Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment

BackgroundGamification in smoking cessation apps has been found to improve cognitive outcomes associated with higher odds of quitting. Although some research has shown that gamification can also positively impact behavioral outcomes such as smoking cessation, studies have lar...

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Main Authors: Nikita B Rajani, Luz Bustamante, Dominik Weth, Lucia Romo, Nikolaos Mastellos, Filippos T Filippidis
Format: Article
Language:English
Published: JMIR Publications 2023-02-01
Series:JMIR Serious Games
Online Access:https://games.jmir.org/2023/1/e39975
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author Nikita B Rajani
Luz Bustamante
Dominik Weth
Lucia Romo
Nikolaos Mastellos
Filippos T Filippidis
author_facet Nikita B Rajani
Luz Bustamante
Dominik Weth
Lucia Romo
Nikolaos Mastellos
Filippos T Filippidis
author_sort Nikita B Rajani
collection DOAJ
description BackgroundGamification in smoking cessation apps has been found to improve cognitive outcomes associated with higher odds of quitting. Although some research has shown that gamification can also positively impact behavioral outcomes such as smoking cessation, studies have largely focused on physical activity and mental health. Only a few studies have explored the effects of gamification on smoking cessation outcomes, of which the majority have adopted qualitative methodologies and/or assessed engagement with apps using self-report. ObjectiveThis study aimed to explore levels of user engagement with gamification features in a smoking cessation app via in-app metrics. Specifically, the objective of this paper was to investigate whether higher engagement with gamification features is associated with the likelihood of quitting in the short term. MethodsData from a larger online study that recruited smokers seeking to quit were analyzed to address the objectives presented in this paper. The study took place between June 2019 and July 2020, and participants were primarily recruited via social media posts. Participants who met the eligibility criteria used 1 of 2 mobile apps for smoking cessation. In-app metrics shared by the developer of one of the smoking cessation apps, called Kwit, were used to assess engagement with gamification features. Out of 58 participants who used the Kwit app, 14 were excluded due to missing data or low engagement with the app (ie, not opening the app once a week). For the remaining 44 participants, mean (SD) values were calculated for engagement with the app using in-app metrics. A logistic regression model was used to investigate the association between engagement with gamification and 7-day smoking abstinence. ResultsIn total, data from 44 participants who used the Kwit app were analyzed. The majority of participants were male, married, and employed. Almost 30% (n=13) of participants self-reported successful 7-day abstinence at the end of the study. On average, the Kwit app was opened almost 31 (SD 39) times during the 4-week study period, with the diary feature used the most often (mean 22.8, SD 49.3). Moreover, it was found that each additional level unlocked was associated with approximately 22% higher odds of achieving 7-day abstinence after controlling for other factors such as age and gender (odds ratio 1.22, 95% CI 1.01-1.47). ConclusionsThis study highlights the likely positive effects of certain gamification elements such as levels and achievements on short-term smoking abstinence. Although more robust research with a larger sample size is needed, this research highlights the important role that gamification features integrated into mobile apps can play in facilitating and supporting health behavior change.
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spelling doaj.art-07808794f8c14f739907ef67961ac98e2023-08-28T23:34:10ZengJMIR PublicationsJMIR Serious Games2291-92792023-02-0111e3997510.2196/39975Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative AssessmentNikita B Rajanihttps://orcid.org/0000-0001-6016-6705Luz Bustamantehttps://orcid.org/0000-0001-5563-6688Dominik Wethhttps://orcid.org/0000-0003-0033-7140Lucia Romohttps://orcid.org/0000-0002-9432-0528Nikolaos Mastelloshttps://orcid.org/0000-0003-4573-3657Filippos T Filippidishttps://orcid.org/0000-0002-2101-2559 BackgroundGamification in smoking cessation apps has been found to improve cognitive outcomes associated with higher odds of quitting. Although some research has shown that gamification can also positively impact behavioral outcomes such as smoking cessation, studies have largely focused on physical activity and mental health. Only a few studies have explored the effects of gamification on smoking cessation outcomes, of which the majority have adopted qualitative methodologies and/or assessed engagement with apps using self-report. ObjectiveThis study aimed to explore levels of user engagement with gamification features in a smoking cessation app via in-app metrics. Specifically, the objective of this paper was to investigate whether higher engagement with gamification features is associated with the likelihood of quitting in the short term. MethodsData from a larger online study that recruited smokers seeking to quit were analyzed to address the objectives presented in this paper. The study took place between June 2019 and July 2020, and participants were primarily recruited via social media posts. Participants who met the eligibility criteria used 1 of 2 mobile apps for smoking cessation. In-app metrics shared by the developer of one of the smoking cessation apps, called Kwit, were used to assess engagement with gamification features. Out of 58 participants who used the Kwit app, 14 were excluded due to missing data or low engagement with the app (ie, not opening the app once a week). For the remaining 44 participants, mean (SD) values were calculated for engagement with the app using in-app metrics. A logistic regression model was used to investigate the association between engagement with gamification and 7-day smoking abstinence. ResultsIn total, data from 44 participants who used the Kwit app were analyzed. The majority of participants were male, married, and employed. Almost 30% (n=13) of participants self-reported successful 7-day abstinence at the end of the study. On average, the Kwit app was opened almost 31 (SD 39) times during the 4-week study period, with the diary feature used the most often (mean 22.8, SD 49.3). Moreover, it was found that each additional level unlocked was associated with approximately 22% higher odds of achieving 7-day abstinence after controlling for other factors such as age and gender (odds ratio 1.22, 95% CI 1.01-1.47). ConclusionsThis study highlights the likely positive effects of certain gamification elements such as levels and achievements on short-term smoking abstinence. Although more robust research with a larger sample size is needed, this research highlights the important role that gamification features integrated into mobile apps can play in facilitating and supporting health behavior change.https://games.jmir.org/2023/1/e39975
spellingShingle Nikita B Rajani
Luz Bustamante
Dominik Weth
Lucia Romo
Nikolaos Mastellos
Filippos T Filippidis
Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
JMIR Serious Games
title Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
title_full Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
title_fullStr Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
title_full_unstemmed Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
title_short Engagement With Gamification Elements in a Smoking Cessation App and Short-term Smoking Abstinence: Quantitative Assessment
title_sort engagement with gamification elements in a smoking cessation app and short term smoking abstinence quantitative assessment
url https://games.jmir.org/2023/1/e39975
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