Augmented Reality for Extinction of Cue-Provoked Urges to Smoke: Proof of Concept

• Published in: Psychology of addictive behaviors 2022-12, Vol.36 (8), p.990-998
• Main Authors: Yang, Min-Jeong, Brandon, Karen O., Sutton, Steven K., Kleinjan, Marloes, Hernandez, Laura M., Sawyer, Leslie E., Brandon, Thomas H., Vinci, Christine
• Format: Article
• Language: English
• Subjects: Augmentation; Augmented Reality; Craving; Cue exposure; Cues; Deployment; Efficacy; Exposure Therapy; Extinction; Extinction (Learning); Female; Human; Humans; Laboratories; Latency; Male; Middle Aged; Natural environment; Psychological extinction; Reactivity; Smartphones; Smokers; Smoking; Smoking Cessation; Teams; Tobacco Smoking
• ISSN: 0893-164X; 1939-1501
• DOI: 10.1037/adb0000868

Objective: Cue-exposure therapy (CET) aims to extinguish conditioned cue reactivity (CR) to aid in smoking cessation. A key disadvantage of extant CET is its limited ability to generalize extinction to the real world. Our team developed a set of augmented reality smoking-related and neutral cues that can appear in real-time in smokers' natural environments as viewed through a smartphone screen. Prior to deployment as a clinical tool, the present study tested the ability of AR smoking cues to extinguish CR in a controlled laboratory study with an AR smartphone application developed for this project. We hypothesized that daily smokers who completed a single session of cue exposure with AR smoking cues (extinction condition) would demonstrate lower cue-provoked urge to smoke at posttest compared to those who viewed AR neutral cues (control condition). Method: Daily smokers (N = 129, 46.5% female, Mage = 47.6, Mcigarettes/day = 19.1) in acute abstinence were randomized to either the extinction or control condition comprising 28 AR trials. Results: As hypothesized, we found a Time × Condition interaction indicating that posttest urge ratings were lower in the extinction condition than in the control condition (p = .034). A secondary hypothesis that participants in the extinction condition would show a longer latency to smoke when provided a cigarette was not supported. Conclusions: These laboratory findings provide evidence supporting the potential clinical efficacy of AR cues for cue-exposure trials, setting the stage for testing in smokers' naturalistic environments. Public Health Significance Statement This study found that a single cue-exposure session with augmented reality (AR) cigarette cues produced evidence of extinction of urge to smoke among daily smokers. Findings support the potential clinical efficacy of AR for cue exposure.