Health Behavior and Policy Review · Oct 2026
Gamified Exercise and Smoking Cessation Intention in Male Smokers: A Within-Person Mediation Analysis
Objective: We examined whether physical activity (PA) mediates the effect of gamified exercise on cessation intention, and to test the a priori hypothesis that this indirect effect would be negative, based on the Compensatory Health Beliefs framework. Methods: In a quasi-experimental single-group pre-post study, we enrolled 52 adult male smokers in Indonesia in a 12-week gamified exercise program. PA was measured using the Global Physical Activity Questionnaire (GPAQ), and cessation intention using the Intention to Quit Smoking Scale (IQSS). We analyzed within-subject mediation using MEMORE with 10,000 bootstrap samples. Results: PA increased significantly (+347 metabolic equivalent of task [MET]-min/week; p < .001), while cessation intention decreased non-significantly (p = .077). Mediation analysis revealed a statistically significant negative indirect effect (ab = −0.52; 95% CI: −1.23 to −0.03; p = .04), indicating PA gains were associated with reduced cessation intention despite non-significant total and direct effects. Conclusions: Gamified exercise increased PA but did not improve cessation intention in this short-term, single-group exploratory trial, suggesting motivational trade-offs. Findings are preliminary and hypothesis-generating, given the absence of a control group, reliance on self-reported intention rather than biochemically verified outcomes, and predominance of light smokers.