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Budgetary impact from multiple perspectives of sustained antitobacco national media campaigns to reduce the harms of cigarette smoking
  1. Michael V Maciosek1,
  2. Brian S Armour2,
  3. Stephen D Babb2,
  4. Steven P Dehmer1,
  5. Elizabeth S Grossman1,
  6. David M Homa2,
  7. Amy B LaFrance1,
  8. Robert Rodes2,
  9. Xu Wang2,
  10. Zack Xu1,
  11. Zhuo Yang3,
  12. Kakoli Roy4
  1. 1HealthPartners Institute, Bloomington, Minnesota, USA
  2. 2Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  3. 3Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  4. 4National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Michael V Maciosek, HealthPartners Institute, Bloomington, MN 55425, USA; michael.v.maciosek{at}


Background High-intensity antitobacco media campaigns are a proven strategy to reduce the harms of cigarette smoking. While buy-in from multiple stakeholders is needed to launch meaningful health policy, the budgetary impact of sustained media campaigns from multiple payer perspectives is unknown.

Methods We estimated the budgetary impact and time to breakeven from societal, all-payer, Medicare, Medicaid and private insurer perspectives of national antitobacco media campaigns in the USA. Campaigns of 1, 5 and 10 years of durations were assessed in a microsimulation model to estimate the 10 and 20-year health and budgetary impact. Simulation model inputs were obtained from literature and both pubic use and proprietary data sets.

Results The microsimulation predicts that a 10-year national smoking cessation campaign would produce net savings of $10.4, $5.1, $1.4, $3.6 and $0.2 billion from the societal, all-payer, Medicare, Medicaid and private insurer perspectives, respectively. National antitobacco media campaigns of 1, 5 and 10-year durations could produce net savings for Medicaid and Medicare within 2 years, and for private insurers within 6–9 years. A 10-year campaign would reduce adult cigarette smoking prevalence by 1.2 percentage points, prevent 23 500 smoking-attributable deaths over the first 10 years. In sensitivity analysis, media campaign costs would be offset by reductions in medical care spending of smoking among all payers combined within 6 years in all tested scenarios.

Conclusions 1, 5 and 10-year antitobacco media campaigns all yield net savings within 10 years from all perspectives. Multiyear campaigns yield substantially higher savings than a 1-year campaign.

  • cigarette smoking
  • media campaign
  • national programmes
  • economic analysis
  • budgetary impact
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  • Correction notice This paper has been updated since first published to correct author name 'Steven P Dehmer'.

  • Contributors BSA and KR conceived the study. MVM, BSA, SPD, DMH, ABL, RR, ZX and KR contributed to study design. MVM, SPD, ESG, ABL, XW, ZX and ZY acquired the data that were used in the simulation. MVM and ZX conducted the analysis. MVM, BSA, SDB, DMH, ABL, RR, ZX and KR interpreted the simulation results. MVM, BSA, ABL and KR drafted the manuscript. All authors critically reviewed and edited the manuscript. Coauthors employed by the Centers for Disease Control and Prevention (BSA, SDB, DMH, RR, XW, ZY and KR) conceptualised the study, conducted analysis of simulation model inputs and participated in interpreting results and revising the manuscript.

  • Funding This study was supported by research contract from the Centers for Disease Control and Prevention (200-2017-M-95242).

  • Competing interests MVM, SPD, ESG, ABL and ZX received funding for this work through a research contract between the Centers for Disease Control and Prevention and their employer.

  • Patient consent for publication Not required.

  • Ethics approval All analyses were conducted using deidentified data to produce simulated outcomes. Therefore, Institutional Review Board approval was not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Any simulation model inputs that are not already provided in the manuscript or supplements are available upon request from the corresponding author.

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