This study aimed to analyze how game interaction affects user experience and smoking attitudes of smoking simulation game. To verify differences in smoking attitudes and user experience such as arousal, flow, spatial presence, social presence, and empathy in game interaction and simple watching, a playtest experiment was performed among 100 male smokers. The smoking simulation used for the experiment was the ‘Smoking Sims’ developed by the group of researchers from ‘Hallym University Health Communication Center’. As a result, in eliciting negative attitude toward smoking, which is a functional effect of the smoking game along with the flow, spatial presence, and social presence, active gaming behavior appeared to be more effective than the passive watching behavior. Such result has shown that game media has better communication effect than usual visual media as a tool for anti-smoking campaign.