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The Real Cost Campaign

The Real Cost Campaign

“What can smoking take away? Fresh breath, healthy lungs, a strong immune system…”

When “The Real Cost” launched in 2014, the goal was to educate at-risk teens about the harmful effects of cigarette smoking. Over time, it became clear that the campaign’s science-based approach could educate at-risk youth about other tobacco products.

Teens who want to know “The Real Cost” can find us at our campaign site.  
Our goal is to keep "The Real Cost" campaign an authentic and effective youth tobacco prevention brand. "The Real Cost" campaign website and social channels are intended for the campaign target audience only—youth ages 12-17. 

On this page:

"The Real Cost” Youth E-Cigarette Prevention Campaign

An ad from "The Real Cost" e-cigarette prevention campaign


By 2017, 2.1 million middle and high school students reported they currently use e-cigarettes,2raising alarm about pervasive vaping in schools.  In 2018, with the upward trajectory of youth e-cigarette use continuing at an even more distressing rate, “The Real Cost” developed a new series of messages for reaching the 10.7 million youth aged 12-17 who have ever used e-cigarettes or are open to trying them.

To address the “cost-free” mentality found in a majority of middle and high schoolers, campaign messages focus on educating youth that using e-cigarettes, just like cigarettes, puts them at risk for addiction and other health consequences. Advertising and other prevention materials are delivered across a variety of channels, including:

  • Television ads
  • Online video ads
  • “The Real Cost” campaign’s youth-targeted website
  • Social media
  • High schools nationwide (e.g., posters for school bathrooms)

Looking for the Posters for School Bathrooms? 

“The Real Cost” E-Cigarette Prevention Campaign, in collaboration with Scholastic sent e-cigarette prevention posters to all high schools nationwide. Unfortunately, we are unable to take orders for these posters, but a variety of other youth e-cigarette prevention materials, including print materials and social media content, can be found on the CTP Exchange Lab.

Looking for resources to teach youth about the harms of e-cigarette use?

FDA and Scholastic created educational resources for middle and high schools that are available in English and Spanish. Materials include a student magazine, videos, lesson plans, activity sheets, a guide for parents to talk to kids about e-cigarettes, and infographics. These materials are accessible online for free and are adaptable for remote instruction or independent student work.

Health Impacts of E-cigarettes

“The Real Cost” Smokeless Tobacco Prevention Campaign

Each day in the United States, more than 950 male youth under 18 years of age use smokeless tobacco for the first time.4“The Real Cost” smokeless tobacco prevention campaign seeks to educate rural male teenagers about the risks of dipping – including nicotine addiction, gum disease, tooth loss, and multiple kinds of cancer.

The campaign’s central message is “smokeless doesn’t mean harmless,” which motivates teens to reconsider what they think they know about smokeless tobacco use. It has a national digital presence and additional out-of-home advertisements appear in markets across 20 states specifically selected to reach the campaign’s at-risk target audience.

Cigarette Smoking Prevention Campaign

An illustrated fish chasing a cigarette on a hook
A sample shareable image from “The Real Cost” smoking prevention campaign.

FDA’s first tobacco prevention campaign, “The Real Cost,” seeks to educate the more than 10 million1 at-risk teens in the United States about the harmful effects of cigarette smoking.

In its first two years, research shows the campaign has done just that: “The Real Cost” prevented up to 587,000 youth ages 11 to 19 from initiating smoking between February 2014 and November 2016, 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 like early loss of life, costly medical care, lost wages, lower productivity, and increased disability.

Campaign Resources

Campaign Overview

A thumbnail of the The Real Cost Overview PDF

Research & Evaluation

The Real Cost Research and Evaluation PDF Handout Thumbnail

Cost-Effectiveness Infographic
The Real Cost - Cost Effectiveness

Download or order free youth e-cigarette prevention posters and infographics

Vaping Facts & Misperceptions
More than 3.6 million U.S. youth are using e-cigarettes
Educational Materials
CTP Ends Chemicals Nickel
Educational Materials
CTP Ends Chemicals Chromium

Free Tobacco Education Materials at CTP’s Exchange Lab

Learn more about print materials, web content, and social media posts available for free that help keep communities informed about tobacco-related issues.

The Real Cost Ads

Awards and Recognition

  • Effie Awards
    • 2017: Bronze Effie in the Youth Marketing category 
    • 2015: Gold Effie in the Disease Awareness and Education category.
  • Shorty Award 
    • 2016: Creative work on Tumblr

Additional Resources

1. Centers for Disease Control and Prevention (CDC). Tobacco product use among middle and high school students – United States, 2011-2015. Morbidity and Mortality Weekly Report. 2016; 65(14):361-367.
2. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018. MMWR Morb Mortal Wkly Rep 2018;67:1276–1277. (Original Data Source: NYTS 2018)
3. Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use: 1975-2017: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.
4. Substance Abuse and Mental Health Services Administration (SAMHSA). 2017 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: U.S. Department of Health and Human Services, SAMHSA, Center for Behavioral Health Statistics and Quality; 2018. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf. Accessed October 12, 2018.
5. 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


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