From Linear TV to Curated Media: Challenges for Youth Public Education Media Campaigns and How "The Real Cost" is Adapting.

"The Real Cost" Youth Cigarette Prevention Campaign launched in 2014 when broadcast television (TV) was the main media channel. However, over the last two decades, the media landscape has changed dramatically, and now digital media is the primary way teens consume media. As it is critical that "The Real Cost" appear in places where teens spend their time, the campaign adapted its media and implementation strategies to continue effectively reaching its intended audience. Additionally, the campaign is exploring new measurement methodologies to understand the full impact of digital media campaigns. Although "The Real Cost" has shown success preventing teens from initiating tobacco use with cigarettes and e-cigarettes, the evolving digital media landscape poses challenges for public education media campaigns trying to reach teen audiences who can now curate their own personal content streams to view whatever they want, whenever and wherever they want to watch. This commentary discusses these key challenges, including evolving data privacy policies and practice, existing data gaps, and practical implementation and measurement considerations, as well as a description of solutions that the U.S. Food and Drug Administration's Center for Tobacco Products are pursuing to address these challenges.