Cost and Threshold Analysis of the FinishIt Campaign to Prevent Youth Smoking in the United States

Abstract

In 2014, Truth Initiative launched the national FinishIt campaign to prevent smoking initiation among youth and young adults. The significant changes in the communications landscape requires further analysis to determine resource requirements for public education campaigns relative to their impact. This analysis estimates the cost of the FinishIt campaign based on data from expenditure records and uses published estimates of the lifetime treatment costs and quality-adjusted life years associated with smoking. The total cost of the FinishIt campaign for 2014–2016 was $162 million. Under assumptions associated with the pessimistic base-case (no medical care costs saved through prevention), 917 smoking careers would need to be averted for the campaign to be cost-effective. Assuming smoking leads to increased medical care costs, 7186 smoking careers would need to be averted for the campaign to be cost-saving. Given these thresholds (917 and 7186) and the estimate of the impact of the previous truth campaign, the investments in the Truth Initiative’s FinishIt campaign are likely warranted for preventing smoking careers among youth and young adults.

Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns

“…This review found that there is a wide range of metrics used in tobacco control campaign evaluations, as a consequence of the diversity of media platforms and activities employed by campaigns (see Multimedia Appendix 2 [ 5 , 8 , 15 - 32 , 35 - 63 , 65 - 85 ]). While this gives the impression that there is a lot of information about how a campaign performed, in reality the large number of metrics makes it difficult to meaningfully interpret the reported numbers.…”

Cost-Effectiveness of Using Mass Media to Prevent Tobacco Use among Youth and Young Adults: The FinishIt Campaign

“…The value of parameter C (program costs) was described in detail in the previous cost and threshold analysis on the FinishIt campaign [8]. Briefly, the components of C include costs incurred by Truth Initiative related to the campaign development and implementation, including marketing and creative production, advertising purchases, agency fees, evaluation-related research, and Truth Initiative staff salaries.…”

“…Briefly, the components of C include costs incurred by Truth Initiative related to the campaign development and implementation, including marketing and creative production, advertising purchases, agency fees, evaluation-related research, and Truth Initiative staff salaries. The resulting value of C was previously reported as $162,056,543 [8], and that value was used here.…”

“…Results from economic evaluations can provide benchmarks for campaign planners and help guide decisions about whether a campaign needs to change course in some way. Economic evaluations also provide frameworks for determining under what conditions a particular campaign would not be cost-saving or cost-effective [8]. Additionally, changes in tobacco use trends and media consumption among young people in recent years have resulted in changes to campaign target audiences, message content, and methods of message delivery.…”

“…“Cost-saving” refers to an overall reduction is societal costs, which is directly beneficial, while “cost-effectiveness” reflects the prudent use of resources as compared to other types of interventions. The threshold analysis revealed that even with conservative assumptions regarding medical care cost savings, only 917 individuals would need to be prevented from becoming lifetime smokers in order for the campaign to be cost-effective [8]. The objective of the current study is to build on the previous cost-threshold analysis by fully examining the cost-effectiveness of the implementation of the new truth FinishIt campaign, and to examine the return on investment (ROI).…”