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A Virtual Arm to Stop Smoking
A pilot perceptual learning experiment
Benoît Girard and Vincent TurcotteGRAP, Occupational psychology clinicSaguenay (Québec) Canada
Cybertherapy and behaviour conferenceWashington D.C., June 12th 2007
TO STOP SMOKING
VIRTUAL ARM
INTRODUCTION
SMOKING - 25 cig/day
- Hand-mouth movement: 90,000 / year
- Crushing cigarettes: 9,000 / year
CONDITIONED REFLEX
- Each smoker develops his own complex of stimuli (objects,
emotions, social conditions…) which provokes the urge to smoke.
INTRODUCTION
• RESPONDANT CONDITIONING (Pavlov)
CET = CUE-Reactivity + Desensitization
VR APPROACH
• OPERANT CONDITIONING (Skinner)
Action-Exposure = Modifying or blocking outcome of the addiction
INTRODUCTION
• Is a VR action-exposure (AE-VR) strategy capable of modifying craving and smoking behaviours?
• Could any clinical evidence be derived from this procedure?
QUESTIONS
OBJECTIVES
• Observation study of heavy smokers to evaluate the usability of this method• Exploration of different variables for futures studies
PARTICIPANTS
Age
Nb. Cig./day
Fagerström
Motivation
Nb. Attempts
Female (8)
43.6 ± 3.8
20.6 ± 5.6
6.7 ± 2.6
8.4 ± 0.5
4.4 ± 3.3
Male (8)
49.7 ± 5.4
25.0 ± 8.0
8.3 ± 1.4
8.3 ± 1.3
6.5 ± 4.6
TOTAL (mean)
46.6
22.8
7.5
8.3
5.5
• Pentium IV with nVidia 7300GS video card capable of stereoscopy
• eMagin Z800 HMD• Logitech wireless gamepad
• 3D work was integrated into a well-know game engine call Unreal 2 from the game Unreal Tournament 2004
• XSI from Softimage was used for the virtual arm and environment’s creation
EQUIPMENTS
PROCEDURESVR sessions :
• 4 sessions in 2 weeks• Explanation of procedure and practice• VR session (25 cigarettes to crush with no time limit)• 10 to 15 minutes recovery time
Data compilation :
• Profile of the subject• Immersion propensity questionnaire• Cybersickness and State of Presence Questionnaire• Question regarding if any change occurred since last session• Status of smokers
• Phone contact if participants abandoned before completion of 4 sessions.
RESULTS
• A fun user-friendly video game• Average time: 20-40 minutes• Running commentaries
+ Sense of enjoyment, waging war
- Regret to doing it, confusion, scepticism• High level of awareness and attraction• All objects in the VR environment were seen as smoking symbols
DURING SESSION
RESULTS
• Flashbacks (virtual arm, sounds, objects)• Revisiting the virtual environment• Reliving the session in their sleep• Needs to crush cigarettes• Crushing cigarettes instead of tapping it in the ashtray• Recurrent images
These reactions can be spontaneous or provocated by an urge to smoke
AFTER SESSION
RESULTS
• 10/16 subjects completed 4 sessions• Drop out rate 34.8%• 8/10 quitted smoking (5 ♀, 3 ♂)• 1/8 relapsed after 1 month• Less urges to smoke• Quantity: before: 22.8 cig./day
after: 12.8 cig./day (p<0.01)
OUTCOMES
DISCUSSION
1) IMPRINTING: An integrated sensorimotor system of conditioned stimuli in VR environment created a new cognitive map.
2) BLOCKING: Modifying craving or smoking behaviours.
3) DISRUPTING: In subjects not ready to quit.
OBSERVATIONS
CONCLUSION
1) Usability of the method for smokers and clinicians
2) Some clinical evidences of modifying craving and smoking behaviours
3) A VR action-exposure (AE-VR) strategy could be considered in the treatment of substance addiction
3750, BOULEVARD DU ROYAUME, SUITE 2053750, BOULEVARD DU ROYAUME, SUITE 205VILLE DE SAGUENAY, JONQUIÈRE (QUÉBEC)VILLE DE SAGUENAY, JONQUIÈRE (QUÉBEC)CANADACANADAG7X 0A4G7X 0A4
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