Virtual Reality-Based Smoking Cessation Treatment in Patients With Schizophrenia

Dokuz Eylul University160 enrolled

Overview

Schizophrenia is associated with high rates of cigarette smoking, which contributes to serious physical health problems and reduced life expectancy. Existing smoking cessation treatments have shown limited long-term success in this population. Virtual Reality-based interventions may provide a new approach for supporting smoking cessation. This study evaluated the effects of a 10-week virtual reality-based smoking cessation program in patients with schizophrenia and healthy smokers. Participants were assigned to either a virtual reality intervention group or a no-intervention control group. Smoking behavior, nicotine dependence, clinical symptoms, cognitive functioning, and quality of life were assessed before and after the intervention period.

Schizophrenia is associated with elevated rates of cigarette smoking compared with the general population. Smoking is considered one of the major contributors to reduced life expectancy and increased physical morbidity in individuals with schizophrenia. Previous pharmacological and behavioral smoking cessation interventions have demonstrated limited effectiveness in this population, with low long-term abstinence rates and frequent relapse. Virtual Reality has recently emerged as a promising therapeutic tool in mental health research. Studies conducted in non-clinical populations suggest that virtual reality-based interventions may support smoking cessation by providing immersive and controlled environments related to smoking behavior and craving management. However, there is currently limited research examining the effectiveness of virtual reality-based smoking cessation interventions in schizophrenia. The present study investigated the effects of a 10-week virtual reality-based smoking cessation intervention in patients with schizophrenia and healthy smokers. The study included four parallel groups: schizophrenia patients receiving virtual reality intervention, schizophrenia patients receiving no intervention, healthy controls receiving virtual reality intervention, and healthy controls receiving no intervention. Participants were evaluated before and after the intervention period using measures of nicotine dependence, cigarette consumption, clinical symptoms, neuropsychological performance, quality of life, and social condition.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Interventions

Schizophrenia VR Intervention GroupBEHAVIORAL

Participants received Virtual Reality-based smoking cessation treatment consisting of immersive virtual scenarios designed to reduce smoking behavior and support smoking cessation. The intervention was administered over 10 weeks through structured virtual reality sessions.

Healthy Control VR Intervention GroupBEHAVIORAL

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Being between 18 and 60 years of age * Being on a stable dose of the same antipsychotic medication for the previous 12 weeks * Being able to read and write in Turkish * Scoring at least 3 on the Fagerström Test for Nicotine Dependence Exclusion Criteria: * Diagnosis of any severe physical or neurological disorder affecting clinical functioning * Presence of auditory or visual impairment * Alcohol or substance use disorder/dependence * Having Intellectual disability * Suicidal risk or harmful/aggressive behavior * Any pulmonary disease or severe respiratory condition * Having prior smoking cessation treatment or intervention history * Having received electroconvulsive therapy (ECT) within the past 6 months

Outcomes

Primary Outcomes

Fagerstrom Test for Nicotine Dependence (FTND)

The Fagerström Test for Nicotine Dependence, developed by Karl Fagerström in 1996 (Fagerström et al., 1996), was used to assess the level of nicotine dependence. The FTND is a self-report measure consisting of six items, with total scores ranging from 0 to 10; higher scores indicate greater nicotine dependence. In this study, the FTND was administered at baseline before the intervention and again at the post-treatment assessment conducted 10 weeks later.

Time frame: From enrollment to the end of treatment at 10 weeks.