Craving is a strong desire to consume that emerges in every case of substance addiction. Previous studies have shown that eliciting craving with an exposure cues protocol can be a useful option for the treatment of nicotine dependence. Thus, the main goal of this study was to develop a virtual platform in order to induce craving in smokers. Fifty-five undergraduate students were randomly assigned to two different virtual environments: high arousal contextual cues and low arousal contextual cues scenarios (17 smokers with low nicotine dependency were excluded). An eye-tracker system was used to evaluate attention toward these cues. Eye fixation on smoking-related cues differed between smokers and nonsmokers, indicating that smokers focused more often on smoking-related cues than nonsmokers. Self-reports of craving are in agreement with these results and suggest a significant increase in craving after exposure to smoking cues. In sum, these data support the use of virtual environments for eliciting craving.
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References
1.
HenleySJ, ThunMJ, ConnelC, et al.Two large prospective studies of mortality among men who use snuff or chewing tobacco. Cancer Causes Control, 2005; 16:347–358.
2.
XuX, FloydAHL, WestmaasJL, et al.Self-expansion and smoking abstinence. Addictive Behaviors, 2010; 35:295–301.
3.
USDHHS (2004) The health consequences of smoking: a report of the surgeon general. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health.
4.
World Health Organization. Regional Office for Europe (2007) The European tobacco control report 2007. World Health Organization, Geneva.
5.
FergusonSG, ShiffmanS. The relevance and treatment of cue-induced cravings in tobacco dependence. Journal of Substance Abuse Treatment, 2009; 36:235–243.
6.
BecharaA. Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature Neuroscience, 2005; 8:1458–1463.
7.
MahlerSV, WitH. Cue-reactors: individual differences in cue-induced craving after food or smoking abstinence. PLoS One, 2010; 5:154–175.
8.
ChoiJS, ParkS, LeeJY, et al.The effect of repeated virtual nicotine cue exposure therapy on the psychophysiological responses: a preliminary study. Psychiatry Investigation, 2011; 8:155–160.
9.
Van RensburgKJ, TaylorA, HodgsonT, et al.Acute exercise modulates cigarette cravings and brain activation in response to smoking-related images: an fMRI study. Psychopharmacology, 2009; 203:589–598.
10.
TongC, BovbjergD, ErblichJ. Smoking-related videos for use in cue-induced craving paradigms. Addictive Behaviors, 2007; 32:3034–3044.
11.
GossopM, PowellJ. What do opiate addicts and cigarette smokers mean by “craving”? A pilot study. Drug & Alcohol Dependence, 1990; 26:85–87.
12.
TiffanyST, CarterL. Is craving the source of compulsive drug use?. Journal of Psychopharmacology, 1998; 12:23–30.
13.
BaumannSB, SayetteMA. Smoking cues in a virtual world provoke craving in cigarette smokers. Psychology of Addictive Behaviors 2006;, 20:484.
14.
BordnickPS, GraapKM, CoppH, et al.Utilizing virtual reality to standardize nicotine craving research: a pilot study. Addictive Behaviors, 2005; 29:1889–1894.
15.
MoonJ, LeeJH. Cue exposure treatment in a virtual environment to reduce nicotine craving: a functional MRI study. CyberPsychology & Behavior, 2009; 12:43–45.
16.
ParisMM, CarterBL, TraylorAC, et al.Cue reactivity in virtual reality: the role of context. Addictive Behaviors, 2011; 36:696–699.
17.
CarterB, BordnickP, TraylorA, et al.Location and longing: the nicotine craving experience in virtual reality. Drug Alcohol Dependence, 2008; 95:73–80.
18.
Ferrer-GarcíaM, García-RodríguezO, Gutiérrez-MaldonadoJ, et al.Efficacy of virtual reality in triggering the craving to smoke: its relation to level of presence and nicotine dependence. Annual Review of Cybertherapy & Telemedicine, 2010; 154:123–127.
19.
LeeJ, LimY, GrahamSJ, et al.Experimental application of virtual reality for nicotine craving through cue exposure. CyberPsychology & Behavior, 2003; 6:275–280.
20.
ShadelWG, NiauraR, AbramsDB. Effect of different cue stimulus delivery channels on craving reactivity: comparing in vivo and video cues in regular cigarette smokers. Journal of Behavior Therapy & Experimental Psychiatry, 2001; 32:203–209.
21.
LochbuehlerK, EngelsE, ScholteR. Influence of smoking cues in movies on craving among smokers. Addiction, 1009; 104:2102–2109.
