Impact of Gamification on the Self-Efficacy and Motivation to Quit of Smokers: Observational Study of Two Gamified Smoking Cessation Mobile Apps

Rajani, Nikita B; Mastellos, Nikolaos; Filippidis, Filippos T

doi:10.2196/27290

Cited by 33 publications

(21 citation statements)

References 46 publications

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“…Primarily, valued living or enactment of one’s values may not be a mediator of smoking cessation. While it is conceivable that one does not need to work toward broader life goals to quit smoking, this is an unlikely explanation given the central role of motivation in health behavior change overall [ 50 , 51 ]. A more plausible explanation is that the current measure of valued living is not a sensitive measure of valued actions pertinent to smoking cessation.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial

Bricker

Levin

Lappalainen

et al. 2021

JMIR Mhealth Uhealth

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Background Engagement with digital interventions is a well-known predictor of treatment outcomes, but this knowledge has had limited actionable value. Instead, learning why engagement with digital interventions impact treatment outcomes can lead to targeted improvements in their efficacy. Objective This study aimed to test a serial mediation model of an Acceptance and Commitment Therapy (ACT) smartphone intervention for smoking cessation. Methods In this randomized controlled trial, participants (N=2415) from 50 US states were assigned to the ACT-based smartphone intervention (iCanQuit) or comparison smartphone intervention (QuitGuide). Their engagement with the apps (primary measure: number of logins) was measured during the first 3 months, ACT processes were measured at baseline and 3 months (acceptance of internal cues to smoke, valued living), and smoking cessation was measured at 12 months with 87% follow-up retention. Results There was a significant serial mediation effect of iCanQuit on smoking cessation through multiple indicators of intervention engagement (ie, total number of logins, total number of minutes used, and total number of unique days of use) and in turn through increases in mean acceptance of internal cues to smoke from baseline to 3 months. Analyses of the acceptance subscales showed that the mediation was through acceptance of physical sensations and emotions, but not acceptance of thoughts. There was no evidence that the effect of the iCanQuit intervention was mediated through changes in valued living. Conclusions In this first study of serial mediators underlying the efficacy of smartphone apps for smoking cessation, our results suggest the effect of the iCanQuit ACT-based smartphone app on smoking cessation was mediated through multiple indicators of engagement and in turn through increases in the acceptance of physical sensations and emotions that cue smoking. Trial Registration Clinical Trials.gov NCT02724462; https://clinicaltrials.gov/ct2/show/NCT02724462

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Section: Discussionmentioning

confidence: 99%

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial

Bricker

Levin

Lappalainen

et al. 2021

JMIR Mhealth Uhealth

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“…Self-efficacy is an important process variable underlying successful smoking abstinence outcomes 25,26 . Improvement in self-efficacy was greater among those who received QG, relative to controls, an effect that emerged at 26-weeks post-QD.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effectiveness of a Digital Therapeutic Intervention for Smoking Cessation: A Randomized Controlled Trial

Webb¹,

Peerbux

Ang³

et al. 2021

Preprint

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Background: Smoking is the leading cause of preventable mortality worldwide. Digital therapeutic interventions offer a novel approach to smoking cessation and overcome many barriers to accessibility of traditional methods. Yet, the long-term efficacy of these interventions is largely unknown. Based on a chronic disease model of smoking, the present study evaluated the effects of Quit Genius, a novel, long-term digital therapeutic intervention for smoking cessation. Methods and Findings: Using a single-blind, two-arm parallel-group, randomized controlled trial design, adult smokers of 5 or more cigarettes per day (N=556) were recruited between January and November of 2019 via social media advertisements and referrals from primary care practices in the UK. Participants were offered nicotine replacement therapy for a 12-week period and randomly assigned to one of two interventions.The Quit Genius group received a digital therapeutic intervention for smoking cessation comprising a clinician supported smartphone application delivering cognitive behavioral therapy (CBT). The CBT component included self-directed coping skills training and individually tailored therapeutic content, coupled with personalized clinician-delivered counselling via instant messaging. The control intervention was Very Brief Advice, a face-to-face, single session intervention based upon the Ask, Advise, Act model. Half of each group received a carbon monoxide (CO) device for biochemical verification of smoking abstinence. The primary outcome, by intention to treat (ITT), was sustained abstinence at 4, 26, and 52 weeks post-quit date. Secondary outcomes included self-reported 7-day point prevalence abstinence at 26 and 52 weeks post-quit date, and self-reported quit attempts and putative mechanisms of action of CBT for smoking cessation, including self-efficacy and psychological well-being. Participants (N=556) were randomly assigned to Quit Genius (n=277) or the Very Brief Advice control condition (n=279). The final sample included 530 participants, comprising roughly equivalent proportions of men (n=291; 54%) and women, averaging 41 years of age (SD=12), who smoked an average of 15 cigarettes per day (SD=7). Using an Intention-to-treat (ITT) analysis, seven-day point prevalence abstinence from weeks 4 through 52 ranged from approximately 27% to nearly 45% among those who received the Quit Genius intervention, and from 13% to 29% for those in the control condition. Continuous smoking abstinence at 26 and 52 weeks occurred in 27.2% and 22.6% of Quit Genius participants, respectively, relative to 16.6% and 13.2% of those assigned to the control group; Quit Genius participants were more likely to remain abstinent than those in the control group Relative Risk [RR]= 1.71, 95% CI 1.17-2.50; p=0.005). Conclusions: Using an extended care model combining NRT with evidence-based psychosocial treatment, a digital therapeutic intervention (Quit Genius) produces continuous abstinence rates that are notably higher than those typically observed in the literature. Trial Registration: The trial was registered in the ISRCTN database on December 18, 2018 (https://www.isrctn.com/ISRCTN65853476).

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“…The self-determination theory demonstrates that gamification could instill a sense of intrinsically motivating competence in the user by showing the informational feedback of the game elements such as the achievements and rewards of the tasks [9]. The reward in the game serves as a conditional stimulus that could positively reinforce the desired behavior [5].…”

Section: Figurementioning

confidence: 99%

Effectiveness of Personalized Virtual Reality with Game Components Behavioral Intervention on Smoking Cessation

Liu¹

2022

Advances in Social Science, Education and Humanities Research

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Smoking is gradually becoming a concern for most people due to its harm to the lungs, heart, and immune system. Psychological approaches such as cognitive behavior therapy, cue exposed therapy, behavioral change techniques, and motivational interview, are mainstream to treat smoking addiction. However, relapse after quitting smoking is still a significant issue for conventional treatment. Virtual reality (VR) technology is gradually becoming a tool to facilitate behavior therapy toward smoking cessation, but it does not significantly increase the treatment's effectiveness. This paper analyses the potential effectiveness of VR-gamification in quitting smoking, and a literature review is used to analyze this topic. In this paper, the author proves that adding game elements to the treatment could promote the user's self-efficacy and motivation to quit smoking. With the flow features applied in the game, the user could have a sense of their ability compared to game difficulty. This would make the user feel that they are having fun and that they are engaged and challenged. It would therefore inhibit the user's dropout rate. Additionally, gamification should include personalization, social support, a meaningful frame, a user-centered design, and emotion and enjoyment to facilitate further intrinsic motivation to quit.

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Impact of Gamification on the Self-Efficacy and Motivation to Quit of Smokers: Observational Study of Two Gamified Smoking Cessation Mobile Apps

Cited by 33 publications

References 46 publications

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial

Long-Term Effectiveness of a Digital Therapeutic Intervention for Smoking Cessation: A Randomized Controlled Trial

Effectiveness of Personalized Virtual Reality with Game Components Behavioral Intervention on Smoking Cessation

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