New research shows “The Real Cost” educational efforts blocked millions in illegal e-cigarette sales and shifted youth attitudes toward nicotine addiction.
RT’s Three Key Takeaways:
- Youth Initiation Prevention: A peer-reviewed study found that “The Real Cost” campaign successfully deterred an estimated 444,252 American youth from starting e-cigarette use between 2023 and 2024.
- Reduction in Illegal Market: The Food and Drug Administration (FDA) estimates the educational campaign resulted in over $42 million in lost sales for unauthorized e-cigarette products targeted at youth.
- High Audience Reach: Analysis shows that 75% of surveyed youth reported seeing at least one prevention advertisement, with high awareness among groups at elevated risk for nicotine addiction.
The USFDA has released new data demonstrating that its “The Real Cost” public education campaigns prevented an estimated 444,252 youth from starting e-cigarette use between 2023 and 2024.
According to a special issue of the American Journal of Preventive Medicine (AJPM), these efforts also blocked more than $42 million in sales of unauthorized e-cigarette products that would have been purchased by minors. The special issue includes 12 peer-reviewed papers authored by FDA scientists and external researchers detailing the strategy and public healthcare impact of the campaigns.
“Given the careful research that went into the campaign’s development, it’s no surprise that ‘The Real Cost’ has been so effective at its core goal of preventing youth from starting to use tobacco products,” said Bret Koplow, PhD, JD, acting director of FDA’s Center for Tobacco Products (CTP), in a news release. “I’m heartened to see the scientific investment in developing these efforts transformed into real-world success in keeping kids from picking up a cigarette or e-cigarette.”
Originally launched in 2014 to target cigarette use, the program expanded in 2018 to address the rise of e-cigarettes. The campaign has transitioned from broadcast television to digital and social media platforms to match changing media consumption patterns among teenagers. An audience segmentation analysis found that the media strategy successfully reached teens at the highest risk of tobacco use and nicotine addiction.
Research indicates that the campaign is also successfully connecting youth already experiencing nicotine addiction with cessation resources. Between 2021 and 2022, links from the campaign led to more than 253,000 visits to the National Cancer Institute cessation website, SmokefreeTeen. These visitors were significantly more likely to complete quit plans than those arriving from other sources, resulting in over 11,000 completed e-cigarette quit plans driven by the campaign alone.
A meta-analysis of a decade of ad testing found that the prevention ads consistently shifted youth beliefs regarding tobacco use. The largest effects were seen in e-cigarette advertisements, which researchers attribute to the fact that many teenagers were initially unaware of the risks associated with vaping when the campaign launched.
Since 90% of adults who smoke began before age 18, the FDA identifies youth prevention as a vital long-term strategy for reducing overall smoking rates and adverse health outcomes. The agency is now exploring ways to expand these efforts to educate individuals who can influence adults who smoke, such as encouraging cessation or raising awareness of harm-reduction strategies.
“The creativity and scientific rigor of the campaign have proved that evidence-based public education ‘can fundamentally change how people think about tobacco products,’” said Koplow.
