to the opposite - not all sources are created equal! The Death claim is not even supported by its reference (which is a collection of case-reports), the mortality it was referring to was from a fire caused by oxygen equipment close by. -- Kim D. Petersen 15:23, 27 July 2018 (UTC)

Sources are not being combined to reach a new conclusion. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

See WP:OI: "Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments, the core reason behind the NOR policy." This image passed OR because there is no original research. The image would have too much detail if every detail was explained in the image. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

You are aware that synthesis is WP:OR right? Thus there is OR there. Where is that list of adverse effects published? --Kim D. Petersen 21:56, 27 July 2018 (UTC)

The specific detailed list of the adverse effects are at Safety of electronic cigarettes#Adverse effects. The list itself does not need to be published in a source because each entry is supported by each source. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image? --Kim D. Petersen 23:46, 27 July 2018 (UTC)

See "The media have reported a number of EC explosions where individuals suffered burns, lost teeth and/or palate trauma, neck fractures, and battery acid exposure to the face, mouth, and eyes6,7; moreover, one user died when his charging EC exploded and ignited adjacent oxygen equipment.8"[1] Also see "Although the number of serious adverse events is small compared with the number of EC users worldwide, the consequences may be devastating to those involved in an EC-related blast."[2] The content in the image is supported by the source presented. When the image was being created there was a discussion. It was decided to include general information. The image states "- Wounds and burns in case of e-cigarette explosion". There are newer sources that verify the content in the image.[3][4] Again, the details go in an article instead of overcrowding an image. If anyone wants more detailed information in the body of the Safety of electronic cigarettes article I can add more detailed information. Just leave a note on the talk page of that article and let me know what you want summarised. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

Write about it in an article, where it can be described in a WP:NPOV way, where it is possible to explain that this is an extremely rare event, and not something that you even can expect from e-cigarettes in general. --Kim D. Petersen 22:04, 27 July 2018 (UTC)

It not something that a user would expect from vaping. That's what makes it relevant to add to an image. Editors can start working on a dedicated image for e-cig blasts and death when more sources are available. A new image may or may not include the rarity part. It depends on what the sources say and what editors decide at that time. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Who choses what is relevant for the image? You? Can you spell WP:POV. Wikipedia uses WP:WEIGHT, not POV to determine whether something should go in or not. Does the prevalence of WP:MEDRS sources on adverse effects have death as a credible adverse effect? --Kim D. Petersen 23:42, 27 July 2018 (UTC)

There is no issue with it, and there is no WP:OR, since there is no synthesis by editors. The image is a basic overview. It is not meant to go into extreme detail. There are adverse effects that are also coming from the device itself. That means the image is covering a variety of adverse affects. Therefore, there is no real problems with the image, and it really should remain in the article. QuackGuru (talk) 14:10, 26 July 2018 (UTC)

Of course there is an issue - you cannot just dump sources together and get a comprehensive picture. That is the essence of WP:SYN. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

Sources are not being dumped together. Each claim is supported by each source. Therefore, there is no SYN. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

Each claim is supported - yes. But the compilation and the choises of what to add and not to add is done by an editor - and it is not copied or found in any other source - thus it is WP:OR: An original list of adverse effects not published as such elsewhere. --Kim D. Petersen 22:01, 27 July 2018 (UTC)

It is not a list that is coming to a new conclusion - thus it can't be construed as OR. There is a compilation of entries but it was determined that this image can't include too much detail. If there are other entries about the adverse effects that are missing then please share that with me. I don't think an entry was intentionally excluded from the list except for the part about death. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Even assuming that i bought your argument... you would still have to fight with WP:NPOV, since it is quite obvious that the adverse effects were picked not for their prevalence in the literature, but instead by some editors personal opinion on what should be there. Still not good. Now we are even more into WP:POV territory. --Kim D. Petersen 23:38, 27 July 2018 (UTC)

Adding low level details where prevalence is known would not improve the image. That kind of detail belongs in the body of the Safety of electronic cigarettes article with a 4 paragraph summary here in accordance with WP:SYNC. QuackGuru (talk) 19:33, 26 July 2018 (UTC)

A picture needs to follow our WP:POLICIES as well - and this is pure WP:SYN. The picture conflates the extremely rare with the rare, it conflates serious with non-serious adverse effects. It even adds issues that have only been mentioned in an individual source. Basically it is a WP:POV collection someone created by cherry-picking sources => WP:SYN. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

The image follows policies and it uses quality sources rather than individual articles. If there is an issue with a particular source then it can be replaced with a newer source that verifies the same content. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

