Evidence map›Paper›PMID 40211338›Full record

Trial reportAddiction science & clinical practice2025

Virtual reality cue exposure as an add-on to smoking cessation group therapy: a randomized controlled trial.

A M Kroczek, B Schröder, D Rosenbaum, A Mühleck, J Diemer, A Mühlberger, A C Ehlis, A Batra

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Addiction science & clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03707106 (An Efficacy Study Using an Established Cognitive Behavioral Therapy Manual for Smoking Cessation Comparing the Benefit of Virtual Reality Cue Exposure to a Specific Stress Reduction Protocol for Relapse Prevention), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03707106 nacompletednot on this map

An Efficacy Study Using an Established Cognitive Behavioral Therapy Manual for Smoking Cessation Comparing the Benefit of Virtual Reality Cue Exposure to a Specific Stress Reduction Protocol for Relapse Prevention

TypeinterventionalSponsorUniversity Hospital TuebingenRan2017 to 2021Enrolled246ConditionsSmoking CessationArmsCBT smoking cessation, virtual reality based cue exposure, progressive muscle relaxation
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

A M KroczekDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany. agnes.kroczek@med.uni-tuebingen.de.
B SchröderDepartment for Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Regensburg, Germany.
D RosenbaumDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany.
A MühleckDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany.
J Diemerkbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany.
A MühlbergerDepartment for Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Regensburg, Germany.
A C EhlisDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany.
A BatraDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCue exposure (CE) is used for relapse prevention as part of smoking cessation therapy to reduce the automatized response to smoking-related cues. Using CET in virtual reality (VR) is an approach to increase its efficacy by creating cost-efficient high-risk situations. The efficacy of VR-based CETs was compared to that of an unspecific relaxation intervention as an add-on to an established cognitive-behaviorally oriented smoking cessation group therapy (G-CBT).

methodsN = 246 abstinence-motivated smokers were included in a two-armed randomized controlled trial (G-CBT with VR-CET vs. G-CBT with progressive muscle relaxation/PMR) with 1-, 3-, and 6-month follow-ups (measurements in 2018-2020). All smokers joined a well-established G-CBT smoking cessation program with six sessions with four additional sessions of either VR-based smoking cue exposure therapy (VR-CET) or four sessions of group-based PMR. The primary outcome was abstinence after 6 months according to the Russell Standard; secondary outcomes included changes in the number of smoked cigarettes, craving (assessed by the Questionnaire of Smoking Urges/QSU), and self-efficacy (assessed by the Smoking Abstinence Self-Efficacy Scale/SES) over time.

resultsPrimary outcome: Six months after G-CBT, 24% of the participants were abstinent, and there was no significant difference between the PMR (n = 34/124) and VR-CET (n = 24/122) groups (odds ratio PMR/VR = 0.64). Secondary measures: SES increased, and QSU and the number of smoked cigarettes decreased over time. Baseline craving ratings predicted abstinence only in the VR-CET group.

conclusionThis randomized controlled trial did not show increased abstinence rates related to smoking cue exposure in virtual reality. Secondary measures demonstrated significant reductions in craving and cigarette consumption as well as increases in self-efficacy over time, regardless of the intervention. However, high baseline craving was negatively related to abstinence in the VR-CET group, suggesting that intense craving was insufficiently addressed. This may indicate that the amount of training was insufficient and should be intensified. Individualization, e.g., adaptive, individualized approaches, is required to improve the effects of the VR-CET on smoking cessation in future studies.

trial registrationClinicalTrials.gov Identifier NCT03707106.

Indexed as

Cognitive Behavioral TherapyCuesPsychotherapy, GroupSmoking CessationVirtual Reality Exposure TherapyAdultCravingFemaleHumansMaleMiddle AgedRelaxation TherapySelf EfficacyVirtual RealityCravingCue exposureCue reactivitySmokersSmoking cessationVirtual reality

Identifiers

PMID40211338
PMCPMC11987342

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.