E cigarette makers aim to hook youth on their products using music festivals, free samples and candy flavored versions, U.S. Democratic lawmakers said.

The findings, in a survey released today by members of Congress, should prod U.S. regulators to curb the industry, the lawmakers said. While e cigarettes currently are unregulated, the Food and Drug Administration is working on a plan that would extend its tobacco oversight to the products.

Six of nine companies surveyed had sponsored or provided free samples at 348 events in the last two years, including the Bonnaroo and Coachella music festivals and Grand Prix races. Six companies including Green Smoke, acquired April 1 by Altria Group Inc. (MO) and Lorillard Inc. (LO), also offer flavors such as cherry crush and vanilla dreams.

These are the same tactics that were used by major cigarette manufacturers before they were banned, said U.S. Representative Henry Waxman, a Democrat from California, on a conference call. Our findings demonstrate the FDA regulation of e cigarettes is necessary to prevent manufacturers from targeting youth with aggressive marketing practices.

E cigarettes are battery powered tubes that simulate the effect of smoking by producing nicotine vapor. E cigarette smokers are sometimes referred to as vapers. The FDA found there isn t enough information on the products to determine if they re less harmful than traditional cigarettes, according to a study published today in the journal Tobacco Control.

In October, the agency submitted a proposal to oversee the industry to the White House s Office of Management and Budget that authorizes all regulations. The proposal is still under review at OMB, according to the office s website.

Prod to Act

This report we re issuing today should be a prod for them to act, Waxman said.

The use of e cigarettes by middle school and high school students in the U.S. doubled to 10 percent in 2012 from 2011, the Centers for Disease Control and Prevention found in September. The agency has also said e cigarette related calls to poison centers rose to 215 a month in February, compared with one a month in September 2010.

Waxman and U.S. Senator Richard Durbin, a Democrat from Illinois, led the investigation. Durbin called e cigarettes a gateway to smoking rather than a cessation tool as some studies have asserted.

Regulation Urged

The congressional report calls on the FDA to assert its authority over e cigarettes and companies to immediately prevent the sale of the products to anyone younger than 18 and refrain from television and radio advertising. The FDA should ban flavored e cigarettes that appeal to youth and companies should stop selling them as well, the report said.

Altria has expressed support for FDA regulation, David Sutton, a spokesman for the Richmond, Virginia based company, said by telephone.

Obviously, we think that the agency should include an appropriate set of marketing regulations, Sutton said. Those regulations should allow the companies to communicate to adult vapers.

Sutton declined to specify the type of marketing regulation the FDA should impose.

NJOY has long supported sensible regulations, Whit Clay, a spokesman for the company at Sloane & Co., said in an e mail.

Reynolds American Inc. (RAI) backs strengthening and updating state youth tobacco control laws to prohibit youth purchase of tobacco products, Jane Seccombe, a spokeswoman for the Winston Salem, North Carolina based company said.

$7.5 Billion in Sales

Bloomberg Industries estimates global e cigarette sales may reach $7.5 billion in 2015, compared with $3.5 billion last year. The sales projection almost cuts in half an October estimate of $14 billion in 2015 sales based in part on expected advertising restrictions.

Six e cigarette companies spent $59 million in 2013 to market their products, double the amount spent the year before. Seven of the manufacturers including NJOY and Reynolds have used radio or television advertisements, some featuring celebrities such as Jenny McCarthy. Seven companies also used social media sites such as Facebook and Twitter to market their products.

Twenty eight states have prohibited the sale of e cigarettes to minors while most companies had some type of restriction on youth sales.

Given the varied scope and company oversight of these policies, their effectiveness at restricting sales to minors is unclear, according to the congressional report.

To contact the reporter on this story Anna Edney in Washington at aedney

To contact the editors responsible for this story Reg Gale at rgale5 Angela Zimm, Andrew Pollack

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Q I recently have started using an e cigarette. It has dramatically cut down my smoking of traditional cigarettes, plus there is no smoke smell or residual on clothing or furniture.

I initially experienced headaches and was told to reduce the nicotine percentage in the liquid. That helped. Are you aware of any other side effects?

A Electronic cigarettes contain a battery powered heater to vaporize a nicotine solution so that the nicotine can be inhaled. This avoids some of the other toxins in cigarette smoke, but nicotine itself can have side effects. They include headache, heart rhythm disturbances and elevated blood pressure.

A preliminary report in JAMA Internal Medicine (online, March 24, 2014) noted that people using e cigarettes were no more likely to quit smoking than those using traditional cigarettes alone. Nicotine is a powerfully addicting drug.

Q Insurers require us to use generic drugs. My wife and I both take Ambien when we travel, which is quite often.

If we were buying brand name Ambien, it would cost us more than $350 out of pocket for 30 pills. Our insurance would not pay a penny.

The generic zolpidem costs $8 to $10 for the same number of pills. We have found that one generic works just like the brand name, but a different maker s generic doesn t work at all.

So far, we ve been able to request the specific maker we prefer from the pharmacy. But we worry that if the pharmacy can t supply the one that works, we might get no sleep at all on our journeys. Do you have any recommendations about how to deal with this problem?

A Like hundreds of other readers, you have discovered that generic drugs are not all “identical.” Despite reassurances from the Food and Drug Administration, some generic manufacturers seem to provide better products than others.

Your strategy to request the generic that works for you is sensible. This approach may require planning ahead, since the pharmacy might have to place a special order for you.

Q Ever since I went on a low carb diet in 1964 (before Atkins), I have used only whole milk. When the government began advocating a low fat diet, Americans became obese, because when you remove the fat from a product, you have to add carbs to make it taste better.

My husband is a type 2 diabetic. When he took charge of his diet, he found that by eating very low carb and high fat, his blood lipids improved, and he lost weight. He can keep his blood sugar under control without insulin when he eats very low carb.

A Contrary to conventional dietary advice, a recent meta analysis of nutritional studies found no convincing connection between a diet high in saturated fat and an elevated risk of heart disease (Annals of Internal Medicine, March 18, 2014). This finding is controversial, but seems in line with your family s experience.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website