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To determine the e-cigarette prevention campaign impact, researchers measure teens: Awareness of campaign ads Knowledge, attitudes, and beliefs about e-cigarettes Behaviors toward tobacco use, like whether they start using e-cigarettes or not Current Campaigns FDA Tobacco Education Resource Library The Real Cost Campaign Publications Special Issue: A Decade of Innovations and Insights from FDA's The Real Cost Campaigns and Youth Prevention Efforts (2026) Evaluating The Real Cost Digital and Social Media Campaign: Longitudinal Effects of Campaign Exposure on E-cigarette Beliefs (2024) Adolescent Risk Perceptions of ENDS Use: Room for Change in Tobacco Education (2022) Effects of a National Campaign on Youth Beliefs and Perceptions About Electronic Cigarettes and Smoking (2022) The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth (2022) The Real Cost Smokeless Campaign: Changes in Beliefs About Smokeless Tobacco Among Rural Boys, a Longitudinal Randomized Controlled Field Trial (2021) Perceived Message Effectiveness and Campaign-Targeted Beliefs: Evidence of Reciprocal Effects in Youth Tobacco Prevention (2020) Impact of The Real Cost Media Campaign on Youth Smoking Initiation (2019) The Case and Context for The Real Cost Campaign (2019) Cost-Effectiveness Analysis of The Real Cost Campaigns Effect on Smoking Prevention (2018) Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths United States, 20142016 (2017)

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