Jun 03, 2026
UniQuit: Protocol for a Mixed-Methods Feasibility Study of an AI- and Gamification-Based Smoking Cessation App Prototype for University Students in Saudi Arabia
- Farhan Alanazi1,2,
- Stathis Th. Konstantinidis1,
- Holly Blake1,3
- 1School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK;
- 2Health Informatics Department, College of Health Sciences, Saudi Electronic University, Jeddah 11673, Saudi Arabia;
- 3NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
- Saudi Electronic University, Saudi Arabia
Protocol Citation: Farhan Alanazi, Stathis Th. Konstantinidis, Holly Blake 2026. UniQuit: Protocol for a Mixed-Methods Feasibility Study of an AI- and Gamification-Based Smoking Cessation App Prototype for University Students in Saudi Arabia. protocols.io https://dx.doi.org/10.17504/protocols.io.rm7vzwmr2vx1/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: June 02, 2026
Last Modified: June 03, 2026
Protocol Integer ID: 318398
Keywords: smoking cessation app prototype for university student, based smoking cessation app prototype, smoking cessation intervention, exploratory smoking, cessation intervention, baseline nicotine dependence, smoking, nicotine dependence, gamification, feasibility among university student, vulnerable to smoking, health credit, cigarettes per day, usability of uniquit, cigarette, craving help, fagerström test for nicotine dependence, methods feasibility study, uniquit prototype, saudi arabia smoking, engagement with app feature, using uniquit, primary feasibility outcome, intervention, uniquit, adherence, preventable illness
Abstract
Smoking remains a leading cause of preventable illness and premature mortality worldwide. University students are particularly vulnerable to smoking due to academic stress and social and environmental influences. Digital smoking cessation interventions incorporating artificial intelligence (AI) and gamification may offer flexible and engaging support; however, their feasibility among university students remains underexplored. This study aims to assess the feasibility, acceptability, and usability of UniQuit, an AI- and gamification-based smoking cessation app prototype for university students. An explanatory sequential mixed-methods feasibility study with a single-arm pre-post repeated-measures design will be conducted among university students who smoke. A sample of 40–50 university students who smoke at least five cigarettes per day will be recruited. Participants will use the UniQuit prototype for 6 weeks. The prototype includes Daily Missions, Craving Help, an AI Quit Coach, tailored reminders, progress tracking, Health Credits, badges, stress support, relapse support, and anonymous peer support. Primary feasibility outcomes will include recruitment rate, retention throughout the 6-week intervention period, adherence, engagement with app features, completion of baseline and follow-up measures, and usability of the prototype. Exploratory smoking-related outcomes will include cigarettes smoked per day (CPD) and 7-day point prevalence abstinence (7-day PPA) (1), assessed at baseline and post-intervention. Baseline nicotine dependence will be assessed using the Fagerström Test for Nicotine Dependence (FTND) (2), and post-intervention usability will be assessed using the System Usability Scale (SUS) (3). Semi-structured interviews will be conducted with a subset of participants after the intervention to explore participants’ experiences, acceptability, usability, and perceived barriers and facilitators to using UniQuit. Ethical approvals have been obtained from the relevant institutional ethics committees. Findings will be disseminated through doctoral thesis, conference presentations, peer-reviewed publication. Findings may also be shared with relevant university stakeholders, where appropriate.
Methods
An explanatory sequential mixed-methods feasibility study with a single-arm pre-post repeated-measures design will be conducted among university students who smoke. A sample of 40–50 participants will be recruited. Eligible participants will be aged 18 years or older, currently enrolled as university students, smoke at least five cigarettes per day, own a smartphone with internet access, and be able to provide informed consent. Participants will use the UniQuit prototype for 6 weeks. Quantitative data will be collected at baseline and post-intervention to assess feasibility outcomes, usability, and exploratory smoking-related outcomes, including CPD and 7-day PPA. Baseline nicotine dependence will be assessed using FTND. Post-intervention semi-structured interviews will be conducted with a subset of participants to explore acceptability, usability, and perceived barriers and facilitators to engagement. Quantitative data will be analyzed descriptively, and qualitative data will be analyzed thematically.
