FDA's Real Cost Campaign Helps Reduce Youth E-Cigarette Use
SILVER SPRING, Md. — Youth e-cigarette use is on the decline.
A study coauthored by the U.S. Food and Drug Administration (FDA) revealed that the agency's youth e-cigarette prevention campaign, "The Real Cost," successfully reduced e-cigarette use among youth. The campaign, which launched in 2018, was found to have prevented an estimated 444,252 American youth (aged 11 to 17 at study recruitment) from starting to use e-cigarettes between 2023 and 2024.
The new study, published in the peer-reviewed scientific journal "American Journal of Preventive Medicine," found evidence that the campaign contributed to the nearly 70% decline in e-cigarette use among American youth that has occurred since 2019.
According to the "National Youth Tobacco Survey," the number of U.S. middle and high school students who currently use e-cigarettes declined from 5.38 million in 2019 to 1.63 million in 2024, the lowest level in a decade.
"As part of our work to 'Make America Healthy Again,' we must ensure that children have a healthy start in life," said Acting FDA Commissioner Sara Brenner. "This includes taking evidence-based actions to prevent youth tobacco product use."
Marketing Tactics
"The Real Cost" Youth E-cigarette Prevention Campaign uses digital, social media and gaming platforms to educate teens about the dangers of e-cigarettes. It is part of a broader strategy to prevent youth tobacco use, which also includes enforcement actions to hold manufacturers, distributors and sellers of illegal tobacco products accountable.
Data from the evaluation, which followed a nationally representative sample of U.S. youth over time, showed that viewing ads from "The Real Cost" lowered the chances that youth who had never used an e-cigarette would later initiate use. The survey collected information on how frequently youth were exposed to "The Real Cost" campaign and which youth went on to try e-cigarettes, among other variables.
"Adolescence is a critical period for prevention efforts because most adults who use tobacco products begin using them in their teenage years," said Brian King, director of the FDA's Center for Tobacco Products. "Youth tobacco prevention campaigns not only work, but they are also a cost-effective approach to protecting young people from a lifetime of nicotine addiction."
These data build on prior scientific studies showing that exposure to "The Real Cost" campaign is a cost-saving strategy by reducing the lifetime risks of tobacco-related disease and death, including chronic disease. A previous study that evaluated the campaign found that the effort prevented up to 587,000 American youth from initiating smoking over a three-year period, half of whom might have gone on to become established adult cigarette users. The cigarette prevention campaign also was found to save $180 for every dollar spent on the effort in its first two years, totaling more than $53 billion in reduced smoking-related costs like early loss of life, costly medical care, lost wages, lower productivity and increased disability.
To read the full article, "The Impact of 'The Real Cost' on E-cigarette Initiation among U.S. Youth," click here.
