Engaging with Children Using Augmented Reality on Clothing to Prevent Them from Smoking

  • Zuzana Borovanska
  • Matthieu PoyadeEmail author
  • Paul M. Rea
  • Ibrahim Daniel Buksh
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1262)


Smoking is a harmful habit, causing a range of severe consequences which could lead to premature death. This habit is still prevalent amongst young people. In order to protect children, effective early interventions supported by public instances need to be set in place. Raising awareness and educating the youth is crucial to change their mindset about the severity of smoking. Emerging technologies, such as augmented reality (AR) on mobile devices, have been shown to be useful in providing engaging experiences and educating children about a range of issues, including health and anatomy. This chapter presents a research which explores the use of AR as an exciting and engaging medium to effectively help educating children from 5 to 13 years about the effects of smoking. A mobile application, called SmokAR, was developed. This app includes AR visualization amongst other functionalities, whereby children are presented a realistic model of the human lungs of a healthy person and of a smoker. The aim of this research is to propose a transformative experience in order to put children off this dangerous habit whilst they gain knowledge about the effect of smoking on their organs. The anatomical accuracy of the 3D models and animations proposed by the app has been verified by an expert anatomist. A group of children (n = 17) also took part in usability and knowledge acquisition testing at the Glasgow Science Centre. Findings showed a significant high usability suggesting a user-friendly app design. Moreover, results also suggested that participants gained knowledge to a certain extent and felt discouraged from smoking after seeing the model of the smoker’s lungs. Although there were several limitations to the study, the potential of the app to support learning and raising awareness is encouragingly positive. In addition, user testing in a more controlled environment, such as a classroom, can help gain further insights into the effectiveness and usability of the app. In the future, this simple but engaging approach to raise public awareness and support education could be used to further communicate with children about negative health effects of other harmful habits such as alcohol or drug consumption.


