Approach Bias Retraining With Virtual Reality Technology Reduces Smoking

man breaking a cigarette in half
man breaking a cigarette in half
The researchers combined virtual reality with Approach Bias Modification to determine if this would improve smokers’ motivation to quit smoking and reduce the number of dropouts from smoking cessation programs.

Virtual reality (VR) combined with Approach Bias Modification (ABM) may improve smoking cessation efficacy, according to a recent study published in Behaviour Research and Therapy.

With ABM, smokers learn, through repetition, to avoid substance use-related stimuli, such as ashtrays. While effective, low participant motivation and a high dropout rate hinders its benefit. Combining VR with ABM may improve motivation and lower dropouts.

Smokers were assigned to either a brief smoking cessation program with VR or a smoking cessation program with ABM and VR for 2 weeks. They also attended 2 follow-up assessments at 3 and 7 weeks after baseline. The study involved 96 current smokers.

The VR-ABM group smoked fewer cigarettes per day than the VR-alone group. There were no significant differences in cravings or other smoking- or health-related outcomes.

Limitations of this study include the low reliability of cognitive bias measurement tasks, the VR scenario, and the conceptualization of the control training.

“Enriching approach bias retraining through VR technology has merit in reducing smoking and promoting health behavior,” the researchers concluded. They suggest embedding environments of a participant’s usual risk situations into the VR training to narrow the gap between laboratory and real-life behavior.

The study authors believe that “the implementation of VR techniques in psychological interventions clearly warrants further investigation.”


Machulska A, Eiler TJ, Kleinke K, et al. Approach bias retraining through virtual reality in smokers willing to quit smoking: A randomized-controlled study. Behav Res Ther. Volume 141, 2021, 103858. doi:10.1016/j.brat.2021.103858

This article originally appeared on Psychiatry Advisor