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

David R. Holtgrave, Katherine A. Wunderink, Donna M. Vallone, Cheryl G. Healton

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)385-388
Number of pages4
JournalAmerican journal of preventive medicine
Issue number5
StatePublished - May 2009

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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