Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 11, 2025
Date Accepted: Mar 9, 2026
Psychophysiological Responses in VR for Assessing Current Nicotine Use and Future Addiction Risk Among Young Adults: Study Protocol
ABSTRACT
Background:
Nicotine addiction among youth is a continuing public health concern, and vaping serves as a major pathway to nicotine use. Conventional assessments of craving and addiction risk rely on self-report, which is prone to bias and lacks sensitivity to real-time processes. Virtual reality (VR) enables controlled cue exposure while capturing real-time multimodal data, including subjective experiences, behavioral patterns, and physiological responses, which offers a more implicit and dynamic approach to identifying addiction risk.
Objective:
This pilot study examines whether subjective craving and psychophysiological responses (e.g., eye gaze, heart rate (HR), electrodermal activity (EDA)) to vaping-related cues in VR can distinguish young adults who vape from those who do not. Our secondary objective is to explore associations between these multimodal biomarkers and self-reported measures of craving, dependence, motivation to quit, and susceptibility to initiate vaping.
Methods:
Bespoke VR scenes were developed with input from a youth advisory board to ensure ecological validity. Forty young adults aged 18–21 (20 vapers, 20 non-vapers) will complete a single laboratory session. Participants will experience three VR scenes (neutral baseline; vaping cues without social pressure, and vaping cues with social pressure, counterbalanced). Eye gaze, HR, and EDA will be recorded continuously. Participants will complete standardized assessments of craving, sense of presence, and social presence in VR after each cue scene, followed by a short interview at the end. Quantitative data will be analyzed using mixed-model ANOVAs and exploratory machine learning models to examine physiological and behavioral relationships.
Results:
The project has received the institutional review broad (IRB) approval in August 2025, with the VR stimuli development completed in December 2025. Data collection will start in January 2026.
Conclusions:
This protocol outlines a pilot study integrating immersive VR and multimodal biometrics to examine vaping cue reactivity in young adults. The findings will guide the development and evaluation of VR-based psychophysiological tools for identifying early markers of nicotine use risk. This work will also lay the foundation for adapting the approach to younger adolescents to support scalable early detection and prevention of nicotine addiction and initiation. Clinical Trial: https://osf.io/8d6pv/overview
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