22.
EhrmanRN, RobbinsSJ, BromwellMA, et al.Comparing attentional bias to smoking cues in current smokers, former smokers, and nonsmokers using a dot-probe task. Drug Alcohol Dependence, 2002; 67:185–191.
23.
FieldM, MoggK, BradleyBP. Eye movements to smoking-related cues: effects of nicotine deprivation. Psychopharmacology, 2004; 173:116–123.
24.
KwakSM, NaDL, KimG, et al.Use of eye movement to measure smokers' attentional bias to smoking-related cues. CyberPsychology & Behavior, 2007; 10:299–304.
25.
RaynerK, CastelhanoMS. (2007) Eye movements during reading, scene perception, visual search, and while looking at print advertisements. In WedelM, PietersR, eds. Visual marketing: from attention to action. Mahwah, NJ: Lawrence Erlbaum, pp. 9–42.
26.
AlbertiCF, GamberiniL, SpagnolliA, et al.Using eye-tracker to assess the effectiveness of a three-dimensional riding simulator in increasing hazard perception. CyberPsychology, Behavior & Social Networking, 2012; 15:274–276.
27.
FagerstromKO. Measuring the degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 1978; 3:235–241.
28.
WitmerBG, SingerMJ. (1994) Measuring immersion in virtual environments (ARI Technical Report 1014). Alexandria, VA: U. S. Army Research Institute for the Behavioral and Social Sciences.
29.
KennedyRS, FowlkesJE, LilienthalMG. Postural and performance changes following exposures to flight simulators. Aviation, Space, & Environmental Medicine, 1993; 64: 912–920.
30.
CoxLS, TiffanyST, ChristenAG. Evaluation of the brief questionnaire of smoking urges (QSU-Brief ) in laboratory and clinical settings. Nicotine & Tobacco Research, 2001; 3:7–16.
31.
FindlaterL, MoffattK, McGrenereJ, et al. (2009). Ephemeral adaptation: the use of gradual onset to improve menu selection performance. In Proceedings of the ACM Conference on Human Factors in Computing Systems (CHI ’09). New York: ACM Press, pp. 1655–1664.
32.
WobbrockJO, FindlaterL, GergleD, et al. (2011) The aligned rank transform for nonparametric factorial analyses using only ANOVA procedures. In Proceedings of the ACM Conference on Human Factors in Computing Systems (CHI ’11). New York: ACM Press, pp. 143–146.
33.
MarôcoJ. (2010) Análise Estatística com utilização do SPSS. 3rd ed. Lisbon: Edições Sílabo.
34.
FieldAP. (2009) Discovering statistics using SPSS: and sex and drugs and rock ’n’ roll. 3rd ed. London: Sage.
35.
AkritasMG. The rank transform method in some two-factor designs. Journal of the American Statistical Association, 1990; 85:73–78.
36.
ConoverWJ, ImanRL. Rank transformations as a bridge between parametric and nonparametric statistics. American Statistician, 1981; 35:124–129.
37.
ShiffmanS, PatyJA, GnysM, et al.First lapses to smoking: within-participants analysis of real-time reports. Journal of Consulting & Clinical Psychology, 2006; 64:366–379.
38.
BordnickPS, TraylorA, CoopHL, et al.Assessing reactivity to virtual reality alcohol based cues. Addictive Behaviors, 2008; 33:743–756.
39.
RosenthalMZ, BaumannSB, LynchTR. Virtual reality for cue exposure and cell phones as cue extinction reminders in treatment for crack cocaine dependence. Annual Review of Cybertherapy & Telemedicine, 2007; 98:228–230.
40.
ChoiJS, ParkS, LeeJY, et al.The effect of repeated virtual nicotine cue exposure therapy on the psychophysiological responses: a preliminary study. Psychiatry Investigation, 2011; 8:155–160.
41.
BauerRM. Physiological measures of emotion. Journal of Clinical Neurophysiology, 1998; 15:388–396.
42.
DawsonME, SchellAM, et al. (2000) The electrodermal system. In CacioppoJT, TassinaryLG, BerntsonGG, eds. Handbook of psychophysiology. Cambridge: Cambridge University Press, pp. 200–223.
43.
LevensonRW. Autonomic nervous system differences among emotions. Psychological Science, 1992; 3:23–27.
44.
GamitoP, OliveiraJ, BaptistaA, et al.Nicotine craving: ERPs correlates after VR exposure to smoking cues. Studies in Health Technology & Informatics, 2012; 181:78–82.
