Examining youth awareness of the real cost campaigns

Abstract

INTRODUCTION: Public health campaigns should ensure that they reach all segments of intended audiences. This study examines whether awareness of Food and Drug Administration's The Real Cost e-cigarette and cigarette prevention campaigns differs among segments of the national youth audience.

METHODS: Follow-up data (collected in June-September 2024) from campaign evaluations were analyzed in 2025. Weighted means of brand awareness and awareness of e-cigarette and cigarette prevention advertisements were examined among all respondents (n=4,067) and among audience segments defined by sociodemographic and tobacco-related variables. F-tests were used to compare audience segment awareness to the grand mean. Logistic regression models were used to test for group differences, controlling for age and tobacco use.

RESULTS: Half of the respondents reported brand awareness (mean=48.4%). Brand awareness was higher than the grand mean among youth aged 15-17 years; youth who reported another sexual orientation (other than straight, bisexual, or gay or lesbian); and youth in households earning ≥ $110,000 annually. Brand awareness was lower among Black, non-Hispanic youth, and youth aged 11-14 years. Most youth reported e-cigarette prevention ad awareness (mean=75.2%), with higher awareness among Hispanic youth and youth with mild or moderate psychological distress. Fewer youth reported cigarette prevention ad awareness (mean=44.6%), with higher awareness among youth reporting severe psychological distress and youth in households earning <$30,000 annually. Unadjusted findings were consistent with findings from logistic regression models.

CONCLUSIONS: The campaigns are effectively reaching youth across audience segments. Continued awareness monitoring helps to ensure that tobacco prevention campaigns designed for a general youth audience promote healthy behaviors across their audience.