by Kim Carlyle

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A room full of smokers is a tough place to be if you’re trying to quit.

It also may be just what you need.

Therapists sometimes devise role-playing scenarios to teach addicts how to cope — and how to refuse an offer.

“Research has shown that real-life cues lead to arousal and cravings, but it is not feasible or ethical to take addicted persons to some real-life environments like bars or parties,” said Patrick Bordnick, a University of Georgia social work professor who studies addiction and withdrawal.

Role-playing therapy has its limits, too.

“Up to 75 percent of smokers who are in therapy trying to quit will relapse,” said Ken Graap, CEO of the Atlanta clinic Virtually Better. “It is not terribly effective for patients to role play when the person who was their therapist two minutes ago is now supposed to be a fellow smoker at a party offering them a cigarette.”

So Bordnick and Graap collaborated on a technological solution: a virtual reality (VR) environment to treat people addicted to nicotine. The VR program, funded by a grant from the National Institute on Drug Abuse, aims to determine if virtual cues, just like real cues, can lead to cravings.

To test this, Bordnick and Graap are asking study participants to smoke cigarettes; the researchers then measure changes in craving and physiology among smokers during exposure to three virtual environments: a neutral room with no smoking-related stimuli, a room containing smoking paraphernalia and a virtual party that integrates the VR world with films of people smoking.

“Initially, we need to understand whether smokers respond to the VR smoking stimuli,” said Bordnick, who believes “the virtual situations containing filmed people smoking are where the real progress is being made.”

Craving is measured subjectively by asking smokers questions and physiologically by measuring heart rate, respiration and skin response.

Drug cravings — believed to be a factor related to relapse and continued use — can be triggered years after abstinence by something as simple as exposure to a particular environment or certain cues.

Virtual environments will help researchers better understand cravings and ways to minimize them. Ultimately, the researchers plan to assess the success of agents that purport to reduce nicotine cravings combined with behavioral cessation therapies.

“Before we developed this virtual environment, there was no scientific way to generalize cue reactivity’ research results,” Bordnick said. “Different researchers would get different reactions and no one could be sure if it was due to variance in environment, demographics, treatment or what.”

For more information, contact Patrick Bordnick at 678-407-5517, bordnick@uga.edu.

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