Tobacco use among active-duty military personnel is almost double what it is in the civilian population, and while smoking has decreased overall in the U.S., it's been on the rise in the military since 2002. To change that, the Department of Defense (DoD) is looking to…videogames?

The government agency has awarded researchers at M. D. Anderson Cancer Center in Houston a $3.7 million grant create a video game that will deter soldiers from smoking and help those who already do to quit.

"The video game in general is becoming more popular among researchers who want to deliver a health message to a target audience," says Alexander Prokhorov, a professor of behavioral science at the University of Texas M. D. Anderson, who will lead the work. Video games are also being used to teach people about nutrition, asthma and other health-related issues, he notes.

Prokhorov, in partnership with the DoD and Radiant Creative, Inc. in Houston, already developed a similar anti-smoking game for at-risk youth called Escape With Your Life, which is customizable to age, gender, ethnic background and tobacco use and includes user-created avatars.

"I think that the major advantage of this game [is that it] allows [players] to maintain interest," says Prokhorov, noting that traditional anti-smoking approaches have a passive audience that can easily tune out. Tests of Escape With Your Life found that more than 90 percent of participants reported learning a lot about tobacco they didn't previously know.

But isn't changing knowledge a lot easier than changing behavior?

"It changes the depth of knowledge, and deep knowledge is very different from the superficial knowledge that most smokers have," Prokhorov says. Escape With Your Life takes users through, what he calls, "a pretty scary hospital." To escape and earn points, players must venture through different rooms – from radiology to accounting – where they get tips and motivation but also learn the true physical, financial and even environmental costs of lighting up. And "that's a huge, huge discovery for them," Prokhorov notes.

He says that more than half of the 239 young smokers (ages 15 to 19) in a preliminary study reported quitting after using the game. "As a tobacco researcher," he says, "that's unprecedented."

The new game will be designed specifically for military users and, like Escape With Your Life, will be in a standard-looking video game kiosk to appeal to potential players even in their leisure time.

Aside from the health and economic downsides that civilians face, tobacco-using military personnel encounter other risks. Among them, according to DoD's anti-tobacco Web site: a decrease in night vision, slower injury recovery time, and poorer endurance. The site also warns that smoking makes "you stink. You can't hide from enemy forces if they can smell you a block away."

Prokhorov hopes to have a model ready for testing at Fort Hood in Texas by 2011 and a finished product for mass distribution available by 2013. Eventually he hopes to be able to put it online as well.

"Once they try it," he says of the Escape With Your Life game, "they discover there's absolutely nothing boring about it."

Top image of Prokhorov and the Escape With Your Life game and second image of personalized player screen for game both courstesy of M. D. Anderson Cancer Center.