May 11, 2009


Virtual Environment
Technology to Prevent Teen Smoking is a program that uses a virtual environment
to teach adolescents about the dangers of smoking and how to handle situations
involving smoking. Participants are able to explore a virtual world and
interact with characters offering them cigarettes, as well as learn new facts
about smoking. In a random-assignment evaluation, participants in the
intervention had a significant increase in realistic perceptions of peer and
adult drugs use. There were no impacts on drug use, type of drug used, and
intent to use drugs.


Target population:

Virtual Environment
(VE) Technology to Prevent Teen Smoking provides information on the dangers of
smoking and anxiety coping skills. The Virtual Environment Technology provides
an opportunity to practice assertiveness skills with virtual characters. The
system includes goggles, synthesized speech, electromagnetic spatial trackers on
head and hand, a hand-held controller, and simulated speech recognition to
provide an immersive, interactive environment. In the virtual world,
participants enter a virtual park and are able to move around and interact with
objects such as trees, benches, and characters attempting to get the participant
to smoke. Participants can respond to different options that the program
presents them ranging from accepting a cigarette to refusal. Points are given
for more desirable responses. When a participant has earned enough points, they
have the option of exploring other environments, such as inside virtual lungs
where information is given and more points can be earned.

Participants are
also supplied with a workbook, relaxation tape, and participate in discussion.
The intervention lasts eight weeks, with one 50-minute meeting per week. Prior
to the first meeting, participants are tutored for 30 minutes on how to use the
VE Technology. During the weekly meetings, participants first spend 10 minutes
discussing personal goals and workbook material with a research assistant. The
next 30 minutes are spent using the VE equipment in the virtual world. The
remaining time is used to adjust equipment and complete questionnaires.


Nemire, K., Beil,
J., & Swan, R. (1999). Preventing teen smoking with virtual reality. CyberPsychology & Behavior, 2(1).

60 seventh-graders from one middle school participated in the

Students were screened to determine that they have not ingested alcohol or drugs
in the past 72 hours, had no psychiatric morbidity, psychotropic medications,
history of seizure disorders, intracranial pathology, or susceptibility to
motion sickness. The students were randomly assigned to one of three
conditions: Virtual Environment (VE) program, Life Skills Training (LST) group
session, and a nonintervention control group. The VE program is implemented as
discussed above. The LST group session involves group discussion and
role-playing activities centered on self-esteem, decision making, dangers of
smoking, anxiety coping skills, and assertiveness skills. Participants met in
groups for eight weekly meetings consisting of personal goal sharing,
role-playing, anxiety coping, and a 20 minute relaxation period. Further
information on LST is available


Smoking knowledge
and behavior were assessed using a questionnaire. Saliva samples were also

There were no differences in frequency of drug use, type of drug used, intent to
use drugs, and intent to use different kinds of drugs between the three groups
at post-test. The VE group’s perception of drug use by peers and adults became
significantly more realistic, while the control group’s perception of drug use
by peers and adults because significantly more distorted. The VE group was
significantly more likely to agree with the statement “Becoming a smoker
reflects poor judgment,” while the control group was significantly more likely
to disagree with the statement. There were no significant impacts on decision
making. There was a significant main effect of group for coping with anxiety.


Link to program curriculum:


Nemire, K., Beil,
J., & Swan, R. (1999). Preventing teen smoking with virtual reality. CyberPsychology & Behavior, 2(1).

categorized in this guide according to the following:

participant ages: 11-12

Program components:

Measured outcomes:
physical health, mental health

Middle Childhood (6-11), Adolescence (12-17), School-based, Children (3-11),
Adolescents (12-17), Tobacco Use, Conflict Resolution Skills, Self Esteem

information last updated 5/11/2009.