Overall, the campaign prevented an estimated 380,446 to 587,515 youths aged 11 to 19 years from initiating smoking from 2014 to 2016, according to the data. House rules: bit.ly/TGuidelines Sustained campaigns such as The Real Cost can speed progress toward a tobacco-free future.In the United States, approximately 900,000 youths smoke their first cigarette each year (FDA’s The Real Cost was based on behavior change theories and designed to prevent the initiation of cigarette smoking among youths who have never smoked and discourage further smoking among youths who have previously experimented with smoking (Self-reported campaign media exposure was assessed with a validated measure (High campaign exposure was associated with a 30% decrease in the risk for smoking initiation (aOR = 0.70, 95% CI = 0.55–0.91) (The association between campaign exposure and youth smoking initiation remained unchanged in survival models that accounted for youths’ use of e-cigarettes and other tobacco products during the study period. The images are part of the U.S. Food and Drug Administration's $60 million anti-vaping ad campaign, called "The Real Cost." However, such a positive association would be expected to lead to smaller observed campaign effects on initiation. First, measurements were self-reported and are subject to bias. * With 95% confidence intervals represented by error bars.Centers for Disease Control and Prevention. You already know that tobacco is bad for you, but even experimenting can come with a cost. Approximately 350,000 youths aged 11–18 years were prevented from smoking nationwide during 2014–2016 as a result of FDA’s youth-specific public education campaign.The findings indicate that youths’ self-reported exposure to the campaign was associated with a reduction in smoking initiation from 2014 to 2016. Receive an email when new articles are posted on To address the concerns of using self-reported exposure, future research that examines potential campaign exposure based on measures of market-level media delivery (i.e., target rating pointsThe Real Cost is the first federally funded U.S. youth-focused tobacco education campaign, and these findings indicate that youths’ self-reported exposure to the campaign was associated with a reduction in smoking initiation during the evaluation’s 2014 to 2016 time frame. “The results from our work demonstrate that ‘The Real Cost’ will have lasting benefits on public health by convincing these teens to not smoke and it’s imperative that public education campaigns like ours continue in order to reduce the individual and collective burden of tobacco-related disease and death among current and future generations,” Sharpless said in the FDA statement. Receive an email when new articles are posted on The researchers also found that between-wave and cumulative target rating points were linked to a decreased risk for smoking initiation among youths.

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