Virtual Reality Cue Exposurefor the Relapse Prevention of Tobacco Consumption
Condition: Chronic Tabagism
MeSH terms: Recurrence
Study type: Interventional

Summary: 
      The therapeutic efficacy of virtual reality has been validated for the treatment of various
      mental disorders ,smoking behavior is the first preventable cause of death in developed
      countries However, after a successful withdrawal, a high relapse rate (between 40 and 70%)has
      been observed, which emphasize the urgent need to implement new strategies. Virtual reality
      cue exposure for the relapse of tobacco consumption
    

Detailed description: 
      Smoking behavior is the first preventable cause of death in developed countries
      (World.Health.Organisation, 2009).It is reinforced by the nicotine found in cigarettes. This
      compound is responsible for a notable dependence effect. As a result of mass consumption,
      this subsequent addiction of tobacco is a psychiatric disorder that represents a significant
      public health issue. In France, the latest health survey INEPS (2010) retrieved an increase
      of daily smokers with a prevalence of 28.7% among adults over 15 years (Beck et al., 2010).
      However, after a successful withdrawal, a high relapse rate (between 40 and 70%) (Hatsukami
      et al., 2008) has been observed, which emphasize the urgent need to implement new strategies.
      These relapses are due to the presence of conditions associated with tobacco consumption
      (drinking in bars or restaurant, coffee break at the workplace, etc.). (Garcia-Rodriguez et
      al., 2012). These same situations are difficult to reconstruct in the framework of a hospital
      or an office.

      Virtual reality has been introduced in the field of psychiatry as a method entitled virtual
      reality exposure therapy (VRET). Virtual reality allows patients to interact with a virtual
      environment (Riva and Wiederhold, 2002). This media can therefore help to generate synthetic
      environments which represent risk situations for the patient in the context of relapse
      prevention.

      The therapeutic efficacy of virtual reality has been validated for the treatment of various
      mental disorders (phobias, agoraphobia and post-traumatic stress, etc.) (Powers and
      Emmelkamp, 2008). These studies have shown that VRET was at least as effective as traditional
      CBT while providing immersive and controllable virtual environments. During the recent years,
      its scope has expanded to tobacco addiction (Garcia-Rodriguez et al., 2012), although this
      area of research remains in experimental field and requires carrying out ad-hoc clinical
      trials. Indeed, compared to the standard treatment, VRET offers various advantages for cue
      exposure, such as controlled environments and complex, dynamic interactive three-dimensional
      situations (virtual Bars, office and artificial smokers computerized restaurants, etc.). It
      features the possibility of gradually exposing the patient to situations considered to be of
      a "high risk of relapse" in the confidentiality of an office and repeating these procedures
      as often as necessary. Lastly it allows the therapist to guide the patient in real time
      helping them to modify emotions and addiction related cognitions.
    

Intervention name(s): virtual reality exposure treatment; cognitive and behavioral approaches therapy
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention