Talk:Tobacco harm reduction

Use of Electronic Cigarette as Delivery Mechanism for Cannabis
Although I can find references to people attempting (and even succeeding at this) online, I can find no references to any concern on the part of law enforcement about this (searched for "law enforcement concern electronic cigarettes cannabis") and there is no relevant citation. I've never seen this concern raised before this article, and find it unlikely this is a true concern given the proliferation of other subtle and stealthy devices for administering cannabis. Marked citation needed for now with the intention to remove this claim should it not prove founded in the near future. ND (talk) 00:19, 9 December 2012 (UTC)


 * I edited out some of the harsh language (e.g. brazenly smoke cannabis in public -> vaporize cannabis in public) in this section because it seemed like non-NPOV. 67.5.25.53 (talk) 01:15, 18 November 2013 (UTC)

Legality of Electronic Cigarettes in certain Countries
-I don't have any actual sources to support legality of electronic cigarettes in the United States but the article states that it is illegal to purchase or use electronic cigarettes in the US but I have been able to purchase and use them without any issue. I will search for an actual source for this data. Robotunicr0n (talk) 15:44, 30 May 2012 (UTC)

Sources addressing Legality of Ecigs in the US

 * Electronic_cigarette
 * "In December, a federal appeals court in Washington, D.C., ruled in the e-cigarette industry’s favor, and in January the U.S. Court of Appeals for the District of Columbia rejected an FDA request to overturn the lower court’s ruling, setting the stage for a potential showdown before the Supreme Court on the issue of whether the devices should be regulated under existing tobacco legislation or be subject to a nationwide ban until such time they are approved by the FDA." Article published in Feb 2011
 * "In December, a federal appeals court in Washington, D.C., ruled in the e-cigarette industry’s favor, and in January the U.S. Court of Appeals for the District of Columbia rejected an FDA request to overturn the lower court’s ruling, setting the stage for a potential showdown before the Supreme Court on the issue of whether the devices should be regulated under existing tobacco legislation or be subject to a nationwide ban until such time they are approved by the FDA." Article published in Feb 2011


 * -From this information it seems that at a federal level, ecigs are not illegal though there is no definitive language in the Sun Times article that states the actual outcome of that court case, it just says "ruled in favor". Assumption based on that evidence leads to the conclusion that it is at least not illegal. It also seems that  at the state government level some states have created laws governing certain forms of distribution, which may include making them illegal in some states. Robotunicr0n (talk) 16:01, 30 May 2012 (UTC)
 * ~From my understanding, the FDA attempted to regulate e-cigarettes as a drug / drug delivery device, but Judge Leon said no, they are no more a drug delivery device than cigarettes and were NOT subject to pre-market review. Going second hand the FDA the FDA granted authority to health departments to regulate them as they see fit.  I'd have to find a source for this assertion, however there are plenty of secondary sources that show the FDA's intent to regulate e-cigarettes as tobacco products .  To date, AFAIK, they have not done so.  Based on the Reuters citation it seems clear e-cigarettes are legal to sell on the federal level at this time.  Further a court ruling stating they are no more drug delivery devices than tobacco products suggests their de facto legal status until expressly addressed. MattZuke (talk) 07:01, 28 September 2012 (UTC)

American Association of Public Health Physicians
I will probably not have time to edit this article much. So I am leaving some info and references on the talk page. See also: electronic cigarettes and its talk page.

Harm reduction, a modality of dealing with other drug use, is beginning to be applied to tobacco use. In October 2008 the American Association of Public Health Physicians (AAPHP) became the first medical organization in the U.S. to officially endorse tobacco harm reduction as a viable strategy to reduce the death toll related to cigarette smoking.
 * Update on the Scientific Status of Tobacco Harm Reduction, 2008-2010. Prepared for the American Association of Public Health Physicians. Brad Rodu, DDS and Joel L Nitzkin, MD. June 28, 2010.
 * Principles to Guide AAPHP Tobacco Policy. American Association of Public Health Physicians.
 * The Scientific Foundation for Tobacco Harm Reduction, 2006-2011. Brad Rodu. Harm Reduction Journal. 2011, 8:19 . Published: 29 July 2011.
 * Joel L Nitzkin. LinkedIn.

Joel Nitzkin, MD, of the AAPHP wrote: "So if we can figure that the nicotine in the e-cigarettes is basically a generic version of the same nicotine that is in prescription products, we have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent, probably lower than one tenth of one percent of the hazard posed by regular cigarettes." --Timeshifter (talk) 15:06, 18 May 2013 (UTC)
 * Electronic Cigarette Interview with Dr Joel Nitzkin.
 * Nitzkin E Cigarette Interview 2 : E Cigarette Direct.

Smoking tobacco without additives
Smoking tobacco without additives. See also: List of additives in cigarettes.
 * Tobacco Additives - European Commission. On Europa, the official web portal of the European Union (EU).

