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Am J Prev Med. 2009 May;36(5):385-8. doi: 10.1016/j.amepre.2009.01.020. Epub 2009 Feb 11.

Cost-utility analysis of the National truth campaign to prevent youth smoking.

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  • 1Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland 21205, USA.



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.


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.


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.


This study suggests that the truth campaign not only markedly improved the public's health but did so in an economically efficient manner.

[PubMed - indexed for MEDLINE]
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