No. The image fails WP:SYN - since it describes a original list of adverse effects, not published in any sources before. --Kim D. Petersen 22:06, 27 July 2018 (UTC)

The image passes WP:Verifiability - since it describes a general list of adverse effects, where each claim is published in a source. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

WP:V is not the only policy that needs to be adhered to. WP:SYN also needs to be followed, and it isn't. --Kim D. Petersen 23:34, 27 July 2018 (UTC)

No editor is suggesting to add more WP:OR to the image to make it more acceptable and no editor has shown there is WP:OR in the image. KimDabelsteinPetersen, what is the OR? Please keep in mind the image is meant to be a very basic overview. The Safety of electronic cigarettes article contains the details. QuackGuru (talk) 14:02, 27 July 2018 (UTC)

Why are you writing this here? The discussion is below. And Yes, someone is suggesting that: Adding more cherry-picks to an already WP:OR collection, doesn't make it less WP:OR. --Kim D. Petersen 14:50, 27 July 2018 (UTC)

I started this thread first and the discussion was here first. Using MEDRS compliant sources is not cherry-picking and no evidence of WP:OR has been presented. If a better source is found then we can use a better source. There are other sources that can verify each claim. QuackGuru (talk) 16:31, 27 July 2018 (UTC)

You may have started this thread first - but the discussion was in another thread. As for the rest: The adverse effects are cherry-picked, since it did not include everything from all sources, and included some from sources that aren't even WP:MEDRS compliant. To summarize: Some adverse effects glanced from a variety of sources, not supported by all sources and no source contains a similar list => WP:SYN. --Kim D. Petersen 22:10, 27 July 2018 (UTC)

Another of the adverse effects (blurry vision) is taken from a review where it is even stated that it is from a single paper, where "the extent to which these effects were attributable to ECIG use was unclear" ... And some of the more common (and better supported) adverse effects (in this review) aren't in the image..... So basically a very clear cherry-pick. --Kim D. Petersen 22:22, 27 July 2018 (UTC)

You said "some of the more common (and better supported) adverse effects (in this review) aren't in the image..... So basically a very clear cherry-pick." Please share what was the more common adverse effects that are missing from the image from the review. More information can be added to the image as long as it is basic information. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

The adverse effects are not cherry-picked. It is impossible to include everything from all sources in an image. It is possible to include almost everything in the Safety of electronic cigarettes article. The image is a general list that includes an overview of the adverse effects. If you want a better source for any entry then you can update the list or ask me which one you want updated. In summary: The list is a basic overview of the adverse effects from various sources, which are supported by each source presented. QuackGuru (talk) 23:00, 27 July 2018 (UTC)

Which is basically the same as saying: Yes! it is WP:SYN. Cherry-picked from various sources, as the list that the image-creater wanted to present WP:POV. --Kim D. Petersen 23:29, 27 July 2018 (UTC)

I previously said "Please share what was the more common adverse effects that are missing from the image from the review."

You recently said "Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image?" What is missing? QuackGuru (talk) 00:02, 28 July 2018 (UTC)

How would that solve the WP:SYN issue? Or any of the many other issues with this image? --Kim D. Petersen 02:25, 31 July 2018 (UTC)

Each entry is sourced using at least one source. There is no combining of sources or statements. Therefore, there is no SYN issue. It would help solve the accusation it is a cherry picked list. If you don't tell me what is missing from the list then I don't know what is missing or maybe nothing important is missing from the NPOV collection. We can't turn the image into a detailed paragraph and explain almost everything. But I will explain almost everything in the Safety of electronic cigarettes article.

You previously said "Isn't it remarkable that the most common adverse effects described by the article, that you quote as the source, isn't in the image?" Please tell me what is missing from the image. QuackGuru (talk) 02:49, 31 July 2018 (UTC)

You are just repeating what makes this WP:SYN. From your argument anyone can create an image that presents a synthesis of sources to present a unique combination, without having to present them according to WP:WEIGHT. Purely according to the image creator's WP:POV. Something that he/she wouldn't be able to do in article text. And of course they can't. Which is why this image is WP:SYN. --Kim D. Petersen 03:18, 31 July 2018 (UTC)

See WP:SYN: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources." Each entry is explicitly sourced to each source. For example, see "Less serious adverse events include throat and mouth irritation, cough, nausea, and vomiting."[5] That supports 4 entries (irritation, cough, nausea, and vomiting) in the image. Presenting a unique combination of entries is not a SYN violation. I repeatedly asked you what is missing from the image. QuackGuru (talk) 16:15, 31 July 2018 (UTC)