Smoking Augmented reality 3D visualization Education Community engagement 


  1. Akçayır M, Akçayır G (2017) Advantages and challenges associated with augmented reality for education: a systematic review of the literature. Educ Res Rev 20:1–11. Scholar
  2. Bhat J (2017) Attention spans in the age of technology | NAMI: National Alliance on Mental Illness [WWW Document]. Accessed 8 Oct 19
  3. Billington C (2016) Digital technology and the early years [WWW Document]. National Literacy Trust. Accessed 8 Oct 19
  4. Birch J (2012) Worldwide prevalence of red-green color deficiency. JOSAA 29:313–320. Scholar
  5. Bower M, Howe C, McCredie N, Robinson A, Grover D (2014) Augmented reality in education – cases, places, and potentials. Educ Media Int 51.
  6. Brooke J (1996) SUS – a quick and dirty usability scale. In: Usability evaluation in industry. Taylor & Francis, London, pp 189–194Google Scholar
  7. Bruvold WH (1993) A meta-analysis of adolescent smoking prevention programs. Am J Public Health 83:872–880CrossRefGoogle Scholar
  8. Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), Office on Smoking and Health (US) (2010) How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the surgeon general, publications and reports of the surgeon general. Centers for Disease Control and Prevention (US), Atlanta (GA)Google Scholar
  9. Chien CH, Chen CH, Jeng TS (2010) An interactive augmented reality system for learning anatomy structure. In: Proceedings of the international multiconference of Engineers and Computer Scientists 2010, IMECS 2010, pp 370–375Google Scholar
  10. Codd AM, Choudhury B (2011) Virtual reality anatomy: is it comparable with traditional methods in the teaching of human forearm musculoskeletal anatomy? Anat Sci Educ 4:119–125. Scholar
  11. Dai H, Hao J (2016) Flavored electronic cigarette use and smoking among youth. Pediatrics 138:e20162513. Scholar
  12. Dunleavy M, Dede C, Mitchell R (2009) Affordances and limitations of immersive participatory augmented reality simulations for teaching and learning. J Sci Educ Technol 18:7–22. Scholar
  13. Ferrer-García M, Gutiérrez-Maldonado J, Riva G (2013) Virtual reality based treatments in eating disorders and obesity: a review. J Contemp Psychother 43:207–221. Scholar
  14. Fichtenberg CM, Glantz SA (2002) Youth access interventions do not affect youth smoking. Pediatrics 109:1088–1092. Scholar
  15. Flynn BS, Worden JK, Secker-Walker RH, Badger GJ, Geller BM, Costanza MC (1992) Prevention of cigarette smoking through mass media intervention and school programs. Am J Public Health 82:827–834CrossRefGoogle Scholar
  16. Freina L, Ott M (2015) A literature review on immersive virtual reality in education: state of the art and perspectivesGoogle Scholar
  17. [WWW Document] (n.d.) PSPP. Accessed 8 Oct 19
  18. Henn JS, Lemole GM, Ferreira MAT, Gonzalez LF, Schornak M, Preul MC, Spetzler RF (2002) Interactive stereoscopic virtual reality: a new tool for neurosurgical education. Technical note. J Neurosurg 96:144–149. Scholar
  19. Hoffman BR, Monge PR, Chou C-P, Valente TW (2007) Perceived peer influence and peer selection on adolescent smoking. Addict Behav 32:1546–1554. Scholar
  20. Huang H-M, Liaw S-S, Lai C-M (2016) Exploring learner acceptance of the use of virtual reality in medical education: a case study of desktop and projection-based display systems. Interact Learn Environ 24:3–19. Scholar
  21. Johansson A, Halling A, Hermansson G (2003) Indoor and outdoor smoking: impact on children’s health. Eur J Pub Health 13:61–66. Scholar
  22. Kamphuis C, Barsom E, Schijven M, Christoph N (2014) Augmented reality in medical education? Perspect Med Educ 3:300–311. Scholar
  23. Kerawalla L, Luckin R, Seljeflot S, Woolard A (2006) “Making it real”: exploring the potential of augmented reality for teaching primary school science. Virtual Reality 10:163–174. Scholar
  24. Kesim M, Ozarslan Y (2012) Augmented reality in education: current technologies and the potential for education. Procedia – social and behavioral sciences. Cyprus international conference on Educational Research (CY-ICER-2012)North Cyprus, US08–10 February, 2012 47, pp 297–302.
  25. Lai A-F, Chen C-H, Lee G-Y (2018) An augmented reality-based learning approach to enhancing students’ science reading performances from the perspective of the cognitive load theory: augmented reality-based science learning. Br J Educ Technol 50.
  26. Lu S-J, Liu Y-C (2014) Integrating augmented reality technology to enhance children’s learning in marine education. Environ Educ Res 21:1–17. Scholar
  27. Max W (2001) The financial impact of smoking on health-related costs: a review of the literature. Am J Health Promot 15:321–331. Accessed 8 Nov 19
  28. Mohan BR, Bijlani K, Jayakrishnan R (2015) Simulating consequences of smoking with augmented reality. In: 2015 international conference on Advances in Computing, Communications and Informatics (ICACCI). Presented at the 2015 International Conference on Advances in Computing, Communications and Informatics (ICACCI), pp 919–924.
  29. Moro C, Štromberga Z, Raikos A, Stirling A (2017) The effectiveness of virtual and augmented reality in health sciences and medical anatomy. Anat Sci Educ 10:549–559CrossRefGoogle Scholar
  30. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2012) Preventing tobacco use among youth and young adults: a report of the surgeon general, reports of the surgeon general. Centers for Disease Control and Prevention (US), Atlanta (GA)Google Scholar
