Cost-Utility Analysis of the National truth^® Campaign to Prevent Youth Smoking

Background: In 2005, the American Journal of Public Health published an article that indicated that 22% of the overall decline in youth smoking that occurred between 1999 and 2002 was directly attributable to the truth^® social marketing campaign launched in 2000. A remaining key question about the truth campaign is whether the economic investment in the program can be justified by the public health outcomes; that question is examined here. Methods: Standard methods of cost and cost-utility analysis were employed in accordance with the U.S. Panel on Cost-Effectiveness in Health and Medicine; a societal perspective was employed. Results: During 2000-2002, expenditures totaled just over $324 million to develop, deliver, evaluate, and litigate the truth campaign. The base-case cost-utility analysis result indicates that the campaign was cost saving; it is estimated that the campaign recouped its costs and that just under $1.9 billion in medical costs was averted for society. Sensitivity analysis indicated that the basic determination of cost effectiveness for this campaign is robust to substantial variation in input parameters. Conclusions: This study suggests that the truth campaign not only markedly improved the public's health but did so in an economically efficient manner.