JMIR Publications

ABSTRACT

Background:

Social contextual factors influence the onset and maintenance of substance abuse. Virtual Reality (VR) provides a standardized method to present social stimuli and is increasingly used in addiction research.

Objective:

This study examines the influence of a smoking versus a non-smoking agent in VR on craving in nicotine-dependent males. Our primary hypothesis was that the interaction with a smoking agent is associated with increased craving compared to a non-smoking agent. We expected higher craving in the presence of an agent regardless of agent smoking status.

Methods:

Using a head-mounted display (Oculus Rift), 50 nicotine-dependent smokers were exposed to four VR conditions on a virtual marketplace: first without an agent, second and third with an agent who either smoked or did not smoke in randomized order, and fourth without agent as a follow-up condition. Craving was assessed with the QSU and a visual analog scale (VAS) within VR and after each session. We also examined anxiety and agitation (VAS) and immersion and presence with the iPQ.

Results:

Results showed no significant difference in the participants’ craving, anxiety or agitation between the smoking and non-smoking agent conditions. However, craving, anxiety and agitation increased from marketplace without interacting agent to the conditions with an interacting agent, and decreased after smoking a cigarette. Immersion was low in all conditions and decreased over time.

Conclusions:

These findings suggest that the presence of an agent (as a contextual factor) may override the specific influence of proximal stimuli (burning cigarette). The low immersion highlights the challenges in developing effective VR environments for cue exposure. Clinical Trial: Deutsches Register Klinischer Studien, ID: DRKS00025746