  31. NHS (2018) What at are the health risks of smoking? [WWW Document], 2018. Accessed 8 Jan 19
  32. NHS Statistics on Smoking – England (2018) [PAS] [WWW Document]. NHS digital. Accessed 8 Jan 19
  33. Nincarean D, Alia MB, Halim NDA, Rahman MHA (2013) Mobile augmented reality: the potential for education. In: Procedia – social and behavioral sciences, 13th international educational technology conference 103, pp 657–664.
  34. Noar SM, Hall MG, Francis DB, Ribisl KM, Pepper JK, Brewer NT (2016) Pictorial cigarette pack warnings: a meta-analysis of experimental studies. Tob Control 25:341. Scholar
  35. Office for National Statistics (2017) Adult smoking habits in the UK – Office for National Statistics [WWW Document]. Accessed 8 Nov 19
  36. Parker C, Kay J, Baldauf M, Tomitsch M (2016) Design implications for interacting with personalised public displays through mobile augmented reality, pp 52–58.
  37. Radu I (2014) Augmented reality in education: a meta-review and cross-media analysis. Pers Ubiquit Comput 18:1533–1543. Scholar
  38. Riva G, Mantovani F, Capideville CS, Preziosa A, Morganti F, Villani D, Gaggioli A, Botella C, Alcañiz M (2007) Affective interactions using virtual reality: the link between presence and emotions. Cyberpsychol Behav 10:45–56. Scholar
  39. Riva G, Baños RM, Botella C, Mantovani F, Gaggioli A (2016) Transforming experience: the potential of augmented reality and virtual reality for enhancing personal and clinical change. Front Psych 7.
  40. Roussou M (2004) Learning by doing and learning through play: an exploration of interactivity in virtual environments for children. Comput Entertain 2:10. Scholar
  41. Sanchez-Vives MV, Slater M (2005) From presence to consciousness through virtual reality. Nat Rev Neurosci 6:332–339. Scholar
  42. Sandford A (2003) Government action to reduce smoking. Respirology 8:7–16CrossRefGoogle Scholar
  43. Scarborough P, Bhatnagar P, Wickramasinghe KK, Allender S, Foster C, Rayner M (2011) The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. J Public Health (Oxf) 33:527–535. Scholar
  44. SurveyLegend (2014) What are likert-type scale responses [WWW Document]. SurveyLegend. Accessed 8 Nov 19
  45. Taylor BV, Oudit GY, Kalman PG, Liu P (1998) Clinical and pathophysiological effects of active and passive smoking on the cardiovascular system. Can J Cardiol 14:1129–1139PubMedGoogle Scholar
  46. Thaqi A, Franke K, Merkel G, Wichmann H-E, Heinrich J (2005) Biomarkers of exposure to passive smoking of school children: frequency and determinants. Indoor Air 15:302–310. Scholar
  47. The Children’s Hospital of Philadelphia (2011) How a normal heart pumps blood – the children’s hospital of Philadelphia – YouTube [WWW Document]. Accessed 8 Oct 19
  48. Thomas RG, John NW, Delieu JM (2010) Augmented reality for anatomical education. J Vis Commun Med 33:6–15. Scholar
  49. Trythall J (2015) Web design for kids: color [WWW Document]. Web Design Envato Tuts+. Accessed 8 Oct 19
  50. Urrutia-Pereira M, Oliano VJ, Aranda CS, Mallol J, Solé D (2017) Prevalence and factors associated with smoking among adolescents. J Pediatr 93:230–237. Scholar
  51. Veeranki SP, Mamudu HM, Anderson JL, Zheng S (2014) Worldwide never-smoking youth susceptibility to smoking. J Adolesc Health 54:144–150. Scholar
  52. Vuolo M, Staff J (2013) Parent and child cigarette use: a longitudinal, multigenerational study. Pediatrics 132:e568–e577. Scholar
  53. Wakefield M, Terry-McElrath Y, Emery S, Saffer H, Chaloupka FJ, Szczypka G, Flay B, O’Malley PM, Johnston LD (2006) Effect of televised, tobacco company–funded smoking prevention advertising on youth smoking-related beliefs, intentions, and behavior. Am J Public Health 96:2154–2160. Scholar
  54. West R (2017) Tobacco smoking: health impact, prevalence, correlates and interventions. Psychol Health 32:1018–1036. Scholar
  55. White V, Webster B, Wakefield M (2008) Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviours? Addiction 103:1562–1571. Scholar
  56. Whittaker R, Maddison R, McRobbie H, Bullen C, Denny S, Dorey E, Ellis-Pegler M, van Rooyen J, Rodgers A (2008) A multimedia mobile phone-based youth smoking cessation intervention: findings from content development and piloting studies. J Med Internet Res 10:e49. Scholar
  57. Yilmaz RM (2016) Educational magic toys developed with augmented reality technology for early childhood education. Comput Hum Behav 54:240–248. Scholar
  58. Yoon S, Wang J (2014) Making the invisible visible in science museums through augmented reality devices. TechTrends 58.
  59. Yuen S, Yuen Y, Yaoyuneyong G, Johnson E (2011) Augmented reality: an overview and five directions for AR in education. J Educ Technol Dev Exch 119:119–140. Scholar
  60. Zappar (2019) How augmented reality affects the brain [WWW Document]. Zappar. Accessed 8 Nov 19

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Zuzana Borovanska
    • 1
    • 2
  • Matthieu Poyade
    • 3
    Email author
  • Paul M. Rea
    • 2
  • Ibrahim Daniel Buksh
    • 3
  1. 1.School of Simulation and VisualisationThe Glasgow School of ArtGlasgowUK
  2. 2.Anatomy Facility, School of Life Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
  3. 3.School of Life Sciences, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK

Personalised recommendations