FDA’s ‘Real Cost’ Campaign Cuts Cigarette Smoking by Teens

The Food and Drug Administration’s (FDA) antismoking campaign prevented nearly 350,000 youth from becoming cigarette smokers, saving the nation $31 billion in mortality, earnings loss, and other costs, according a study last month in the American Journal of Preventive Medicine.

But while traditional cigarette smoking among youth has declined, their use of another product that delivers nicotine—e-cigarettes—has reached “epidemic proportions,” FDA Commissioner Scott Gottleib, M.D., wrote in a press release on September 18 (see box).

The antismoking campaign—called The Real Cost—was launched in February 2014 and focused on preventing youth aged 12 to 17 years old from starting the use of traditional, combustible cigarettes. Campaign ads appeared on national television and radio stations and the Internet, as well as in magazines and on movie theater screens, with the central theme of “Every cigarette costs you something.” Its first three years of advertising focused on the cosmetic effects of smoking, the loss of control caused by addiction, and the dangerousness of the toxic mix of chemicals in cigarette smoke.

The study examined the campaign’s cost-effectiveness during its first two years, for which the FDA had spent nearly $247 million. Among youth who had never smoked a cigarette, those with high exposure to The Real Cost campaign were 30 percent less likely to start, another study found. The campaign was associated with preventing about 350,000 youth aged 11 to 18 years from starting smoking; about half of youth who initiate smoking become established adult smokers, so the campaign was estimated to have prevented nearly 176,000 youth from becoming established adult smokers, the study found.

The authors determined that the total lifetime costs to society for each smoker who begins at age 15 is more than $180,000, according to Anna J. MacMonegle, M.A., research public health analyst at RTI International, and colleagues. The greatest costs, in order, included the cost of the smoker’s mortality, the smoker’s spouse’s mortality (due to secondhand smoke), loss in the smoker’s earnings, the cost of the smoker’s disability, and the cost of the cigarettes.

Ultimately, the campaign resulted in an overall return on investment of $128 for every $1 spent, for a cost savings of $31 billion. “This value represents a large reduction in the financial burden to individuals, their families, and society as a result of tobacco use,” the authors wrote. “Public health campaigns like The Real Cost reduce the burden of tobacco-related morbidity and mortality for a generation of U.S. youth. The findings suggest that these interventions not only markedly improve public health outcomes, but they also provide substantial cost savings.” ■

“The Cost-Effectiveness Analysis of The Real Cost Campaign’s Effect on Smoking Prevention” can be accessed here.

See related article: E-Cigarette Use Rising Sharply.