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  1. The Real Cost Campaign

The Real Cost Smokeless Tobacco Campaign

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In April 2016, FDA launched a new campaign under “The Real Cost” brand to reach rural male youth ages 12-17 who were at risk for smokeless tobacco use.

The Real Cost Smokeless Tobacco

Our Goal: Prevent and reduce smokeless tobacco use in rural male youth, an audience that was more than twice as likely to use smokeless tobacco as those in urban areas.

This was the first large-scale smokeless prevention campaign designed to reach this audience and was built on extensive research.

Smokeless doesn’t mean harmless,” the campaign’s central message, motivated rural male youth to reconsider what they think they know about smokeless tobacco use.

Campaign Research

How We Used Research to Develop “The Real Cost” Smokeless Tobacco Campaign

Extensive research with male youth was conducted across the country in rural communities with high rates of smokeless tobacco use. Research included focus groups and in-depth interviews with teens to understand their unique cultural and behavioral characteristics.

Smokeless Doesn't Mean Harmless

From research, we learned:

  • Male youth were more likely to initiate smokeless tobacco use if it was offered by a family member or friend.
  • “Dip” use is a common form of social bonding during sports and outdoor activities.
  • Messages that create negative emotional responses, such as disgust or fear, were compelling and easy to understand for this audience.
  • Motivating messages needed to include straightforward facts about the consequences of dipping and depict a story or include an emotional appeal.
  • Rural male youth had strong sense of community within their hometown and valued relationships with adult mentors, such as coaches or family members.

Our Approach

The campaign delivered facts about the dangers of using smokeless tobacco in relevant and attention-grabbing ways with a focus on addiction and negative health consequences that was relatable and appealed to the audiences’ identity. Advertising was tailored to the interests of rural male youth (hunting, fishing, sports) in communities with the highest smokeless tobacco rates.

The campaign used a variety of tactics and communication channels that aligned with the audiences’ interests, including:

  • Local television and radio
  • Outdoor signs
  • Digital advertising, such as online videos
  • Social media on Instagram and Facebook
  • Influencers
  • Campaign website

Our Impact

“The Real Cost” Smokeless campaign ended in 2020 and was successful in reaching the target audience and delivering tailored messages that changed the audiences’ beliefs and attitudes. Some key learnings and accomplishments include:

  • Older adults, influential dads, coaches, and female peers played an important role in influencing the audience’s behavior – featuring these influential figures in our ads evoked positive feelings and aligned with the audiences’ values.
  • Graphic depiction of cosmetic and health consequences grabbed the audience’s attention. For instance, illustrating the long-term effects such as gum disease and jaw removal or developing white patches in the mouth was described as compelling.
  • Addiction messages depicting loss of control paired with a negative social consequence, such as dip interfering with teens’ personal goals, were believable and motivating to the audience.
  • Social media influencers active in outdoor activities (hunting, fishing, sports) delivered authentic messages, built credibility, and increased audience engagement on social media.
  • “The Real Cost” Smokeless Tobacco Prevention Campaign website had over 3.7 million visitors, and the campaign’s social media channels had over 340K monthly social interactions, such as likes, shares, comments, link clicks, and video views.

“The Real Cost” Smokeless Campaign – Making Sure Rural Male Youth Understand that Smokeless Does Not Mean Harmless
  • “Don’t Search It” ads peaked teen curiosity by using graphic visuals in ads to show negative health effects from smokeless tobacco and encouraged teens not to search for those consequences. These ads resulted in increased searches of keywords, such as mandibular cancer and white patches, and increased visits to the campaign website.
  • Worked with sports coaches in rural communities to share their personal experiences with dip using storytelling through videos on social media.

Campaign Evaluation Highlights

FDA conducted a longitudinal study on the impact of “The Real Cost” Smokeless.

  • The campaign was successful in reaching almost 90 percent of the intended rural male youth audience.
  • Several beliefs and attitudes on addiction and health consequences, such as “If I use smokeless tobacco, I will damage my body” and “If I use smokeless tobacco, it will shorten my life” changed significantly during the campaign among older boys, ages 14 to 16.

Campaign Ads


Dip can cause mouth cancer poster
Smokeless tobacco poster - This can can cause mouth cancer, tooth loss, brown teeth, jaw pain, white patches and gum disease.


Up to 87 Tools

Dip Can Leave a Mark

Don't Search It


Select campaign print advertisements are available on the Tobacco Education Resource Library.


Awards and Recognition

  • Effie Award
    • 2017 Bronze: Youth Marketing category
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