Intervention
Participants will use UniQuit, an AI- and gamification-based smoking cessation app prototype, for 6 weeks. The prototype is designed to provide private, personalized, and nonjudgmental support for university students who smoke. UniQuit includes Daily Missions, Craving Help, an AI Quit Coach, tailored reminders, progress tracking, Health Credits, badges, stress support, relapse support, and anonymous peer support. The AI Quit Coach content will be informed by the World Health Organization’s clinical treatment guideline for tobacco cessation in adults and will provide general supportive guidance only. It will not provide diagnosis, prescribing, medication recommendations, or individualized medical treatment advice.
Participants and Setting
The study will be conducted with university students recruited from a higher education institution in Saudi Arabia. A sample of 40–50 students who smoke at least five cigarettes per day will be recruited. Eligible participants will be aged 18 years or older, currently enrolled as university students, own a smartphone with internet access, and be able to provide informed consent. Exclusion criteria will include current enrollment in another structured smoking cessation program, self-reported medical conditions requiring supervised smoking cessation, inability to provide informed consent or understand study procedures, and self-reported visual or cognitive impairments that may limit engagement with the prototype.
Recruitment
Participants will be recruited from a higher education institution in Saudi Arabia using convenience sampling. Recruitment will take place through student social media platforms, including WhatsApp and Telegram groups. Interested students will complete a screening form, and eligible students will receive the Participant Information Sheet and Consent Form. Students who provide informed consent will complete the baseline questionnaire before using the UniQuit prototype.
Sample Size
As this is a feasibility study, a power calculation is not required. The study will aim to recruit 40–50 university students who smoke.
Outcomes
The primary feasibility outcomes will include recruitment rate, retention throughout the 6-week intervention period, adherence, engagement with app features, completion of baseline and follow-up measures, and usability of the UniQuit prototype. Exploratory smoking-related outcomes will include CPD and 7-day PPA, assessed at baseline and post-intervention. Baseline nicotine dependence will be assessed using FTND. Acceptability, usability, and perceived barriers and facilitators to engagement will be explored through post-intervention semi-structured interviews with a subset of participants.
Interviews
Post-intervention semi-structured interviews will be conducted with a subset of participants after the 6-week intervention period. The interviews will explore participants’ experiences of using the UniQuit prototype, including acceptability, usability, perceived usefulness, barriers and facilitators to engagement, and suggestions for improvement. Interviews will be audio-recorded with consent, transcribed, anonymized, and analyzed thematically.
Data Analysis
Quantitative data will be analyzed descriptively using frequencies, percentages, means, and standard deviations, where appropriate. Feasibility outcomes will be summarized descriptively. Changes in CPD from baseline to post-intervention will be explored using paired t-tests or Wilcoxon signed-rank tests, depending on data distribution. 7-day PPA will be summarized at post-intervention using frequencies and percentages. Qualitative data generated from the interviews will be analyzed thematically using Braun and Clarke’s thematic analysis approach to identify participants’ experiences, acceptability, usability, and perceived barriers and facilitators to engagement with the UniQuit prototype.
Results
The study will report participant flow, baseline characteristics, feasibility outcomes, usability findings, exploratory smoking-related outcomes, and qualitative themes on acceptability and engagement with the UniQuit prototype.
Ethics and Dissemination
Ethical approvals have been obtained from the relevant institutional ethics committees. The study will be conducted in accordance with the Declaration of Helsinki. Participants will provide informed consent before taking part in the study. Data will be anonymized and stored securely. Findings will be disseminated through doctoral thesis, conference presentations, and peer-reviewed publication. Results may also be shared with relevant university stakeholders to inform future development and evaluation of the UniQuit prototype.
Protocol references
1. JR Hughes; JP Keely; RS Niaura; DJ Ossip-Klein; RL Richmond; GE Swan. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res 5, 13–25 (2003)
2. TF Heatherton; LT Kozlowski; RC Frecker; K Fagerstrom. The Fagerström Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction 86, 1119–1127 (1991)
3. J Brooke. SUS: A “Quick and Dirty” Usability Scale. In: Usability Evaluation In Industry. PW Jordan, B Thomas, IL McClelland, B Weerdmeester, eds. , CRC Press (1996)
4. World Health Organization. WHO clinical treatment guideline for tobacco cessation in adults. World Health Organization, Geneva, Switzerland (2024)
5. V Braun; V Clarke. Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101 (2006)
6. World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA 333, 71 (2025)