The U.S. Food and Drug Administration published new information in a special issue of the American Journal of Preventive Medicine highlighting the measurable public health impact of its youth tobacco prevention efforts, particularly the “The Real Cost” campaign. According to studies featured in the issue, the campaign is estimated to have prevented roughly 444,252 U.S. youth from initiating e-cigarette use between 2023 and 2024, while also reducing an estimated $42 million in illegal e-cigarette sales that would have otherwise been consumed by minors. The findings are based on peer-reviewed research and analyses conducted by FDA scientists and external collaborators, reinforcing the campaign’s effectiveness in shaping youth behavior at scale.
FDA officials, including leadership from the Center for Tobacco Products, emphasized that the results demonstrate how sustained, evidence-based public education can materially shift youth attitudes and reduce nicotine initiation. The special journal issue compiles 12 studies examining campaign reach, audience segmentation, behavioral impact, and cessation engagement. One analysis found that roughly three-quarters of surveyed youth reported exposure to at least one prevention ad, with especially strong reach among higher-risk groups, while another showed more than 253,000 visits driven to the SmokefreeTeen cessation platform, including over 11,000 completed quit plans.
The FDA’s broader claim is that “The Real Cost” campaign — launched in 2014 for cigarettes and expanded in 2018 to address vaping — has become a long-running model for data-driven prevention messaging. Officials argue that its demonstrated impact on youth behavior and attitudes provides a foundation for expanding educational efforts, including potential messaging aimed at influencing adults who smoke toward cessation and harm reduction, while maintaining a continued focus on preventing youth initiation.