"While these ingredients are approved as additives for foods, they were not tested by burning them, and it is the burning of many of these substances which changes their properties, often for the worse. Over 4000 chemical compounds are created by burning a cigarette – 69 of those chemicals are known to cause cancer."
 * Cigarette Ingredients - Chemicals in Cigarettes. Tri-County Cessation Center. New York State Department of Health Tobacco Control Program.

"From a public health perspective, increasing the addictive potential of cigarettes with additives (e.g., via formulas including sugar, sorbitol, and DAP) increases the likelihood that new smokers will become addicted and that current smokers will have more difficulty quitting. Consequently, there will be greater levels of morbidity and mortality associated with smoking. ..."

"The tobacco industry has actively manipulated cigarette content by using potentially hazardous chemical and phytochemical additives that should be regulated. Unregulated use of additives in tobacco products subjects billions of smokers and nonsmokers alike to an uncontrolled experiment with potentially devastating health effects."
 * Pharmacological and Chemical Effects of Cigarette Additives. American Journal of Public Health. 2007 November; 97(11): 1981–1991..

Marijuana habit not linked to lung cancer. IMNG Oncology Report. By Michelle G. Sullivan, Oncology Report Digital Network, May 8, 2013: "The difference in risk is likely related to chemical additives in commercial cigarettes that aren’t present in most methods of inhaling marijuana smoke." Article is also found here. --Timeshifter (talk) 15:52, 18 May 2013 (UTC)

These are all speculations. None of these sources show that the presence of additives affects the mutagenic and inflammatory properties of smoke. Including this suggests to users they can reduce their hazards simply by smoking without additives. This isn't supported by any literature listed here, and until it is, that notion needs to be challenged and removed. In fact, it is a serious misconception. — Preceding unsigned comment added by 68.84.199.178 (talk) 02:18, 17 April 2019 (UTC)

E-cigarettes at least as effective as nicotine patches for quitting, and better at cutting down on cigarettes
E-cigarettes 'as effective' as nicotine patches. By James Gallagher. 7 September 2013. BBC News. From the article:

"The results published in the Lancet showed 7.3% using e-cigarettes had quit after six months compared with 5.8% using patches. However, the study did not involve enough people to definitively prove which is the better option. After six months, however, 57% of e-cigarette users had halved the number of cigarettes smoked each day compared with 41% in those using patches." --Timeshifter (talk) 15:02, 9 September 2013 (UTC)

Deleted sentence about the "role" of e-cigarettes
I'm having difficulty putting this round peg into the square hole of Wikipedia rules, policies, etc... but minimum it's an objection to style. If there's a "role" for e-cigarettes, and if, when and how people should be allowed to use them (or not) who determines that "role". This sentences says: "The invisible masters that determine for all humanity what is allowed and what is not have not yet determined the roles of all the millions of people that might want to use e-cigarettes, but someday they will, and then wikipedia will give you their imperial edict." It raise the idea of a "role", some kind of track of expected behavior, etc... but then cannot deliver. It's an expectation, and from a personal freedom perspective I find it's presence in the article thoroughly objectionable and offensive. And I can't think of a compelling reason to keep it in. It adds nothing but FUD.Jonny Quick (talk) 05:34, 10 August 2015 (UTC)
 * I improved the wording. QuackGuru  ( talk ) 16:34, 10 August 2015 (UTC)
 * Changing "role" to "strategy" merely changes the metaphor. Instead of being assigned "roles" by an unnamed and unseen controlling power, smokers are now being presented with a "strategy" by the same unnamed and unseen power.  Who's the power?  Who's strategy is it?  Who decided on this strategy and what is and is not a part of it?  And when did the smoker sign the contract to be part of a group that volunteers to subscribe to someone else's "strategy" in order to quit smoking?Jonny Quick (talk) 03:34, 15 August 2015 (UTC)
 * The evidence is still very limited according to MEDRS. Do you have a suggestion to improve the wording. QuackGuru  ( talk ) 03:36, 15 August 2015 (UTC)

MEDRS violation restored
QuackGuru removed the MERDRS violation. Now it was restored along with another MEDRS violation. Both sources are MEDRS violations. This source is a study. The other source is from a university. QuackGuru ( talk ) 21:55, 3 May 2018 (UTC)

Another source recently added is also a MEDRS violation. I want the MEDRS violations addressed before addressing citation issues. For now I tagged the MEDRS violations and unsourced content. Many sources state that "More long term research is needed." Even if the part about more research is needed was sourced it is not giving any useful information. QuackGuru ( talk ) 18:50, 4 May 2018 (UTC)

