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Abstract
Background
Preventing tobacco product initiation in youth is a critical need. While cigarette smoking among youth has been on the decline, tobacco use in other forms, such as e-cigarettes and vaping, continue to be a major concern. The purpose of this study was to conduct a real-world, quasi-experimental test of the effectiveness of a web-based videogame, smokeSCREEN, aimed at developing healthy beliefs and knowledge associated with tobacco product use prevention, including electronic cigarettes. Methods: Adolescents (N = 560) aged 10–16 years were enrolled from schools and afterschool programs in a single-group pre–post study. Measures included a pre- and post-survey of beliefs and knowledge about tobacco product use. At post-survey, participants were asked questions regarding their gameplay experience. Paired responses for the tobacco product use in the beliefs and knowledge survey before and after the smokeSCREEN videogame intervention were compared using McNemar’s test. Descriptive statistics were generated to assess overall participant gameplay experience. Results: McNemar’s test showed significant differences in the proportions of correct answers before (pre-survey) and after (post-survey) the intervention in seven out of eight belief questions (p < . 0001). It also suggested significant differences in the proportions of correct answers before (pre-survey) and after (post-survey) the intervention in all six knowledge questions (p < . 0001). Several gender and age differences were noted for belief and knowledge questions related to e-cigarettes and vaping. There was no association between gameplay duration at post-survey or to the answers of the beliefs or knowledge questions. Overall, participants reported that they enjoyed playing the game. Conclusions: Findings suggest that the videogame intervention, smokeSCREEN, has a promising effect on participants’ beliefs and knowledge about tobacco product use, including electronic cigarettes and vaping, and is well accepted by adolescents.
Acknowledgements
This study was generously supported through the CVS Health Foundation. smokeSCREEN was developed by Schell Games and 1st Playable Productions. This manuscript has been submitted solely to Substance Abuse and has not been previously published, either in whole or in part, nor have the findings been posted online. The findings from this article were presented as a roundtable session at the Society for Public Health Education 70th Annual Conference on March 27, 2019 and presented as a poster presentation at the National Institutes of Health Tobacco Regulatory Summit on October 21, 2019. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Dr. Hieftje had full access to all aspects of the research and writing process and takes final responsibility for this article.
Disclosure statement
No potential conflict of interest was reported by the authors.
Author contributions
Dr. Hieftje contributed to the study design conceptualization, game development, and writing of the manuscript; Dr. Fiellin contributed to the study design conceptualization and writing of the manuscript; Dr. Fernandes contributed through assisting in writing the manuscript; and Dr. Lin contributed through data analysis and writing of the manuscript. CVS Health Foundation did not have any role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication.