Use of Gamification Strategies and Tactics in Mobile Applications for Smoking Cessation: a Review of the UK Mobile App Market

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Jun 20

PMID 31213452

Citations 13

Authors

Nikita B Rajani

Dominik Weth

Nikolaos Mastellos

Filippos T Filippidis

Affiliations

Soon will be listed here.

Abstract

Objective: Mobile phone-based interventions have been proven to be effective tools for smoking cessation, at least in the short term. Gamification, that is, the use of game-design elements in a non-game context, has been associated with increased engagement and motivation, critical success factors for long-term success of mobile Health solutions. However, to date, no app review has examined the use of gamification in smoking cessation mobile apps. Our review aims to examine and quantify the use of gamification strategies (broad principles) and tactics (on-screen features) among existing mobile apps for smoking cessation in the UK.

Methods: The UK Android and iOS markets were searched in February 2018 to identify smoking cessation apps. 125 Android and 15 iOS apps were tested independently by two reviewers for primary functionalities, adherence to Five A smoking cessation guidelines, and adoption of gamification strategies and tactics. We examined differences between platforms with χ tests. Correlation coefficients were calculated to explore the relationship between adherence to guidelines and gamification.

Results: The most common functionality of the 140 mobile apps we reviewed allowed users to track the days since/until the quit date (86.4%). The most popular gamification strategy across both platforms was performance feedback (91.4%). The majority of apps adopted a medium level of gamification strategies (55.0%) and tactics (64.3%). Few adopted high levels of gamification strategies (6.4%) or tactics (5.0%). No statistically significant differences between the two platforms were found regarding level of gamification (p>0.05) and weak correlations were found between adherence to Five A's and gamification strategies (r=0.38) and tactics (r=0.26).

Conclusion: The findings of this review show that a high level of gamification is adopted by a small minority of smoking cessation apps in the UK. Further exploration of the use of gamification in smoking cessation apps may provide insights into its role in smoking cessation.

Citing Articles

The regulatory status of health apps that employ gamification.

Freyer O, Wrona K, de Snoeck Q, Hofmann M, Melvin T, Stratton-Powell A Sci Rep. 2024; 14(1):21016.

PMID: 39251786 PMC: 11383928. DOI: 10.1038/s41598-024-71808-2.

Gamification in Mobile Apps for Children With Disabilities: Scoping Review.

Mahmoudi E, Yejong Yoo P, Chandra A, Cardoso R, Denner Dos Santos C, Majnemer A JMIR Serious Games. 2024; 12:e49029.

PMID: 39240675 PMC: 11415723. DOI: 10.2196/49029.

Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis.

Qian Y, Liu Z, Lee E, Wang Y, Ni Z J Med Internet Res. 2023; 25:e42260.

PMID: 37402146 PMC: 10354654. DOI: 10.2196/42260.

Conducting a systematic review and evaluation of commercially available mobile applications (apps) on a health-related topic: the TECH approach and a step-by-step methodological guide.

Gasteiger N, Dowding D, Norman G, McGarrigle L, Eost-Telling C, Jones D BMJ Open. 2023; 13(6):e073283.

PMID: 37308269 PMC: 10277147. DOI: 10.1136/bmjopen-2023-073283.

Identification of smoking cessation phenotypes as a basis for individualized counseling: An explorative real-world cohort study.

Paciorkowski M, Baty F, Pohle S, Burki E, Brutsche M Tob Induc Dis. 2022; 20:81.

PMID: 36212737 PMC: 9502004. DOI: 10.18332/tid/152546.

References

Cugelman B . Gamification: what it is and why it matters to digital health behavior change developers. JMIR Serious Games. 2015; 1(1):e3. PMC: 4307817. DOI: 10.2196/games.3139. View

Azar K, Lesser L, Laing B, Stephens J, Aurora M, Burke L . Mobile applications for weight management: theory-based content analysis. Am J Prev Med. 2013; 45(5):583-9. DOI: 10.1016/j.amepre.2013.07.005. View

Epton T, Currie S, Armitage C . Unique effects of setting goals on behavior change: Systematic review and meta-analysis. J Consult Clin Psychol. 2017; 85(12):1182-1198. DOI: 10.1037/ccp0000260. View

Iacobucci G . Stop smoking services: BMJ analysis shows how councils are stubbing them out. BMJ. 2018; 362:k3649. DOI: 10.1136/bmj.k3649. View

