Gamification to enhance engagement in digital smoking cessation interventions: a systematic review using the octalysis framework
4 affiliations
- 1School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- 2Health Informatics Department, College of Health Sciences, Prince Musaid bin Abdulrahman University, Jeddah, Saudi Arabia
- 3Health Informatics Department, College of Health Sciences, Prince Musaid bin Abdulrahman University, Riyadh, Saudi Arabia
- 4NIHR Biomedical Research Centre: Nottingham, Nottingham, United Kingdom
Abstract
BackgroundSmoking remains a leading cause of preventable morbidity and mortality worldwide. Digital interventions have shown promise in addressing the limitations of traditional smoking cessation approaches. Gamification is increasingly being integrated into these interventions to enhance engagement. However, engagement may decline over time, and the gamification elements used across interventions have not been systematically characterized. The Octalysis Framework provides a structured approach to classifying these elements according to their underlying motivational drives.ObjectiveThis systematic review aimed to identify, classify, and describe the gamification elements used in digital smoking cessation interventions using the Octalysis Framework, and to summarize reported engagement-related outcomes to inform the design of future interventions.MethodsWe followed PRISMA guidelines. Studies of gamified digital smoking cessation interventions were eligible, whereas studies of related but distinct concepts, including serious games, were excluded. MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Epistemonikos, and Scopus were searched from inception through April 16, 2026. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using design-appropriate JBI tools. Elements were grouped and counted at the intervention level, classified using the Octalysis Framework, and narratively synthesized because of heterogeneity.ResultsThirteen studies describing nine predominantly smartphone-based interventions met the inclusion criteria. Across the interventions, 56 elements were mapped to all eight core drives. Development and Accomplishment contained the most elements, whereas Unpredictability and Curiosity contained the fewest. Engagement-related findings were heterogeneous and often favorable. Formal cessation outcomes were reported in seven studies and were mixed. Only three studies explicitly reported using a formal gamification framework or taxonomy.ConclusionsThis review provides a focused, framework-based synthesis of gamification elements used in digital smoking cessation interventions. By identifying how these elements have been applied across interventions, it offers a structured basis for future intervention design. The findings may inform the selection of theory-informed gamification strategies; however, their effects on sustained engagement and smoking cessation outcomes require further evaluation.RegistrationNot registered.
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BibTeX
@article{alanazi2026gamification,
title = {{Gamification to enhance engagement in digital smoking cessation interventions: a systematic review using the octalysis framework}},
author = {Farhan Alanazi and Farhan Alanazi and Roaa Aljuraid and Saleh Alzughaibi and Stathis Th. Konstantinidis and Holly Blake and Holly Blake},
journal = {Frontiers in Digital Health},
year = {2026},
month = nov,
doi = {10.3389/fdgth.2026.1995984},
url = {https://doi.org/10.3389/fdgth.2026.1995984},
note = {CC BY},
}
RIS
TY - JOUR
TI - Gamification to enhance engagement in digital smoking cessation interventions: a systematic review using the octalysis framework
AU - Farhan Alanazi
AU - Farhan Alanazi
AU - Roaa Aljuraid
AU - Saleh Alzughaibi
AU - Stathis Th. Konstantinidis
AU - Holly Blake
AU - Holly Blake
PY - 2026
DA - 2026/11/04
JO - Frontiers in Digital Health
DO - 10.3389/fdgth.2026.1995984
UR - https://doi.org/10.3389/fdgth.2026.1995984
AB - BackgroundSmoking remains a leading cause of preventable morbidity and mortality worldwide. Digital interventions have shown promise in addressing the limitations of traditional smoking cessation approaches. Gamification is increasingly being integrated into these interventions to enhance engagement. However, engagement may decline over time, and the gamification elements used across interventions have not been systematically characterized. The Octalysis Framework provides a structured approach to classifying these elements according to their underlying motivational drives.ObjectiveThis systematic review aimed to identify, classify, and describe the gamification elements used in digital smoking cessation interventions using the Octalysis Framework, and to summarize reported engagement-related outcomes to inform the design of future interventions.MethodsWe followed PRISMA guidelines. Studies of gamified digital smoking cessation interventions were eligible, whereas studies of related but distinct concepts, including serious games, were excluded. MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Epistemonikos, and Scopus were searched from inception through April 16, 2026. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using design-appropriate JBI tools. Elements were grouped and counted at the intervention level, classified using the Octalysis Framework, and narratively synthesized because of heterogeneity.ResultsThirteen studies describing nine predominantly smartphone-based interventions met the inclusion criteria. Across the interventions, 56 elements were mapped to all eight core drives. Development and Accomplishment contained the most elements, whereas Unpredictability and Curiosity contained the fewest. Engagement-related findings were heterogeneous and often favorable. Formal cessation outcomes were reported in seven studies and were mixed. Only three studies explicitly reported using a formal gamification framework or taxonomy.ConclusionsThis review provides a focused, framework-based synthesis of gamification elements used in digital smoking cessation interventions. By identifying how these elements have been applied across interventions, it offers a structured basis for future intervention design. The findings may inform the selection of theory-informed gamification strategies; however, their effects on sustained engagement and smoking cessation outcomes require further evaluation.RegistrationNot registered.
SN - 2673-253X
ER -