Augmented Reality for Smoking Cessation: Development and Usability Study

Abstract

Background The recent widespread availability of augmented reality via smartphone offers an opportunity to translate cue exposure therapy for smoking cessation from the laboratory to the real world. Despite significant reductions in the smoking rates in the last decade, approximately 13.7% of the adults in the United States continue to smoke. Smoking-related cue exposure has demonstrated promise as an adjuvant therapy in the laboratory, but practical limitations have prevented its success in the real world. Augmented reality technology presents an innovative approach to overcome these limitations. Objective The aim of this study was to develop a smartphone app that presents smoking-related augmented reality images for cue exposure. Smokers provided feedback on the images and reported on the perceived urge to smoke, qualities of reality/coexistence, and general feedback about quality and functioning. The feedback was used to refine the augmented reality images within the app. Methods In collaboration with an augmented reality design company, we developed 6 smoking-related images (cigarette, lighter, ashtray, lit cigarette in ashtray, etc) and 6 neutral images similar in size or complexity for comparison (pen, eraser, notebook, soda bottle with droplets, etc). Ten smokers completed a survey of demographic characteristics, smoking history and behavior, dependence on nicotine, motivation to quit smoking, and familiarity with augmented reality technology. Then, participants viewed each augmented reality image and provided ratings on 10-point Likert scales for urge to smoke and reality/coexistence of the image into the scene. Participants were also queried with open-ended questions regarding the features of the images. Results Of the 10 participants, 5 (50%) had experienced augmented reality prior to the laboratory visit, but only 4 of those 5 participants used augmented reality at least weekly. Although the sample was small (N=10), smokers reported significantly higher urge to smoke after viewing the smoking-related augmented reality images (median 4.58, SD 3.49) versus the neutral images (median 1.42, SD 3.01) (Z=–2.14, P=.03; d=0.70). The average reality and coexistence ratings of the images did not differ between smoking-related and neutral images (all P>.29). Augmented reality images were found on average to be realistic (mean [SD] score 6.49 [3.11]) and have good environmental coexistence (mean [SD] score 6.93 [3.04]) and user coexistence (mean [SD] score 6.38 [3.27]) on the 10-point scale. Participant interviews revealed some areas of excellence (eg, details of the lit cigarette) and areas for improvement (eg, stability of images, lighting). Conclusions All images were generally perceived as being realistic and well-integrated into the environment. However, the smoking augmented reality images produced higher urge to smoke than the neutral augmented reality images. In total, our findings support the potential utility of augmented reality for cue exposure therapy. Future directions and next steps are discussed.

Augmented reality as a novel approach for addiction treatment: development of a smoking cessation app

“…Usability was supported by high ratings across several measures. Consistent with our earlier findings in laboratory settings [ 20 , 21 ], AR cues were perceived as highly realistic and well-integrated in the user’s natural environment. Perceived reality/co-existence is one crucial component for an immersive AR experience [ 34 ], which was met in our study.…”

“…Finally, the current results, together with our previous laboratory findings, have demonstrated that a smoking-related AR app elicits cue reactivity [ 20 , 21 ], produces extinction [ 22 ], and is feasible and acceptable to participants. Thus, not only does this suggest that CET for smoking cessation may be an effective and feasible treatment option, but AR-based CET could also be considered for the treatment of addictive behaviors involving other substances, such as alcohol or illicit drugs.…”

“…yes/no). Besides the SUS, the rest of the usability and acceptability measures in the follow-up survey reported in the current study were developed by our study team and mimic those used in previous research in this area [ 20 , 21 ].…”

“…cigarette, ashtray) activated via a smartphone AR app. Our earlier studies demonstrated that the AR cues were perceived as realistic and well-integrated into the user’s environment [ 20 , 21 ]. Additionally, AR smoking cues demonstrated higher cue reactivity with a large effect size as compared to AR neutral cues, with cue-reactivity magnitude comparable to in vivo smoking cues ( Figure 1(a) , [ 20 ]).…”

Social Media Users’ Perceptions of a Wearable Mixed Reality Headset During the COVID-19 Pandemic: Aspect-Based Sentiment Analysis

“…First, there is a lack of evaluations that analyze the usability of sentiments for developers, researchers, and users separately [ 4 ]. Moreover, most studies have been evaluated with a limited number of people invited to the laboratory [ 2 , 5 , 6 ]. Finally, the real-time opinions worldwide have not been reflected [ 4 ].…”