Cost-Effectiveness Analysis of It's Messing With Our Heads: A Campaign to Prevent Youth E-cigarette Use.

Diaz, Megan C; Bertrand, Adrian; D'Esterre, Alexander P; Schillo, Barbara A; Hair, Elizabeth C · Am J Prev Med · 2026

other · Level V

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Abstract

Mass media campaigns are an effective tool in ongoing efforts to reduce electronic cigarette use among young people. This study assessed the cost-effectiveness of the truth® national vaping prevention campaign It's Messing With Our Heads, which launched in September 2021 and ran until October 2022. The cost-effectiveness analysis used 4 main parameters: program cost, estimates of the number of vaping careers averted, excess medical treatment cost to society, and the number of quality-adjusted life years saved whenever a vaping career is averted. Various parameters were estimated, and 5 cost-effectiveness scenarios (conservative, less conservative, midpoint, less optimistic, and optimistic) with 2 corresponding threshold analyses were calculated. The midpoint analysis revealed that the campaign resulted in societal cost savings of $451 million. Even under the most conservative assumptions, the campaign was found to be highly cost effective at a rate of $669 per quality-adjusted life year saved. Under all other assumptions, the campaign was estimated to be cost saving, with savings ranging from $1,127 to $32,260 per quality-adjusted life year. This research highlights the value of mass media campaigns that message on nicotine and tobacco use. Campaigns such as It's Messing With Our Heads are effective in reaching a new, younger generation that actively rejects cigarettes but has fully embraced electronic cigarettes. Even under the assumption that electronic cigarettes pose no harm, this study has proven the campaign cost effective and beneficial to society.

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