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Statement from FDA Commissioner Scott Gottlieb, M.D., on significant public health value and cost savings resulting from the agency’s youth smoking prevention campaign
21-Aug-2018

One of the most important ways the U.S. Food and Drug Administration can reduce the disease and death caused by tobacco use is by preventing current and future generations of kids from starting down a path of a lifelong addiction to tobacco. This work includes exploring clear and meaningful measures to make tobacco products less toxic, appealing and addictive; enforcing federal youth access restrictions; and educating our nation’s youth about the dangers of tobacco use.

As part of the agency’s comprehensive plan on tobacco and nicotine regulation announced last summer, we’re taking steps toward a world where combustible cigarettes would no longer create or sustain addiction – making it harder for future generations to become addicted in the first place and allowing more currently addicted smokers to quit. While we explore a product standard to lower nicotine in cigarettes to minimally- or non-addictive levels, we are also continuing to invest heavily in our award-winning public education campaigns.

“The Real Cost” campaign, launched by the FDA in February 2014 to educate at-risk teens about the harmful effects of tobacco use, has proven to be successful by preventing nearly 350,000 youth nationwide from initiating smoking from 2014 to 2016, an estimated half of whom might have gone on to become established smokers. Preventing at-risk youth from smoking can lead to lower rates of smoking-related disease and death in the future and decreased health care costs, which is not only critical to every teen who does not become an addicted smoker, but is also beneficial to public health.

Today, the results of an analysisdisclaimer icon about the cost effectiveness of “The Real Cost” campaign were published online in the American Journal of Preventive Medicine. “The Real Cost” has resulted in 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 – that’s $181,000 saved for each of the 175,000 youth that would likely have become an established smoker.

By preventing these youth from becoming established smokers, the campaign saved $128 for every dollar of the nearly $250 million invested in the first two years of the effort. These results not only highlight the importance of investing in tobacco-related education campaigns, but also reinforce the importance of our public education efforts in reducing the public health and financial burden of tobacco use.

Because almost 90 percent of adult smokers started smoking by the age of 18 and nearly 2,300 youth smoke their first cigarette every day in the U.S., these public education efforts are critical to addressing the public health burden of tobacco use, which still kills more than 480,000 Americans every single year and costs nearly $300 billion a year in direct health care expenses and lost productivity due to premature death.

We know “The Real Cost” campaign is having a meaningful impact in reaching 12- to 17-year-olds in the U.S. who are the on-the-cusp smokers – teens who have already experimented or who are just one interaction away from trying their first cigarette. The campaign has leveraged TV, radio, print, web and social media to highlight consequences that youth are concerned about, such as loss of control due to addiction and health effects like tooth loss and skin damage.

Like all of our work at the FDA, our youth tobacco prevention efforts are developed and evaluated using evidence-based best practices to ensure that we’re reaching our audience with powerful messages that raise awareness, shift beliefs and ultimately save lives by changing behaviors. The analysis published today is part of our ongoing effort to measure our success in a variety of ways, which ensures our public health education campaigns yield significant public health value, including their impact on youth smoking and cost effectiveness.

The success of “The Real Cost” suggests that our other tobacco prevention campaigns, including our upcoming campaign on youth use of e-cigarettes, launching next month, can build on this success as we strive to reduce the number of kids who use tobacco products.

The FDA remains committed to protecting our nation’s youth from the dangers of tobacco use on all fronts as part of our Youth Tobacco Prevention Plan. This includes taking new steps to address the harms of these products themselves, such as exploring measures on flavors/designs that appeal to youth, as well as considering additional restrictions on the sale and promotion of electronic nicotine delivery systems to further reduce youth exposure and access to these products. We’ll also continue enforcement efforts to reduce tobacco product sales to minors and funding cost-effective, compelling and science-based public education campaigns to encourage kids to rethink their relationship with tobacco.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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