Abstract
Smoking is a major cause of worldwide morbidity and mortality. Almost no evidence-based intervention programs are available to help youth quit smoking. We argue that ineffective targeting of peer influence and engagement difficulties are significant barriers to successful youth smoking cessation. To address these barriers, we developed the mobile game intervention HitnRun. A two-armed randomized controlled trial (RCT; n = 144) was conducted and young smokers (Mage = 19.39; SDage = 2.52) were randomly assigned to either play HitnRun or read a psychoeducational brochure. Prior to, directly following the intervention period, and after three-month follow-up, weekly smoking behavior, abstinence rates, intervention dose, and peer- and engagement-related factors were assessed. Results indicated similar reductions in weekly smoking levels and similar abstinence rates for both groups. Yet, we found a dose effect with HitnRun only: The longer participants played HitnRun, the lower their weekly smoking levels were. In the brochure group, a higher dose was related to higher weekly smoking levels at all measurement moments. Exploratory analyses showed the most powerful effects of HitnRun for participants who connected with and were engaged by the intervention. Future work should build on the promising potential of HitnRun by increasing personalization efforts and strengthening peer influence components.
Highlights
Smoking is one of the leading public health problems in the world, killing about seven million people worldwide each year (WHO, 2018)
Two-armed randomized controlled trial (RCT) we examined the effects of HitnRun, a social mobile game, among young smokers who were motivated to quit smoking
The correlational analyses showed that larger decreases in weekly smoking behavior from pretest to post-test and from pretest to follow-up were associated with lower education level, higher prior gaming experience, higher baseline nicotine dependence levels, higher motivation to quit at baseline, and higher exposure to peer smoking
Summary
Smoking is one of the leading public health problems in the world, killing about seven million people worldwide each year (WHO, 2018). Several intervention programs integrate peer influence processes in one way or another, such as by including social skill training that is directed at helping youth say no to smoking peers, by nonsmoking youth’s giving support and advice to smoking youths, or by suggesting to spend less time with their smoking peers (Golechha, 2016; Sussman & Sun, 2009) These programs remain highly problematic, for several reasons: (a) the content is still solely targeted at the individual instead of a broader peer group (Gabble et al, 2015), (b) imbalanced relationships between the support giver and support taker are not helpful (Lenkens et al, 2019), and (c) these programs instigate high resistance among young smokers (Harakeh & Van Nijnatten, 2016; Schenk et al, 2018; Wolburg, 2006)
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