JMIR Publications

ABSTRACT

Background:

Both the number of smokers making quit attempts and the number of smokers successfully quitting has been falling over the past years. Past studies have shown that smokers with high self-efficacy and motivation to quit have an increased likelihood of quitting and staying quit. Consequently, further research on strategies which can improve the self-efficacy and motivation of smokers seeking to quit could lead to substantially higher cessation rates. Some studies have found that gamification can positively impact cognitive components of behavioural change, including self-efficacy and motivation. However, the impact of gamification in the context of smoking cessation and mobile health has been sparsely investigated.

Objective:

The study aims to examine the association between perceived usefulness, perceived ease of use and frequency of use of gamification features embedded in smoking cessation apps on the self-efficacy and motivation to quit of smokers.

Methods:

Participants were assigned to use one of two mobile apps for a duration of four weeks. Online questionnaires were provided to participants before app usage, two weeks after and four weeks after they started using the app. Gamification was quantitatively operationalized based on Cugelman’s gamification framework and concepts from the technology acceptance model. Mean values of perceived frequency, ease of use and usefulness of gamification features were calculated at mid-study and end-study. Two linear regression models were performed to investigate the impact of gamification on self-efficacy and motivation to quit.

Results:

116 participants completed the study. Mean self-efficacy increased from 37.38 to 42.47 points and motivation to quit increased from 5.94 to 6.32 points after app usage. “Goal setting” was perceived to be the most useful gamification feature whilst “sharing” was perceived to be the least useful. Participants self-reported that they used the progress dashboards the most often whilst the sharing feature the least often. Average perceived frequency of gamification features was statistically significantly associated with change in self-efficacy (β=3.35, 95% CI: 0.31 to 6.40) and change in motivation to quit (β=0.54, 95% CI: 0.15 to 0.94) between baseline and end-study.

Conclusions:

Gamification embedded into mobile apps can have positive effects on the self-efficacy and motivation to quit of smokers. The findings of the study can provide important insights for tobacco control policy makers, mobile app developers and smokers seeking to quit.