title: The effect of repeated virtual nicotine cue exposure therapy on the psychophysiological responses: a preliminary study.
abstract: OBJECTIVE
  Smoking related cues may elicit smoking urges and psychophysiological responses in subjects with nicotine dependence. This study aimed to investigate the effect of repeated virtual cue exposure therapy using the surround-screen based projection wall system on the psychophysiological responses in nicotine dependence.
  
  
  METHODS
  The authors developed 3-dimensional neutral and smoking-related environments using virtual reality (VR) technology. Smoking-related environment was a virtual bar, which comprised both object-related and social situation cues. Ten subjects with nicotine dependence participated in 4-week (one session per week) virtual cue exposure therapy. Psychophysiological responses [electromyography (EMG), skin conductance (SC), and heart rate] and subjective nicotine craving were acquired during each session.
  
  
  RESULTS
  VR nicotine cue elicited greater psychophysiological responses and subjective craving for smoking than did neutral cue, and exposure to social situation cues showed greater psychophysiological responses in SC and EMG than did object-related cues. This responsiveness decreased during the course of repeated therapy.
  
  
  CONCLUSIONS
  The present study found that both psychophysiological responses and subjective nicotine craving were greater to nicotine cue exposure via projection wall VR system than to neutral cues and that enhanced cue reactivity decreased gradually over the course of repeated exposure therapy. These results suggest that VR cue exposure therapy combined with psychophysiological response monitoring may be an alternative treatment modality for smoking cessation, although the current findings are preliminary.
authors.affiliation: Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Jung-Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Sumi
authors.initials: S
authors.lastname: Park
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Hee-Yeon
authors.initials: HY
authors.lastname: Jung
authors.forename: Hae-Woo
authors.initials: HW
authors.lastname: Lee
authors.forename: Chong-Hyeon
authors.initials: CH
authors.lastname: Jin
authors.forename: Do-Hyung
authors.initials: DH
authors.lastname: Kang