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The mission of the Food and Drug Administration (FDA)’s Center for Tobacco Products (CTP), is to protect America’s youth from tobacco-related harm. One of FDA’s various health education efforts includes The Real Cost campaign, a national media effort launched in 2014 to reach youth who are open to or experimenting with tobacco.  

The Real Cost Smokeless Campaign targets rural male youth aged 12–17 in 35 markets throughout the U.S.  The campaign’s objective is to educate this population on the risks of smokeless tobacco (such as chewing tobacco or snuff) and discourage them from trying these productsThe FDA identified rural male youth as the primary target for this campaign because they are at a higher risk of using smokeless tobacco compared to other demographics. Almost 900 male youth under the age of 18 are try smokeless tobacco for the first time each day.1 


To ensure the success of the campaign, Fors Marsh Group sought to provide evidence-based recommendations for messaging and communication strategies that were tied to FDA’s regulatory authorityaligned with the current prevention education campaign, and would engage and influence the target audience. FMG: 

  1. Conducted formative research to establish a foundation for strategic direction of the campaign by better understanding rural culture and the target audience;
  2. Identified beliefs to disrupt, points of tension, points that fell under FDA’s messaging platforms, allowing for the development of messaging territories; 
  3. Conducted strategic concept testing to understand which topics or ideas resonate most with youth residing in rural areas; 
  4. Tested creative concepts through focus groups, to understand where an issue (such as addiction, negative health consequences) fits within the larger context of the target audience’s life and perceptions; and, 
  5. Analyzed efficacy of developed creative through copy testing during in-person interviews. 


Leveraging the findings from the strategic concept testing, FMG worked with CTP’s advertising to develop and test creative concepts that that would be most effective at reaching and changing the behavior of these at-risk youth. These impactful concepts  became the advertisements in FDA’s Real Cost Smokeless Campaign platforms. The online and offline campaign reached millions of viewers and ignited the continued allocation of resources for prevention efforts among this target population.  

Partner With FMG

Ronne Ostby

Vice President, Insights and Strategy

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