Background and Aim: Gamification can positively impact self-efficacy and motivation to quit, two vital factors associated with smoking cessation. Since it shares key components with behaviour change theories and is easily applicable to digital interventions, gamification has the potential of improving the effectiveness of mHealth solutions. However, the role of gamification in the context of smoking cessation and mHealth has been sparsely investigated. My research aims to examine gamification elements in smoking cessation mobile apps and quantitatively investigate their effects on the self-efficacy and motivation to quit of smokers seeking to quit.

Methods: A review of smoking cessation apps on the UK market assessed app adherence to treatment guidelines and incorporation of gamification. One of two mobile apps identified from the review were assigned to smokers seeking to quit for a 4-week long study. Linear and logistic regression models investigated the effects of gamification on self-efficacy, motivation to quit and smoking cessation. Pairwise Pearson correlations compared self-reported and in-app engagement data. Statistical significance for all models and tests was determined at the 5% (.05) level.

Results: Smoking cessation apps had low adherence to treatment guidelines and did not incorporate a high level of gamification. Compared to baseline, self-efficacy and motivation to quit statistically significantly increased after app use. Perceived engagement with overall gamification was associated with change in self-efficacy (β=3.35, 95% CI: 0.31 to 6.40) and motivation to quit (β=0.54, 95% CI: 0.15 to 0.94). Engagement with the steps/levels feature (based on self-reported and in-app data) was associated with change in self-efficacy and 7-day smoking cessation. Self-reported and in-app engagement data were positively moderately correlated.

Conclusion: Gamification in mobile apps can have positive effects on the self-efficacy and motivation to quit of smokers. The findings provide important insights for tobacco control policymakers, mobile app developers and smokers trying to quit.