“Go up in smoke”: Feasibility and initial acceptance of a virtual environment to measure tobacco craving in vulnerable individuals

Tobacco smoking is substantially more prevalent in vulnerable groups, such as people with intellectual disability, psychiatric disorders, or low socioeconomic status. Though smoking cessation programs for the general population are available, accessible and inclusive approaches are lacking. An encouraging new approach toward more practice-oriented and tailorable smoking cessation is virtual reality. Research indicates that virtual environments (VEs) with tobacco-related cues can elicit cue-reactivity (e.g. craving and physiological responses) and provide various new options to integrate treatment approaches. Yet, the potential to elicit cue-reactivity and the practicability of cue-reactivity measures have not been studied in vulnerable groups. This explorative study aggregated the data of twenty-three vulnerable individuals, who present themselves in three clinical settings, to validate the VEs, assess the practicability of several cue-reactivity measures (i.e. self-report questionnaires, psychophysiological data), and investigate the initial acceptance toward a prototype VE with tobacco-related cues. The results confirm the potential of the VE to elicit tobacco craving compared to baseline scores and craving in a neutral VE, as measured using one-dimensional (VAS) and multi-dimensional scales (QSU-Brief). Furthermore, the participants reported a good initial acceptance toward the VE as a potential treatment for smoking cessation. However, measuring psychophysiological responses in the clinical setting proved to be unfeasible in this research. Future studies should investigate the versatile possibilities of VEs to assess and treat vulnerable groups with tobacco dependence.