Nicotine addiction poses a serious public health problem in the United States. Cigarette smoking alone has been identified as the cause of numerous diseases, including cancers (e.g., lung, bladder, kidney, and oral cancers, among others), cardiovascular diseases (e.g., atherosclerosis and coronary heart disease, among others), and respiratory diseases (e.g., pneumonia and COPD, among others). Secondhand smoke has been identified as a cause of disease and premature death in adults and children, and the cost burden of smoking, including productivity losses, is estimated to be more than $193 billion annually. Public health awareness campaigns have led to widespread public knowledge regarding the dangers of smoking. Nevertheless, despite 70% of adult smokers indicating that they want to stop smoking, only approximately 6% of adult smokers successfully quit each year. There is a clear an immediate demand for innovation in the end of smoking cessation treatment. Recent research has shown that virtual (i.e., computer-rendered) smoking cues elicit the same types of smoking urges as real-world cues, and that cue/reaction therapy in a virtual reality environment has a significant positive effect on the reduction of nicotine dependence. In one study, patients wore head-mounted display hardware and were tasked with crushing virtual representations of cigarettes. Although the study showed a reduction in nicotine dependence, the system utilized in the research is impractical for commercial use. The head-mounted display hardware is prohibitively expensive (>$1000) and the custom software had very few modern gaming elements. In addition, the virtual reality game used in this study ignored the motivational factors behind behavior modification, so it is not clear whether the system used in this study would have a long-term effect on smoking cessation rates. The proposed Phase I project will develop the VIdeo Game Therapy for Substance Cessation and Recovery (VICTORY) system, a video game therapy system intended to address substance abuse through cue/reaction therapy. The Phase I system will focus on the reduction of nicotine dependence in cigarette smokers. A virtual reality environment will be created using the inexpensive, wireless Kinect motion controller with the Microsoft Xbox360 gaming console, thereby lowering the cost barrier for treatment. Furthermore, the VICTORY system will specifically focus on the motivational factors behind behavior modification;specifically, fulfillment of the basic psychological needs of Competence, Autonomy, and Relatedness. The satisfaction of these needs is not only necessary for behavior modification for healthier living, but also a key factor in how video games continue to keep players motivated. Therefore, it is logical to design a video game therapy system around this proven model in order to effect self-motivated lifestyle changes in an individual, such as the decision to quit smoking. The proposed VICTORY system will use the proven models of self-determination theory and cue/reaction therapy to create a low-cost video game therapy approach for nicotine abuse treatment.

Public Health Relevance

Despite widespread knowledge of the negative health effects of nicotine abuse, significant gaps still exist between those who wish to cease nicotine use and those who succeed in doing so. An innovative, low-cost option is needed to augment existing approaches towards treatment of nicotine addiction. The proposed research will create the rest commercial, consumer-grade video game therapy system designed specifically to treat nicotine addiction.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
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Special Emphasis Panel (ZRG1-RPHB-C (10))
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Grossman, Debra
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Barron Associates, Inc.
United States
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