I think you need to become more familiar with other areas of wikipedia. Since you do not seem to understand what WP:SYN is. The picture is doing exactly that: presenting a conclusion that is not explicitly stated by any of the sources. - that individual items can be referenced to individual sources and that these individual items are combined into a single conclusion is the WP:SYN. No source has this particular conclusion! --Kim D. Petersen 00:28, 1 August 2018 (UTC)

Each source has its own specific conclusion. The individual entries are not combined into a single conclusion. Each entry is its own conclusion and each entry is supported by each source presented. For example, a 2014 review found "Less severe adverse events included sore throat, abdominal pain, headache, blurry vision, cough, and nausea/vomiting."[6] That review is being used to verify under Stomach the word "- Pain". That is a single conclusion and is not being combined with other entries to come to a new single conclusion. QuackGuru (talk) 01:07, 1 August 2018 (UTC)

Semi-protected edit request on 17 August 2018

Addition of paragraph to the 'Health Effects > Safety' heading of the article:

Existing: A 2014 review recommended that e-cigarettes should be regulated for consumer safety.[133] There is limited information available on the environmental issues around production, use, and disposal of e-cigarettes that use cartridges.[155]

Add following in new paragraph: A report published in 2018 in the journal Thorax highlighted important concerns regarding the impacts to human health caused by e-cigarettes. The report highlighted how macrophages, a white blood cell, were negatively impacted by e-cigarette vapor in a similar way to that caused by regular tobacco smoke. E-cigarette vapor caused the release of chemicals from the cells that cause inflammation and potential damage to surrounding tissues, and increased the amount of cell death in a dose-dependent manner. The study also showed how nicotine-containing e-cigarette fluid is more damaging than nicotine-free fluid.

Reference: Scott A, Lugg ST, Aldridge K, et al Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages Thorax Published Online First: 13 August 2018. doi: 10.1136/thoraxjnl-2018-211663 Lesadmick (talk) 08:39, 17 August 2018 (UTC)

The source is a primary source. See WP:MEDRS. QuackGuru (talk) 15:57, 17 August 2018 (UTC)

There is no ban on using primary sources, just that the information may later change - feel free to highlight the preliminary nature of the result, but it is still relevant to the safety discussion. Lesadmick (talk) 08:43, 20 August 2018 (UTC)

 Not done: If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.  spintendo  05:37, 31 August 2018 (UTC)

Spinfuel

Wondering peoples thoughts on this source?

http://spinfuel.com/all-about-temperature-control/

Doc James (talk · contribs · email) 10:02, 15 October 2018 (UTC)

this source has already been used in this article see reference number 91

We should be asking the same question about a page like this with is fairly cut and dry but filled with information the average person will find in few other places. https://vaping360.com/vaping-101/

Few mass media outlets, reference books and non-academic sources exist for all things electronic cigarette related regarding the technical information an average person interested in the topic might have. https://spinfuel.com/about/ is an established website to look to for vaping basics and more advanced information as well as original editorial reviewing products as they are released in addition to news related to the industry. Mrphilip (talk) 11:36, 15 October 2018 (UTC)

There's a discussion at Wikipedia:Reliable sources/Noticeboard#Spinfuel. I'll comment there; that seems a more centralized location for a discussion of the quality of spinfuel.com. Huon (talk) 17:38, 15 October 2018 (UTC)

Can EC article be improved with this 2017 book?

Request for other editors input and suggestions as how and where it may be of use as information resource.

Analytical Assessment of e-Cigarettes From Contents to Chemical and Particle Exposure Profiles Published • 2017 Mrphilip (talk) 06:20, 27 October 2018 (UTC)

Poison Control Concerns, Pediatric and Adult

I do not want to mishandle the information available and ask others to review these two sources of pertinent data.

I believe this article should note the 2016 Poison Control Center numbers (next update comes out in a month so if not these numbers, we can use 2017's) on tobacco/nicotine/e-cigarette products as a single poison category and in comparison to the issue of poison control calls as a whole (transparent perspective, not alarmist editing).

There where 2,159,032 calls about human exposures in 2016. 46.4% where kids 5 and under. Changes in the number of calls between 2000 and 2016 have put this category on the list of 25 most significantly relevant substances. Of the 1,045,339 reported pediatric exposures 1.17% fall under this category representing 11,358 single substance exposures. Serious exposures have been increasing at the rate of about 11 calls a year.

We should note that after breaking this category down and only looking at electronic cigarettes and liquid nicotine the numbers are significantly lower. Such calls started to come in the 2011 and are available through September 30, 2018. In 2013 there were 1,543 calls, 2014 a spike to 4,023 then dropping to 2,478 in 2017 and so far this year 2,226.

Given this information, I think it is clear that tobacco cigarettes comprise the bulk of poison center calls.

How should we present this properly? If 46% of poison calls were pediatric in 2016 and we know those 11,358 were categorized as tobacco/nicotine/e-cigarette are we misrepresenting the issue if we fail to include that specifically 2,907 calls identified e-cigarette and liquid nicotine as the substance exposure... or an estimated 1,337 pediatric exposures. What percent of the 2,159,032 total calls does this articles topic prove to be. Would that number be significant enough to include on the top 25 reported serious concerns. The larger category did not make the list of top 25 concern for those 20 and above.

References

Mrphilip (talk) 07:25, 27 October 2018 (UTC)

From the nicotine article

This content was in the toxicity section of the nicotine article. It's undue weight to cover nicotine toxicity from ecigs at length and concerns about it in that article, so I figured I'd merge it into this one. However, there's no readily apparent place where this material is apt, so I'm putting it here. If anyone can find a home for it in this article, great. If not, it's no big deal.

Ecig-related content exported from nicotine

The rise in the use of electronic cigarettes, many forms of which are designed to be refilled with nicotine-containing e-liquid supplied in small plastic bottles, has raised concerns over nicotine overdoses, especially in the possibility of young children ingesting the liquids. A 2015 Public Health England report noted an "unconfirmed newspaper report of a fatal poisoning of a two-year old child" and two published case reports of children of similar age who had recovered after ingesting e-liquid and vomiting. They also noted case reports of suicides by nicotine. Where adults drank liquid containing up to 1,500 mg of nicotine they recovered (helped by vomiting), but an ingestion apparently of about 10,000 mg was fatal, as was an injection. They commented that "Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake." The FDA recommends that e-cigarettes and e-liquids be kept in a safe place, where children and pets do not have access to them.

Seppi333 (Insert 2¢) 17:28, 23 January 2019 (UTC)

• Thanks for posting this here! I inserted most of it into the Nicotine subsection of the Health effects section. --Chumash11 (talk) 16:47, 25 January 2019 (UTC)
  • There article at least two sections in this article that are undue weight. Both the nicotine section and passive vaping section should be removed. There is an article for nicotine and the content about passive vaping is duplication from the safety article. QuackGuru (talk) 17:55, 25 January 2019 (UTC)

References

Nomenclature of the word "internet"

In the article, the word "internet" is spelled "Internet", which is wrong. The word "internet" is not a brand name or any other kind of proper noun and actually gets a lower case first letter, not a capital letter. What a shame that articles with poor spelling and grammar are blocked for editing to correct their poor spelling and grammar. This foregoing unsigned comment was by Liambot. — Preceding unsigned comment added by 2407:7000:9C3D:4800:5DD8:9967:1F85:A998 (talk) 04:51, 4 March 2019 (UTC)

Long term health effects

These are uncertain and this is a major point. What effects they will have on long term rates of smoking tobacco is unclear with concerns that they will result in nicotine addiction persisting. Doc James (talk · contribs · email) 20:59, 3 April 2019 (UTC)

The sentence "Their long-term health effects are not known." is quite redundant in relation to "The health risks of e-cigarettes are uncertain." and many other reflections of uncertainty in the paragraph.

E-cigarette effects on tobacco smoking and nicotine addiction are already addressed in the paragraph.

Zvi Zig (talk • contribs 21:16, 3 April 2019 (UTC)

Discussion on the talk page

See Talk:Marketing of electronic cigarettes#Issues have not been resolved. Is the page a POV Fork? QuackGuru (talk) 01:25, 4 April 2019 (UTC)

Seizures

Content about seizures was not added. Only a citation was added.[7] Now there is two citations after a claim. Both citations verify very different content. Content about seizures is not a part of a summary of any subpage.

For content about seizures that is verifiable see the subpages.[8][9] The Electronic cigarette#Nicotine content on this page is not a summary of any subpage. The Electronic cigarette#Passive vaping is also not a summary of any subpage. QuackGuru (talk) 18:25, 6 April 2019 (UTC)

Suggest

The "...short-term human studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes"[10] does not mean they are likely substantially safer.[11] The content fails verification because it does not follow the source. The part about "suggest was left out and the other sources do not support it was a suggestion and different sources verify different content. There are five sources for one claim.[13][14][15][16][17] This is not necessary and looks strange. QuackGuru (talk) 20:08, 16 April 2019 (UTC)

"Likely safer"

Is fine. Doc James (talk · contribs · email) 20:22, 16 April 2019 (UTC)

It's not fine at all. It leaves readers in the dark!

