“The Real Cost”: A Social Media Campaign Analysis

By: Sarah Scott

The Problem

Even though the government has banned tobacco ads on television and radio, the amount of people who smoke is still staggering. According to the CDC, in 2017, 34 million US adults smoked cigarettes. Of these, they state that 480,000 die annually. Smoking-related illness, including lung cancer, cost over $300 billion every year. This is a social problem that need to be addressed so that the public can be healthier and not have the burden of the cost of smoking-related medical problems that could be prevented.

Retrieved from the CDC

These smokers are likely to have started smoking when they were younger. In 2012, The Surgeon General stated that almost all smoking begins before the age of 18, and historically smoking has been a habit formed among the youth that carries over into their adult lives. In the article Adolescent Smoking Experimentation as a Predictor of Daily Cigarette Smoking, it says, “experimentation with cigarette smoking during ages 10–14 years predicted daily smoking two years later, independent of other cigarette smoking risk factors.” So, experimentation with cigarettes can lead to a habit of smoking later in life. If we could prevent the youth from smoking, or get them to quit early, it could set the path for building good habits through their lifetimes.

“The Real Cost” Campaign

Retrieved from FDA

To combat this tendency by adolescents to form this bad habit, in 2014, the FDA launched their campaign “The Real Cost” that targeted 10.7 million young middle-schoolers and high schoolers, aged 12-17, in order to inform them about the dangers of smoking. The campaign was targeted toward were both a male and female audience, who might be thinking about experimenting with tobacco because they feel peer pressure or because they think it will make them seem cool. The campaign was meant to show the youth that they were at risk for smoking-related risks even if they thought that a few cigarettes wouldn’t affect their health. The campaign was meant to challenge these young people’s thoughts and get them to change their behaviors. 

In 2018, the campaign also started talking about the dangers of e-cigarette smoking, in which the used the slogan “smokeless doesn’t mean harmless” as a way to say that electronic smoking can still be just as dangerous as smoking a regular cigarette.  

Both times, they ran their digital material, short clips, and videos on Facebook, Instagram, Twitter, Spotify, and YouTube. On YouTube, their videos would play as an ad before a video would start, which is where I first heard of the campaign. 

The Campaign Plan

  • Goal
    • To prevent at-risk youth from smoking and to reduce the amount of youth who go from experimenting to using cigarettes on a regular basis.
  • Strategy
    • The FDA created video content that would either target youth with an idea that smoking would affect their appearance or target youth by shocking them and showing that smoking was just as scary as a sci-fi monster. They also created video clips for Instagram, Twitter, Facebook, and Spotify that also showed how smoking could affect your appearance or health. They also used videos as ads on YouTube, which has a predominantly younger audience. According to Hootsuite, 81% of the YouTube audience is between the ages of 15-25.
  • Tactics
    • The campaign used their videos to run as ads that run before YouTube videos. These videos would usually get the point across in a way that would catch the audience’s attention right out of the gate. This content even used actors that were the same age as the target audience and showed these youth mainly in school settings, showing that the effects of smoking don’t just affect adults, who have been smoking for a while, but also people who are their age, who are just starting or thinking of experimenting with smoking.
    • The campaign also created shorter video clips and pictures for their Instagram page that were meant to capture attention and show in different ways how smoking can damage your health. All of these videos and photos attempted to show different effects or facts about how smoking can lead to bad side effects.

The Campaign Wins

I think that the ads run on YouTube were the thing that stood out the most. Some of the ads were run as videos of school students saying that the were “signing a contract,” when they decide to smoke. This “contract” was one in which they were signing their lives and health over to the control to effects and influence of tobacco.

The other YouTube advertisements were more graphic than those videos, depicting smoking as a monster in sheep’s clothing, like in the above video. This ad was meant by the FDA to cause a visceral response that would stick in the minds of the youth watching it. These videos have definitely gotten stuck in my mind because of the shock value.

They also used a primarily school-aged cast in school settings that the target audience could relate to and form a connection to. All of this was meant to point to the fact that smoking is harmful to one’s health thereby attempting to challenge how young people think about cigarette smoking. This campaign was unique in that there aren’t many campaigns out there that have targeted young people and been this successful.

According to an article on Plos One, “89% of U.S. youth knew of at least one advertisement 6 to 8 months after the campaign launch, and high levels of awareness were attained within the campaign’s two targeted audiences: susceptible nonsmokers (90.5%) and experimenters (94.6%),” which first off, not only means that the campaign had reached most of their targeted audience, but they also left an impression that they recalled months after having seen the advertisements.  

The CDC states that, “High campaign exposure (to the campaign) was associated with a 30% decrease in the risk for smoking initiation,” and they estimated that “348,498 youths aged 11-18 years were potentially prevented from initiating smoking nationwide between February 2014-March 2016.” 

How This Can Apply To Future Health Campaigns

  • Main Takeaway: The youth responded positively to graphic and shocking imagery along with the message that they could damage their health or appearance. 
    • An article published in the International Journal of Environmental Research and Public Health, states that, “data support the messaging strategies the FDA has used in the campaign—particularly messaging that includes graphic imagery and adverse physical health effects of smoking.” This could be applied to other similar campaigns in order to capture the youth’s attention and get them to retain the information over a period of time.
    • In a report from the FDA they talk about how the campaign has created “savings of more than $31 billion for youth, their families and society at large by reducing smoking-related costs like early loss of life, costly medical care, lost wages, lower productivity and increased disability,” which had a net benefit when compared to the amount spent on the campaign. “By preventing these youth from becoming established smokers, the campaign saved $128 for every dollar of the nearly $250 million.”
    • Their campaigns have even won two Effie awards in youth marketing for successfully communicating with the youth.

This campaign has done a lot to help mitigate the amount of American youth, who were thinking of smoking or experimenting with smoking. It should serve as an archetype for other health campaigns that wish to target their messages to the youth.


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