Using virtual reality to investigate cross-cue reactivity and environmental cues in nicotine dependent problem drinkers
Copp, Hilary Lee
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Traditional cue exposure has been limited by the inability to replicate realistic, complex, contextually based cues in a laboratory or clinic setting, and as a result limited generalization has occurred in the real world. VR cue exposure, which has been repeatedly demonstrated to elicit reactivity in drug- or alcohol-dependent individuals, represents an opportunity to expose participants to environmentally situated, complex, standardized cues without the expense or risks associated with a real-world drug or alcohol use situation. This study examined the effects of VR nicotine cues on nicotine and alcohol reactivity in non-treatment-seeking nicotine dependent problem drinkers. This study had two overarching goals: 1) to determine whether nicotine cues can elicit both nicotine and alcohol reactivity (cross-cue reactivity) in nicotine dependent problem drinkers, and 2) to determine whether the environmental context of cues affects nicotine and alcohol reactivity in this population. The VR cue environments utilized in this study contained visual, auditory, and olfactory nicotine cues such as cigarettes, lighters, other people smoking, coffee, soft drinks, and food, situated within a virtual office building courtyard and a virtual party setting. No overt alcohol cues were presented at any time during VR exposure. Participants were also exposed to 2 identical neutral rooms, containing no nicotine or alcohol cues. Participants provided subjective ratings within VR of craving for nicotine and alcohol, attention paid to visual and olfactory nicotine and alcohol cues, and thoughts about smoking and drinking after exposure to each virtual room. Overall, participants reported increased reactivity in response to cue rooms vs. neutral rooms for both nicotine and alcohol, and for alcohol in the alcohol-appropriate party setting vs. the non-alcohol appropriate office setting. This study is the first to utilize VR cue environments in an investigation of cross-cue reactivity and environmental influence on polydrug users. In addition, this study contributes to the growing body of literature concerning the potential effects of continuing to smoke after achieving alcohol sobriety, particularly on the probability of relapse.