Design Insights to Support the Development of Effective Virtual Reality Nicotine and Vaping Dependency Therapy Scenarios for Future Telehealth

Vaping, or the use of electronic nicotine delivery systems (ENDS), has grown rapidly worldwide and is becoming an epidemic among youth in many countries. Invented as a method to help to quit smoking, ENDS are very popular, reaching increasing numbers of users and becoming a health concern. Virtual reality technology (VRT) represents an important tool for conducting addiction-associated interventions, including telemedicine. The design and quality of virtual reality scenarios (VRS) used for VR interventions are fundamental. How well VRS can replicate real-world scenarios has an impact on how realistic the VR immersion experiences are. Thus, VRS development influences therapeutic outcomes. VRT is used for interventions and treatments for smoking-related nicotine addiction but has yet to be validated for vaping-related disorders. Since vaping represents a technological step forward in nicotine consumption, the accurate contextualization of environments surrounding vapers is fundamental for developing advanced VR tools for the prevention and treatment of vaping disorders. Here, we present the results of focus group discussion with young vapers in New Zealand. The knowledge gained from this study will be used to design VRS for cue exposure and reactivity as a first step toward developing effective solutions for vaping disorders using VR interventions and telemedicine

"I virtually quit": A Review of Virtual Reality Technology Applications in Cigarette Craving and Smoking Interventions.

Background: Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. Objective: This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. Methods: A literature review of smoking interventions using VRT was conducted. Results: Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. Conclusions: The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures