A M Kroczek, B Schröder, D Rosenbaum, A Mühleck, J Diemer, A Mühlberger, A C Ehlis, A Batra
{"title":"虚拟现实提示暴露作为戒烟团体治疗的附加内容：一项随机对照试验。","authors":"A M Kroczek, B Schröder, D Rosenbaum, A Mühleck, J Diemer, A Mühlberger, A C Ehlis, A Batra","doi":"10.1186/s13722-025-00561-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cue exposure (CE) is used for relapse prevention as part of smoking cessation therapy to reduce the automatized response to smoking-related cues. Using CET in virtual reality (VR) is an approach to increase its efficacy by creating cost-efficient high-risk situations. The efficacy of VR-based CETs was compared to that of an unspecific relaxation intervention as an add-on to an established cognitive-behaviorally oriented smoking cessation group therapy (G-CBT).</p><p><strong>Methods: </strong>N = 246 abstinence-motivated smokers were included in a two-armed randomized controlled trial (G-CBT with VR-CET vs. G-CBT with progressive muscle relaxation/PMR) with 1-, 3-, and 6-month follow-ups (measurements in 2018-2020). All smokers joined a well-established G-CBT smoking cessation program with six sessions with four additional sessions of either VR-based smoking cue exposure therapy (VR-CET) or four sessions of group-based PMR. The primary outcome was abstinence after 6 months according to the Russell Standard; secondary outcomes included changes in the number of smoked cigarettes, craving (assessed by the Questionnaire of Smoking Urges/QSU), and self-efficacy (assessed by the Smoking Abstinence Self-Efficacy Scale/SES) over time.</p><p><strong>Results: </strong>Primary outcome: Six months after G-CBT, 24% of the participants were abstinent, and there was no significant difference between the PMR (n = 34/124) and VR-CET (n = 24/122) groups (odds ratio PMR/VR = 0.64). Secondary measures: SES increased, and QSU and the number of smoked cigarettes decreased over time. Baseline craving ratings predicted abstinence only in the VR-CET group.</p><p><strong>Conclusion: </strong>This randomized controlled trial did not show increased abstinence rates related to smoking cue exposure in virtual reality. Secondary measures demonstrated significant reductions in craving and cigarette consumption as well as increases in self-efficacy over time, regardless of the intervention. However, high baseline craving was negatively related to abstinence in the VR-CET group, suggesting that intense craving was insufficiently addressed. This may indicate that the amount of training was insufficient and should be intensified. Individualization, e.g., adaptive, individualized approaches, is required to improve the effects of the VR-CET on smoking cessation in future studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT03707106.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"34"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987342/pdf/","citationCount":"0","resultStr":"{\"title\":\"Virtual reality cue exposure as an add-on to smoking cessation group therapy: a randomized controlled trial.\",\"authors\":\"A M Kroczek, B Schröder, D Rosenbaum, A Mühleck, J Diemer, A Mühlberger, A C Ehlis, A Batra\",\"doi\":\"10.1186/s13722-025-00561-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cue exposure (CE) is used for relapse prevention as part of smoking cessation therapy to reduce the automatized response to smoking-related cues. Using CET in virtual reality (VR) is an approach to increase its efficacy by creating cost-efficient high-risk situations. The efficacy of VR-based CETs was compared to that of an unspecific relaxation intervention as an add-on to an established cognitive-behaviorally oriented smoking cessation group therapy (G-CBT).</p><p><strong>Methods: </strong>N = 246 abstinence-motivated smokers were included in a two-armed randomized controlled trial (G-CBT with VR-CET vs. G-CBT with progressive muscle relaxation/PMR) with 1-, 3-, and 6-month follow-ups (measurements in 2018-2020). All smokers joined a well-established G-CBT smoking cessation program with six sessions with four additional sessions of either VR-based smoking cue exposure therapy (VR-CET) or four sessions of group-based PMR. The primary outcome was abstinence after 6 months according to the Russell Standard; secondary outcomes included changes in the number of smoked cigarettes, craving (assessed by the Questionnaire of Smoking Urges/QSU), and self-efficacy (assessed by the Smoking Abstinence Self-Efficacy Scale/SES) over time.</p><p><strong>Results: </strong>Primary outcome: Six months after G-CBT, 24% of the participants were abstinent, and there was no significant difference between the PMR (n = 34/124) and VR-CET (n = 24/122) groups (odds ratio PMR/VR = 0.64). Secondary measures: SES increased, and QSU and the number of smoked cigarettes decreased over time. Baseline craving ratings predicted abstinence only in the VR-CET group.</p><p><strong>Conclusion: </strong>This randomized controlled trial did not show increased abstinence rates related to smoking cue exposure in virtual reality. Secondary measures demonstrated significant reductions in craving and cigarette consumption as well as increases in self-efficacy over time, regardless of the intervention. However, high baseline craving was negatively related to abstinence in the VR-CET group, suggesting that intense craving was insufficiently addressed. This may indicate that the amount of training was insufficient and should be intensified. Individualization, e.g., adaptive, individualized approaches, is required to improve the effects of the VR-CET on smoking cessation in future studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT03707106.</p>\",\"PeriodicalId\":54223,\"journal\":{\"name\":\"Addiction Science & Clinical Practice\",\"volume\":\"20 1\",\"pages\":\"34\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987342/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Addiction Science & Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13722-025-00561-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SUBSTANCE ABUSE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction Science & Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13722-025-00561-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
Virtual reality cue exposure as an add-on to smoking cessation group therapy: a randomized controlled trial.
Background: Cue exposure (CE) is used for relapse prevention as part of smoking cessation therapy to reduce the automatized response to smoking-related cues. Using CET in virtual reality (VR) is an approach to increase its efficacy by creating cost-efficient high-risk situations. The efficacy of VR-based CETs was compared to that of an unspecific relaxation intervention as an add-on to an established cognitive-behaviorally oriented smoking cessation group therapy (G-CBT).
Methods: N = 246 abstinence-motivated smokers were included in a two-armed randomized controlled trial (G-CBT with VR-CET vs. G-CBT with progressive muscle relaxation/PMR) with 1-, 3-, and 6-month follow-ups (measurements in 2018-2020). All smokers joined a well-established G-CBT smoking cessation program with six sessions with four additional sessions of either VR-based smoking cue exposure therapy (VR-CET) or four sessions of group-based PMR. The primary outcome was abstinence after 6 months according to the Russell Standard; secondary outcomes included changes in the number of smoked cigarettes, craving (assessed by the Questionnaire of Smoking Urges/QSU), and self-efficacy (assessed by the Smoking Abstinence Self-Efficacy Scale/SES) over time.
Results: Primary outcome: Six months after G-CBT, 24% of the participants were abstinent, and there was no significant difference between the PMR (n = 34/124) and VR-CET (n = 24/122) groups (odds ratio PMR/VR = 0.64). Secondary measures: SES increased, and QSU and the number of smoked cigarettes decreased over time. Baseline craving ratings predicted abstinence only in the VR-CET group.
Conclusion: This randomized controlled trial did not show increased abstinence rates related to smoking cue exposure in virtual reality. Secondary measures demonstrated significant reductions in craving and cigarette consumption as well as increases in self-efficacy over time, regardless of the intervention. However, high baseline craving was negatively related to abstinence in the VR-CET group, suggesting that intense craving was insufficiently addressed. This may indicate that the amount of training was insufficient and should be intensified. Individualization, e.g., adaptive, individualized approaches, is required to improve the effects of the VR-CET on smoking cessation in future studies.
期刊介绍：
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use.
Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations.
Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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