New App Harnesses Gamification for Smoking Cessation - European Medical Journal

New App Harnesses Gamification for Smoking Cessation

3 Mins

United Kingdom, November 14, 2016 – A framework to gamify anti-smoking apps, and potentially improve adherence to non-smoking regimens, has been developed in a study conducted by Yusuf Sherwani, Imperial College London, London, UK, and colleagues. Today, smoking represents 19% of all the deaths within the UK, costing the National Health Service (NHS) a total of £5.2 billion, and has been announced, at present, as the biggest cause of premature mortality on a global scale. Although an estimated 68% of individuals express a desire to quit smoking, this desire is only successfully actualised in 3% of those individuals, reflecting a massive disparity.

Currently, the most successful treatment paradigm for smoking cessation is a combination of high intensity behavioural support and pharmacological intervention; this costs an average of £7,010 per person, with behavioural support contributing the majority of the cost. Within both this and wider healthcare contexts, m-Heath as an alternative behavioural support component of healthcare programmes is currently being tested.

As part of the study,1 16 active smokers who had expressed a desire to quit smoking were divided into two groups, with group A using a gamified app and group B using a classic non-gamified app. Follow-up was conducted in the form of four semi-structured interviews over a 5-week period. Further data was collated in the forms of a systematic literature review, expert interviews, and a secondary dataset.

Three key factors were found to be vital for users to engage with the app; the absence of a single factor resulted in user disengagement. Firstly, the user needed to be clear about the purpose of the app, and secondly, this purpose had to be aligned with the user’s individual goal. Finally, the user had to believe that the app could assist them in achieving their goal, by satisfying their needs and providing solutions to their difficulties.

Once the three key factors were in place, seven additional modifiers of medical mobile apps were identified; these were: i) personalisation: ensuring relevancy, ii) meaningful framing: presenting the challenge of ceasing smoking in a way that is individually pertinent, iii) challenge-ability balance: there must be an equilibrium between the user perception of challenge difficulty and ability to succeed, iv) unpredictability: of app rewards, v) user-centred design: making sure that the app enables the user to continuously achieve their goals, vi) fun: ensuring the app is enjoyable, vii) social community: building a social network of users and reciprocal validation.

Over the last year, the researchers have also been involved in translating the research findings into an app that serves as a blueprint for the framework in action. The gamified app for smoking cessation, called Quit Genius, is hoped to provide effective behavioural support to smoking cessation programmes. They note that future research is required to further appraise the effectiveness of their proposed gamified framework against current behavioural interventions. Chief Executive Officer Yusuf Sherwani commented that: “Healthcare apps offer tremendous potential for cost-effective and evidence-based support to be offered at scale. Historically, we have failed to deliver on that potential due to development being led in isolation by either software engineers or clinicians. Our view is that real innovation requires a close cross-collaboration between academics, clinicians, software engineers and designers, and we hope that Quit Genius will become a blueprint for what evidence-based healthcare apps can achieve.”


  1. El-Hilly AA et al. Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study. JMIR Serious Games. 2016;4(2):e18.


Mark Wilkes
Editorial Administrator, European Medical Journal

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