JMIR Publications

ABSTRACT

Background:

Smoking remains a significant public health concern, contributing to various chronic diseases and increased healthcare burdens. Traditional smoking cessation interventions often face limitations related to participant engagement and adherence.

Objective:

This study aimed to assess the novel approach of an immersive three-dimensional (3D) virtual reality (VR) smoking cessation program and its effectiveness on smoking outpatients.

Methods:

A randomized controlled trial (RCT) was conducted with 100 outpatients from a smoking cessation clinic in Taiwan. Participants were randomly assigned to either the experimental group (n=50) or the comparison group (n=50) through a coin toss. The experimental group received standard outpatient smoking cessation services in combination with an immersive 3D VR smoking cessation program, while the comparison group received only standard outpatient services. The VR program included five interactive modules that used immersive scenarios to simulate smoking-related cues and provide educational content, employing cognitive-behavioral techniques and practicing coping strategies to promote behavior change. Outcome measures included smoking status indicators—days smoked, daily cigarette consumption, nicotine dependence (FTND), and exhaled CO levels—and smoking cessation effectiveness measures, including smoking-related knowledge, decisional balance, and self-efficacy. Smoking status indicators were assessed at baseline (T0), 1-month (T1), 2-month (T2), and 3-month (T3), while cessation effectiveness was measured at T0, T1, and T3. Data were analyzed using chi-squared tests, paired t-tests, and ANCOVA with SPSS Version 23.0.

Results:

At the 3-month follow-up assessment, the experimental group significantly reduced the number of smoking days in the past month (F=15.87, p<.001), the number of cigarettes smoked per day (F=7.33, P=.008), FTND score (F=4.93, P=.029), carbon monoxide (CO) level (ppm) (F=7.96, P=.006), and increased the smoking abstinence self-efficacy (F=6.16, P=.015), compared to the comparison group. In terms of smoking-related knowledge, the experimental group showed a significant increase in both T1 (F=116.31, P<.001) and T3 (F=168.06, P<.001). There were no significant differences between the two groups regarding benefits and barriers to cessation decisions. At the final 3-month follow-up (T3), the analysis included 31 participants in the experimental group and 30 in the comparison group, with an overall smoking cessation rate of 48.39% for the experimental group and 23.33% for the comparison group, indicating a statistically significant difference (χ²=4.15, P=.042).

Conclusions:

The findings suggest that the immersive 3D VR smoking cessation program was effective among the smoking outpatient population. It has the potential to be further promoted in future smoking cessation services.