A new wrinkle in smoking research

It’s not a game if you can’t lose. But when you do lose at “Super Smoky,” it ain’t pretty!

If health concerns won’t get college students to quit smoking, maybe experiencing the future will.

That’s the finding of Hayeon Song, an assistant professor of communication at the University of Wisconsin-Milwaukee (UWM), who developed a video game that showed social smokers what they might look like after 20 years of smoking.

Hayeon Song

The smokers who viewed their own future face affected by the negative consequences of smoking in the video game had more negative attitudes toward social smoking and were more interested in quitting than those who didn’t see what the future would look like, according to Song’s study, recently published in “Computers in Human Behavior.”

The research grew out of Song’s ongoing interests in computers and human behavior, particularly health habits.

“My research area is using virtual reality to change real-life behaviors,” she says. “Everybody knows smoking is bad, but still they smoke.”

Changing attitudes among young people is particularly challenging, she says, because talking to them about future health problems doesn’t have an impact – even though national figures identify smoking as the leading cause of preventable health problems in the U.S. For every person who dies from a smoking-related disease, another 20 suffer at least one serious illness related to smoking, according to the Centers for Disease Control.  Song believes, she says, that smokers still smoke because they don’t think they will be affected by these horrible health problems.

Humans tend to have inaccurate beliefs about their own future, and those beliefs are often unreasonably optimistic, she says.

Would their attitudes change, she wondered, if quit-smoking efforts focuses on providing more specific information about the future, and they could see right now what they might look like after 20 years of smoking?

Smoke and mirrors

“Aging Booth,” can give a stark outlook on the future appearance (lower photo) of even causal smokers.

To test that hypothesis, she designed an anti-smoking educational video game that incorporated avatars, digital photos of participants and a simple age-progression app.

She chose so-called “social smokers” for her research because this is the category about half of college-age smokers fall into. They don’t consider themselves habitual smokers, but smoke when they are stressed out or at a bar or party, for example, says Song.  They don’t carry around a pack of cigarettes, but will take one when offered.  “They are less addicted to smoking,” she says, “thus it would be easier for them to quit compared to daily smokers.”

Song chose a sample of 62 social smokers to take part in the study, after screening more than 400 in an online survey about their smoking habits. The participants’ average age was just over 22.

Song then created a video game called “Super Smoky” that educates players about the risks of social smoking.  The study participants were randomly assigned to one of four groups – those who played with an avatar representing their own future self, those who played with an avatar of their current selves, those who played with a generic present-time avatar and those who played with a generic future-time avatar.

The future faces were aged using a widely available age-progression software called “Aging Booth,” with the extra wrinkles common to long-time smokers added.  Each level of the game offered rewards and consequences for various actions such as trying to avoiding friends who offered them cigarettes.  If the participants using their own faces on the avatar couldn’t successfully avoid smoking in Level 1, they progressed to their own future, smoking-aged avatar faces, in Level 2.

After playing the game, the participants were questioned about their attitudes toward social smoking and possible risks from continued smoking.  Results showed that those who had played the game and viewed their own future, smoking-damaged faces, were most likely to have negative attitudes toward smoking and be willing to try to quit.

Song concluded that providing concrete and realistic information about an individual’s potential future and using the aged face of a game avatar as a way to get the quit-smoking message across to college-age students could be very effective.

“One of the cool things about health games is that individuals can learn from their own experience,” she says, “while testimonials using other media are based on learning from other people’s experience.”  One of her other studies demonstrated that a game makes the quit-smoking message more effective than brochures, Hong says.

And, she adds, “If you’re viewing smoking with a stranger’s aged face, the message is not as effective as if you see the impact on your own aged face. That’s much more powerful.”