Isn't the Columbia research an analysis of existing data thereby making it a secondary source for the original data? The Mailman citation is where overview is then given and the full analysis is in Sciencedirect. I don't see any new data submitted here, only analysis of 2010-2015 chosen as a useful parameter to investigate recent quitters and not include sample where e cigs were not as much of a consideration... if I understand it's purpose. Bring it before the Source Violations to decide.Mrphilip (talk) 23:31, 4 May 2018 (UTC)
 * See WP:MEDRS: "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies. Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials."
 * None of the sources very recently added are MEDRS compliant. For example, the Mailman School of Public Health source is written by people from the Columbia University. Citing a university for medical content is generally unreliable. Sciencedirect publishes numerous studies. Citing a study for medical content is generally unreliable. Citing ecancer news for medical content is also generally unreliable. QuackGuru ( talk ) 01:57, 5 May 2018 (UTC)
 * The MEDRS violations from the Columbia University and Sciencedirect were removed from another page. QuackGuru ( talk ) 16:54, 8 May 2018 (UTC)


 * MEDRS violation citation 6 that you just referenced was not removed as a MEDRS violation, but for being off topic. The person who made those changes was doing an overall edit of things written by a few editors. MEDRS violation citation 7 you refer to has nothing to do with my work on WP. When you see Columbia University do not immediately assume it is a) not an expert's information, nor that it is referring to the very same article you believe is a MEDRS violation but have yet to put before a review board. The Sciencedirect article is not a study but the experts analysis of existing data. Have you bothered to read it yet?Mrphilip (talk) 07:08, 9 May 2018 (UTC)
 * According to this comment the source from Columbia University does not follow WP:MEDRS.
 * See "This study combines two years of data from the National Health Interview Survey (NHIS) to examine correlates." A study combined with a survey results is a poor source. QuackGuru ( talk ) 10:02, 9 May 2018 (UTC)

Citation issues
QuackGuru How do we address citation issues with numbers 8 and 32. I see they need some attention. Please examine and correct if possible. I have been able to read the UKPAR of 32 and not sure what is meant by RCP has not been referenced. I do know there are many sources with the rudimentary info of number 8, but ask you demonstrate to me how you would fix these errors I found- as a helpful example for me to follow moving forward. Citation reference 47 as well. Mrphilip (talk) 04:47, 4 May 2018 (UTC)
 * QuackGuru has been banned from medicine articles and can no longer reply. -- Beland (talk) 05:01, 8 June 2020 (UTC)

Removal of all external links
In this edit you removed the entire "External links" section with the edit summary "too many links". This implies that the maximum number of links you would like to see is zero, which doesn't make much sense. Could you explain how many links you think are appropriate for this article and why? -- Beland (talk) 19:08, 29 May 2020 (UTC)
 * I agree on their removal per WP:NOT (especially WP:NOTPROMOTION and WP:NOTLINK) and WP:EL (especially WP:ELNO).
 * What specific information are they there to provide that's appropriate to use external links for and that cannot be included in the article body? --Hipal/Ronz (talk) 22:29, 29 May 2020 (UTC)
 * Even one external link to an unreliable source is too many links. The maximum number of spam links should be zero. I agree with removing all of them. QuackGuru ( talk ) 16:02, 30 May 2020 (UTC)
 * OK, if your objection is to the quality of the links or the number of low-quality links, then please mention the quality you're objecting to in your edit summary; otherwise it can be misleading or confusing.
 * I also agree with the removal of most of the links, especially to the Facebook page. They are mostly opportunities for readers to join in advocacy, and provide a little information about what's happening in a specific place. The gsthr.org site stands out as having objective statistics about every country in the world, which is probably more than would fit in this article. I'd consider keeping that one and leaving out the others. -- Beland (talk) 17:22, 30 May 2020 (UTC)
 * That source is unreliable. It would be considered unreliable or spam if it were used in the body of the article. QuackGuru ( talk ) 17:34, 30 May 2020 (UTC)
 * Good point about GSTHR. I've restored it. I'm assuming they are reliable and their pov is in line with perspectives already included in the article.
 * How is it unreliable? I was a bit concerned about that myself, looking into who is publishing it. What about the reports that they mention by Harm Reduction International? --Hipal/Ronz (talk) 17:43, 30 May 2020 (UTC)
 * Global State of Tobacco Harm Reduction (GSTHR) is ran by the Knowledge-Action-Change and receives money indirectly from Philip Morris International through the Foundation for a Smoke-Free World. See "The report is published by Knowledge-Action-Change, a company dedicated to the promotion of harm reduction to improve health, and funded through a grant from the Foundation for a Smoke-Free World." The Foundation for a Smoke-Free World was started and funded by Philip Morris International.. See Special:Diff/959119034/959842432. <b style="color: #e34234;">QuackGuru</b> ( talk ) 22:00, 30 May 2020 (UTC)
 * I wouldn't be against it's removal given the doubts from that relationship.
 * I did some quick searches in https://harmreductionjournal.biomedcentral.com/ and https://www.hri.global, but didn't find anything that would make a good substitute. --Hipal/Ronz (talk) 22:35, 30 May 2020 (UTC)
 * I think a link to the CDC on Global Tobacco Control is a good substitute. <b style="color: #e34234;">QuackGuru</b> ( talk ) 22:54, 30 May 2020 (UTC)
 * The CDC link has since been added to the article. -- Beland (talk) 04:59, 8 June 2020 (UTC)