Tobacco Products

The Real Cost Campaign

Nearly 350,000 Kids Prevented from Smoking

CTP - The Real Cost Campaign Logo

Measuring Success

Evaluation of “The Real Cost” assesses the campaign’s impact on changing attitudes, beliefs and behaviors among youth who are open to smoking or already experimenting with cigarettes, and the results are impressive. Research indicated that almost 9 in 10 youth reported seeing “The Real Cost” advertisements after 7 months from the launch of the campaign, and the campaign positively influenced tobacco-related risk perceptions and beliefs specific to tobacco after 15 months. Most notably, the campaign has prevented nearly 350,000 youth aged 11 to 18 nationwide from smoking. Overall, high levels of exposure to campaign messaging was associated with a 30 percent decrease in the risk of smoking initiation among youth aged 11 to 18. These results demonstrate the effectiveness of a national campaign that focused on the harmful effects of smoking and delivered salient messages that resonated with youth.

As the first federally funded U.S. youth tobacco education campaign, these results show that sustained tobacco education campaigns can encourage U.S. youth to rethink their relationship with tobacco.

Every day in the United States, nearly 2,500 youth under 18 years of age smoke their first cigarette, and nearly 1,300 youth use smokeless tobacco for the first time.1 In fact, tobacco use is almost always started and established during adolescence.2 This highlights a critical need for stronger, more targeted youth tobacco prevention efforts. FDA's award-winning youth tobacco prevention campaign, "The Real Cost," seeks to educate these at-risk teens about the harmful effects of tobacco use. The goal is to prevent youth who are open to tobacco from trying it and to reduce the number of youth who move from experimenting with tobacco to regular use.

The Real Cost campaign launched nationally in February 2014 across multiple media platforms including TV, radio, print, digital, and out-of-home sites. Initial campaign advertising focused on reaching the more than 10 million youth ages 12-17 in the United States who are either open to trying smoking or are already experimenting with cigarettes.3

"The Real Cost" Smokeless Tobacco Prevention Campaign airs in 35 markets

In April 2016, “The Real Cost” expanded its campaign brand umbrella to include new advertising targeting rural male youth ages 12-17 at risk of smokeless tobacco use. These ads air in 35 targeted local markets around the country.  

CTP - The Real Cost Campaign Logo

Campaign Receives Gold Effie Award

"The Real Cost" was awarded a gold Effie in the Disease Awareness and Education category at the 2015 North American Effie Awards. The campaign was recognized for its insightful communications strategy, outstanding creative, and success in market.


Key Messages

Loss of Control Due to Addiction: Reframes addiction to tobacco as a loss of control to disrupt the beliefs of independence-seeking youth who currently think they will not get addicted or feel they can quit at any time.

Dangerous Chemicals: Dramatizes the negative health consequences of tobacco use in a meaningful way to demonstrate that all tobacco use comes with a "cost" that is more than just financial.

Health Consequences: Depicts the dangerous chemicals in tobacco products to motivate youth to find out more about what’s in them and reconsider the harms of tobacco use.


Do You Work With Youth?

Our goal is to keep "The Real Cost" campaign authentic through a peer-to-peer approach. "The Real Cost" campaign website ( and social channels are intended for the campaign target audience—at-risk youth ages 12-17. Organizations that work directly with at-risk youth can help extend the campaign in the following ways:

Smoking as a teen can stunt lung Growth

Campaign Resources

Public health advocates, educators, and anyone else who is interested in spreading the word about “The Real Cost” to adult audiences can access collateral material including:

You can also use FDA's social media channels to engage with us around the campaign, including:


1. Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2014 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality; 2015.
2. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking - 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
3. Based on 2012 data from NYTS on openness to smoking among youth and 2012 youth population estimates from the U.S. Census Bureau.


Page Last Updated: 01/19/2017
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