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(No) escape from reality? Cigarette craving in virtual smoking environments

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Cue-Exposure Therapy (CET) is considered an effective strategy to combat cigarette cravings and smoking relapses, but evidence is mixed. In this lab-based experimental study, we manipulated levels of realism for smoking scenarios in Virtual Environments (VE) and randomly exposed smokers and recent-quitters to one of two versions (low versus high realism) of these scenarios. Prior and after scenario exposure, valid measures of cigarette craving were obtained. Prior to exposure, we assessed nicotine dependence and smoking status (current smokers versus recent-quitter). Within-subject repeated measures analysis of covariance showed that there was an interaction of experimental condition with smoking status on cigarette craving. Amongst recent-quitters, high realistic scenarios produced stronger increases in craving than low realistic scenarios, but this effect was reversed in current smokers. It is concluded that VE technologies are a potentially relevant tool for smoking CET that warrant further exploration.

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Gert-Jan de Bruijn was funded by Netherlands Organisation for Health Research and Development (45900101) and Diabetes Foundation Netherlands (45900101), in the context of the Diabetes Breakthrough Project.

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Correspondence to Gert-Jan de Bruijn.

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Gert-Jan de Bruijn, Joost de Vries, Catherine Bolman, and Reinout Wiers declare that they have no conflict of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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de Bruijn, GJ., de Vries, J., Bolman, C. et al. (No) escape from reality? Cigarette craving in virtual smoking environments. J Behav Med 44, 138–143 (2021).

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