Examining Youth Awareness of The Real Cost Campaigns: An Audience Segmentation Analysis of Data From a Campaign Evaluation Study

Introduction: Public health campaigns should ensure that they reach all segments of intended audiences.This study examines whether awareness of Food and Drug Administration's The Real Cost e-cigarette and cigarette prevention campaigns differs among segments of the national youth audience.Methods: Follow-up data (collected in June-September 2024) from campaign evaluations were analyzed in 2025.Weighted means of brand awareness and awareness of e-cigarette and cigarette prevention advertisements were examined among all respondents (n=4,067) and among audience segments defined by sociodemographic and tobacco-related variables.F-tests were used to compare audience segment awareness to the grand mean.Logistic regression models were used to test for group differences, controlling for age and tobacco use.Results: Half of the respondents reported brand awareness (mean=48.4%).Brand awareness was higher than the grand mean among youth aged 15-17 years; youth who reported another sexual orientation (other than straight, bisexual, or gay or lesbian); and youth in households earning $110,000 annually.Brand awareness was lower among Black, non-Hispanic youth, and youth aged 11-14 years.Most youth reported e-cigarette prevention ad awareness (mean=75.2%),with higher awareness among Hispanic youth and youth with mild or moderate psychological distress.Fewer youth reported cigarette prevention ad awareness (mean=44.6%),with higher awareness among youth reporting severe psychological distress and youth in households earning <$30,000 annually.Unadjusted findings were consistent with findings from logistic regression models. Conclusions:The campaigns are effectively reaching youth across audience segments.Continued awareness monitoring helps to ensure that tobacco prevention campaigns designed for a general youth audience promote healthy behaviors across their audience.