Ubhi H, Michie S, Kotz D, van Schayck O, Selladurai A, West R . Characterising smoking cessation smartphone applications in terms of behaviour change techniques, engagement and ease-of-use features. Transl Behav Med. 2016; 6(3):410-7. PMC: 4987605. DOI: 10.1007/s13142-015-0352-x. View

Filippidis F, Laverty A, Mons U, Jimenez-Ruiz C, Vardavas C . Changes in smoking cessation assistance in the European Union between 2012 and 2017: pharmacotherapy versus counselling versus e-cigarettes. Tob Control. 2018; 28(1):95-100. PMC: 6317445. DOI: 10.1136/tobaccocontrol-2017-054117. View

Breton E, Fuemmeler B, Abroms L . Weight loss-there is an app for that! But does it adhere to evidence-informed practices?. Transl Behav Med. 2013; 1(4):523-9. PMC: 3717669. DOI: 10.1007/s13142-011-0076-5. View

Allam A, Kostova Z, Nakamoto K, Schulz P . The effect of social support features and gamification on a Web-based intervention for rheumatoid arthritis patients: randomized controlled trial. J Med Internet Res. 2015; 17(1):e14. PMC: 4296094. DOI: 10.2196/jmir.3510. View

Hiscock R, Bauld L, Amos A, Platt S . Smoking and socioeconomic status in England: the rise of the never smoker and the disadvantaged smoker. J Public Health (Oxf). 2012; 34(3):390-6. PMC: 3425348. DOI: 10.1093/pubmed/fds012. View

10.

Laranjo L, Arguel A, Neves A, Gallagher A, Kaplan R, Mortimer N . The influence of social networking sites on health behavior change: a systematic review and meta-analysis. J Am Med Inform Assoc. 2014; 22(1):243-56. PMC: 4433372. DOI: 10.1136/amiajnl-2014-002841. View

11.

Merry S, Stasiak K, Shepherd M, Frampton C, Fleming T, Lucassen M . The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial. BMJ. 2012; 344:e2598. PMC: 3330131. DOI: 10.1136/bmj.e2598. View

12.

Hiscock R, Dobbie F, Bauld L . Smoking Cessation and Socioeconomic Status: An Update of Existing Evidence from a National Evaluation of English Stop Smoking Services. Biomed Res Int. 2015; 2015:274056. PMC: 4529910. DOI: 10.1155/2015/274056. View

13.

Bartlett Y, Sheeran P, Hawley M . Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: a meta-analysis. Br J Health Psychol. 2014; 19(1):181-203. PMC: 4253323. DOI: 10.1111/bjhp.12071. View

14.

Johnson D, Deterding S, Kuhn K, Staneva A, Stoyanov S, Hides L . Gamification for health and wellbeing: A systematic review of the literature. Internet Interv. 2018; 6:89-106. PMC: 6096297. DOI: 10.1016/j.invent.2016.10.002. View

15.

Hoeppner B, Hoeppner S, Seaboyer L, Schick M, Wu G, Bergman B . How Smart are Smartphone Apps for Smoking Cessation? A Content Analysis. Nicotine Tob Res. 2015; 18(5):1025-31. PMC: 5942604. DOI: 10.1093/ntr/ntv117. View

16.

de Vries H, Eggers S, Bolman C . The role of action planning and plan enactment for smoking cessation. BMC Public Health. 2013; 13:393. PMC: 3644281. DOI: 10.1186/1471-2458-13-393. View

17.

Nguyen E, Bugno L, Kandah C, Plevinsky J, Poulopoulos N, Wojtowicz A . Is There a Good App for That? Evaluating m-Health Apps for Strategies That Promote Pediatric Medication Adherence. Telemed J E Health. 2016; 22(11):929-937. DOI: 10.1089/tmj.2015.0211. View

18.

Maher C, Lewis L, Ferrar K, Marshall S, De Bourdeaudhuij I, Vandelanotte C . Are health behavior change interventions that use online social networks effective? A systematic review. J Med Internet Res. 2014; 16(2):e40. PMC: 3936265. DOI: 10.2196/jmir.2952. View

19.

Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y . Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2016; 4:CD006611. PMC: 6485940. DOI: 10.1002/14651858.CD006611.pub4. View

20.

Abroms L, Padmanabhan N, Thaweethai L, Phillips T . iPhone apps for smoking cessation: a content analysis. Am J Prev Med. 2011; 40(3):279-85. PMC: 3395318. DOI: 10.1016/j.amepre.2010.10.032. View