At its core, public health is about driving healthy behavior changes by building awareness, meeting people where they are, and offering solutions that are accessible and grounded in evidence. Throughout my career, I have worked on issues ranging from foster adoption and drunk driving prevention to tobacco prevention and cessation, always with science as our foundation. But the media landscape, and how people engage with information, has changed dramatically. To remain relevant and effective, public health must evolve. That means rethinking not just what we communicate, but how we motivate, engage, and sustain healthy behaviors.
WHY IT’S IMPORTANT TO LEAN IN
Gamification, using elements of game design in an existing digital product or intervention to engage users and change behavior, has become an increasingly common approach in public health. It can reframe intimidating goals like exercising more, managing stress, and quitting nicotine into smaller, achievable steps that feel tangible and motivating. When implemented effectively, gamification can improve user engagement by supporting intrinsic motivation, learning and skill development, social interaction, and a sense of accomplishment.
In many ways, public health can’t afford to ignore gamification. Addiction is already gamified—and it’s winning. As one example, “smart” vapes now feature screens, rewards, animations, and puff tracking. These high-tech devices have become top-selling products, with 32% of youth and 33% of young adults reporting using vapes with screens, games, or Bluetooth connectivity in the past month. These products are applying the same engagement strategies used in consumer tech to drive repeat use and ultimately sustain addictive behavior.
WHAT THE EVIDENCE SHOWS
Mounting evidence supports gamification use in public health. As an example, some randomized trials show that socially incentivized gamified interventions can significantly increase physical activity, compared with non-gamified approaches. Similar approaches have been used to improve medication adherence, chronic disease management, and preventive health behaviors. Participants assigned to team-based challenges or friendly competition sustain healthier behaviors longer than those receiving traditional prompts alone. Progress you can see becomes behavior you repeat.
Interventions using gamification share some core principles: making health interactive, trackable, or social. Many effective gamified health interventions align with self-determination theory, which identifies three drivers of motivation: autonomy, competence, and relatedness.
BEHAVIORAL SCIENCE BACKING IS NEEDED
Well-designed programs don’t just reward outcomes; they reward effort, consistency, and resilience. In public health, that distinction matters, because change rarely happens all at once. It happens through daily re-commitments. Public health succeeds when it rewards persistence and practice—not perfection.
Campaigns, which often complement an intervention, can also be gamified. The campaign itself can inspire behavior change, while also encouraging sign-up for the specific health intervention. The collective result: stronger outcomes.
The approach can be especially relevant for younger generations, who may expect things like daily check-ins, streaks, and digital accountability as part of their digital experiences. We are infusing some gamified elements into EX Program from Truth Initiative, our free, digital nicotine-cessation resource developed in collaboration with Mayo Clinic. By implementing elements that mirror gamification principles like check-ins, milestones, progress encouragement, virtual rewards, and social reinforcement, we help participants stay engaged with quitting behavior. These features are designed to reward effort and participation rather than outcomes alone. We know that every try makes you stronger the next time.
APPLY GAMIFICATION BEYOND TRADITIONAL HEALTH TOOLS
We have also tested creator-led digital experiences that reflect how young people already motivate one another online. As part of You Got This Day, a national moment designed to reframe “Quitter’s Day” as an opportunity to recommit after relapse, Truth Initiative worked with Gen-Z creators to create and launch a Snapchat augmented-reality lens called 30 Day Challenge.
Developed through Snap Academies, the lens encourages young people trying to quit nicotine to focus on making it “one more day” without using nicotine, through visual progress tracking, supportive messaging, and social accountability. Rather than relying on financial incentives or competition, the experience emphasizes encouragement, persistence, and community, reinforcing evidence-based support through EX Program.
For Gen Z, platforms like Snapchat and TikTok aren’t channels—they’re cultural fluency. Designing health interventions that live there brings gamification to young consumers where it already resonates.
REASONS FOR CAUTION
Evidence points to important caveats to consider when moving toward a more gamified public health approach. Over-reliance on competition can discourage people who fall behind. Extrinsic rewards can crowd out internal motivation, or risk trivializing an important topic for participants. And without strong privacy protections, data-driven health tools can run the risk of eroding trust—particularly among individuals who are already wary of surveillance and misuse.
There’s also a risk of superficial engagement. Points without purpose don’t change lives. The most effective interventions are grounded in evidence, are culturally relevant, and are responsive to users’ real-world challenges—not just their attention spans.
THE PROMISE
Despite these challenges, the promise of gamification in public health is real. This novel approach for public health can become a catalyst for measurable health behavior change. By recognizing how people already engage with technology and then designing public health tools that feel supportive, human, and achievable, we’re turning participation into progress. In a world where screens dominate attention and traditional health messaging can struggle to break through, gamification can complement proven public health strategies that support sustained behavior change. The future of public health isn’t louder messaging, it’s smarter engagement.
Kathy Crosby is CEO and president of Truth Initiative.