1. The National Academies of Sciences report on e-cigarettes says:

Laboratory tests of e-cigarette ingredients, in-vitro toxicological tests, and short-term human studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.

https://www.ncbi.nlm.nih.gov/books/NBK507163/

2. The Cochrane Review says:

Expert consensus broadly holds that, based on all available evidence, ECs are considerably safer than traditional cigarettes

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub3/full

3. The American Cancer Society says in a published public health statement:

Along the spectrum — and closer to nicotine-replacement therapies than to combustible tobacco products — are current-generation ENDS, which are likely to be much less harmful than combustible tobacco products.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21455

5. A consensus statement of major UK public health organizations:

We all agree that e-cigarettes are significantly less harmful than smoking

https://www.gov.uk/government/news/e-cigarettes-an-emerging-public-health-consensus

Zvi Zig (talk • contribs 21:34, 16 April 2019 (UTC)

Selecting specific sources that support a certain view is not going to help. We could delete all sources and start over. We should stick to a more neutral statement using only reviews rather that pile up multiples sources after one sentence. Using five sources shows there is a problem. QuackGuru (talk) 01:10, 17 April 2019 (UTC)

I do not mean to select sources. The National Health Service (England) and National Academies of Sciences, Engineering, and Medicine agree that e-cigarettes likely pose a substantially reduced health risk compared to traditional cigarettes. No equal or more authoritative WP:MEDRS source contradicts this, to my knowledge. Shouldn't this be somehow conveyed to the reader. I'm afraid that "likely safer" etc. may give the impression that e-cigarettes may be only slightly reduced risk.Zvi Zig (talk • contribs 02:42, 17 April 2019 (UTC)

See "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[12]

Please select from reviews only. The part "likely safer" is POV and not neutral. I found sources that come to a different conclusion than "likely". The part likely is what is causing confusion. The next step is to delete all the sources that are not reviews rather than select from organizations. QuackGuru (talk) 03:25, 17 April 2019 (UTC)

According to NICE, "the evidence suggests that e‑cigarettes are substantially less harmful to health than smoking but are not risk free".

According to the National Academies of Sciences, "... studies suggest that e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes".

How are we to communicate the fact that e-cigarettes are likely more than minimally less harmful than cigarettes?

Zvi Zig (talk • contribs 15:54, 17 April 2019 (UTC)

We should not communicate the statements from organizations when reviews provide more neutral statements. We should use reviews instead that review the overall evidence. When sources disagree we should summarize the more neutral statements. QuackGuru (talk) 16:34, 17 April 2019 (UTC)

1. Reviews are a lesser WP:MEDRS source than major medical and scientific organizations.
2. Stating "the evidence suggests that" is not merely an opinion.
3. The National Academies of Sciences conclusion is in the summary of its comprehensive review.

Zvi Zig (talk • contribs 20:38, 17 April 2019 (UTC)

1. See WP:MEDORG: "Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance with WP:WEIGHT."
2. See WP:MEDORG: "The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature."
3. The opinion from organizations clashes with the statements in the medical literature from reviews. Since there is disagreement we should write a more neutral statement using reviews.

QuackGuru (talk) 21:58, 17 April 2019 (UTC)

1. Scientific reports by the National Academy of Sciences and NICE clinical guidelines comprise the highest levels of evidence according to WP:MEDASSESS and [[WP:MEDORG.
2. No high level source contradicts the NAS and NICE conclusions that evidence suggests that e‑cigarettes are substantially less harmful to health than smoking.

Zvi Zig (talk • contribs 23:21, 17 April 2019 (UTC)

There are MEDRS compliant reviews that come to a different conclusion than they are substantially less dangerous. I recommend we don't ignore reviews that provide more neutral conclusions. QuackGuru (talk) 01:13, 18 April 2019 (UTC)

1. NICE clinical practice guidelines and NAS reports are of higher credibility than mere reviews.
2. To my knowledge, no credible reviews contradict the notion that e-cigs are likely to be substantially less harmful.

Zvi Zig (talk • contribs 04:29, 18 April 2019 (UTC)

1. See again "E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking."[13] This creditable review contradicts the believe that vaping is likely to be substantially less dangerous. We can also take into account vaping products can explode and can cause serious immediate injury such as burns.
2. See WP:MEDORG: "The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature." They may be less authoritative than the underlying medical literature.

QuackGuru (talk) 16:54, 18 April 2019 (UTC)

That source is specifically about tobacco/NRT and e-cigarettes in otologic and neurotologic surgery situations - there is nothing in the review about what is discussed here, which is how e-cigarettes compare to tobacco in general. And aside from that - the review actually based on the little information available on e-cigs in surgery, considers the risk to be comparable to NRT. --Kim D. Petersen 00:03, 19 April 2019 (UTC)