App to help smokers quit developed by health psychologists and game designers

A smartphone app that could help smokers stick to New Year's resolutions to quit has been developed by academics at Queen Mary University of London (QMUL) and Kingston University.

Cigbreak Free works like a regular smartphone game, with players having to complete tasks to progress through levels and gain rewards. However, it also incorporates a combination of some 37 behavioral change techniques—theory-based methods for changing behavior—selected by QMUL health psychologists to help smokers quit.

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In the game, players have to swipe a certain number of cigarettes to break them within a time limit. As well as progressing through levels, the app includes a quit journal where users can calculate how much money they are saving.

The app has now been commissioned for use by five London boroughs (Kingston, Kensington and Chelsea, Hammersmith and Fulham, Tower Hamlets and the City of Westminster) as part of their public health smoking cessation services.

Professor Robert Walton from QMUL's Blizard Institute said: "I was keen to exploit the current trend in gaming to see it could be put to good use and improve people's health.

"Based on our previous research, we selected and embedded health messages and behavior change techniques within the game, to help promote smoking cessation. Some of these include showing the player the health consequences of a behavior, gaining points for grabbing healthy items, or providing virtual financial incentives. But some of these techniques are so subtly embedded in the game, you wouldn't even know they're there."

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"We're essentially trying to 'gamify' health messages and behavior change techniques as a way of embedding them in a person's mind, in the hope that they will then be able to quit smoking."

Games creation processes lecturer Hope Caton from Kingston University said: "The good thing about a smartphone gaming app is that you can play it anywhere. Craving is a short-term thing, so if you get a craving at 11am, you can play the game in the warm until it passes, rather than going out into the cold for a cigarette. You've also got something to do with your hands other than smoke."

Rewards in the game were a way of giving smokers instant positive feedback, Caton added. "When you're trying to quit smoking you don't get much instant feedback except desire. Your health is better but somehow it doesn't have the same effect as being told you're winning or getting a gold star," she explained.

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This month, a key time for smokers to make the resolution to quit, the team will begin a three-month pilot study with app users to evaluate its effectiveness.

The team behind Cigbreak Free were also authors of a recent research study published in the British Medical Journal, which analyzed the use of behavior change techniques and game-like elements in health apps currently on the market. They found that very few of the health apps they looked at were using games to help people make positive health changes.

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Queen Mary University of London   press release

Publication

Edwards EA et al. Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps.   BMJ Open, Published October 4 2016. doi: 10.1136/bmjopen-2016-012447