The Real Cost: A Cost-Effective Approach
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From its launch in Feb. 2014 to Nov. 2016, FDA’s first smoking prevention campaign, “The Real Cost,” prevented up to 587,000 youth ages 11 to 19 from initiating smoking, half of whom might have gone on to become established adult smokers.
Preventing teens from initiating smoking doesn’t just impact their personal health, but also the health of their families and smoking-related costs borne to society. Ultimately, by preventing these kids from becoming established smokers, the campaign will save them, their families, and the country more than $53 billion by reducing smoking-related costs like early loss of life, costly medical care, lost wages, lower productivity, and increased disability – that’s more than $180,000 in savings for each of the up to 293,500 youth that would likely have become an established smoker.
The campaign obtained these impressive results through a carefully executed paid media strategy based on evidence-based best practices for tobacco prevention campaigns, and by ensuring its messaging was designed to reach and motivate an at-risk teen audience. For example, FDA conducts research with at-risk teens across the country to develop campaign advertising that resonates. Near-final TV ads are tested with thousands of target audience members for perceived effectiveness and message comprehension prior to being placed in market.
Read about our Research and Evaluation approach for The Real Cost.
FDA also hired an independent firm, RTI International, to conduct a multi-year evaluation to measure indicators of success throughout the first two years of the campaign, including advertising awareness and changes in the target audience’s tobacco-related beliefs, intentions and behaviors. Results from this research are impressive: More than 90 percent of the target audience was aware of the first wave of ads less than a year after launch, and the campaign changed teens’ perceptions and beliefs about tobacco, ultimately resulting in a 30 percent decrease in youth smoking initiation from 2014 to 2016.
These results not only reinforce the importance of our public education efforts in reducing the public health and financial burden of tobacco use, but also highlight the importance of investing in tobacco-related education campaigns. Investment in tobacco prevention can have huge returns: The campaign had a cost savings of $180 for every dollar of the nearly $250 million invested in the first two years of the campaign. The campaign continues to air nationally across TV, radio, print, web, and social media.
Additional Resources
- Impact of The Real Cost Media Campaign on Youth Smoking Initiation
- Cost-Effectiveness Analysis of The Real Cost Campaign's Effect on Smoking Prevention, American Journal of Preventive Medicine
- How “The Real Cost” successfully changed youth's risk perceptions and beliefs about smoking, American Journal of Health Promotion
- Findings on the target audience's awareness, PLOS ONE (2015)
- Evidence of youth receptivity to the ads during message pretesting, Journal of Health Communication
1. U.S. Census Bureau. Monthly Population Estimates by Age, Sex, Race, and Hispanic Origin for the United States: April 1, 2010 to July 1, 2015. Washington, D.C.: U.S. Census Bureau, Population Division; 2016. Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA). Total At-risk Experimenters and Susceptible Non-trier Estimates: 2015 NYTS Dataset and Codebook. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Updated October 1, 2015. http://www.cdc.gov/tobacco/data_statistics/surveys/nyts/. Accessed February 24, 2017.