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Research Christmas 2016: Being Well

Gotta catch’em all! Pokémon GO and physical activity among young adults: difference in differences study

BMJ 2016; 355 doi: (Published 13 December 2016) Cite this as: BMJ 2016;355:i6270
  1. Katherine B Howe, doctoral candidate1 2,
  2. Christian Suharlim, postdoctoral researcher3,
  3. Peter Ueda, postdoctoral researcher4 5,
  4. Daniel Howe,
  5. Ichiro Kawachi, professor of social epidemiology2,
  6. Eric B Rimm, professor of epidemiology and nutrition1 6 7
  1. 1Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
  2. 2Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
  3. 3Center for Health and Decision Science, Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, USA
  4. 4Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
  5. 5Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Sweden
  6. 6Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
  7. 7Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
  1. Correspondence to: K B Howe khowe{at}
  • Accepted 16 November 2016


Objective To estimate the effect of playing Pokémon GO on the number of steps taken daily up to six weeks after installation of the game.

Design Cohort study using online survey data.

Participants Survey participants of Amazon Mechanical Turk (n=1182) residing in the United States, aged 18 to 35 years and using iPhone 6 series smartphones.

Main outcome measures Number of daily steps taken each of the four weeks before and six weeks after installation of Pokémon GO, automatically recorded in the “Health” application of the iPhone 6 series smartphones and reported by the participants. A difference in difference regression model was used to estimate the change in daily steps in players of Pokémon GO compared with non-players.

Results 560 (47.4%) of the survey participants reported playing Pokémon GO and walked on average 4256 steps (SD 2697) each day in the four weeks before installation of the game. The difference in difference analysis showed that the daily average steps for Pokémon GO players during the first week of installation increased by 955 additional steps (95% confidence interval 697 to 1213), and then this increase gradually attenuated over the subsequent five weeks. By the sixth week after installation, the number of daily steps had gone back to pre-installation levels. No significant effect modification of Pokémon GO was found by sex, age, race group, bodyweight status, urbanity, or walkability of the area of residence.

Conclusions Pokémon GO was associated with an increase in the daily number of steps after installation of the game. The association was, however, moderate and no longer observed after six weeks.


  • Contributors: KBH, CS, and PU contributed equally and are co-first authors. KBH, CS, and DH conceived and designed the project and collected data. CS, PU, and KBH analysed the data. PU, KBH, CS, and DH wrote the manuscript. All authors contributed to the manuscript. IK and EBR provided methodological guidance and financial support for data collection. EBR is the guarantor.

  • Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests: All authors declare: no financial relationships with any organisations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: This study was approved for exemption by institutional review board at Harvard TH Chan School of Public Health on 1 August 2016 (protocol No IRB 16-1243).

  • Data sharing: The statistical code and dataset are available from the corresponding author.

  • Transparency: The manuscript’s guarantor (EBR) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained

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