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Introduction The US Food and Drug Administration (FDA) and other organizations have produced and disseminated public health campaigns designed to deter youth from vaping. Yet it is unknown how these campaigns affect adult smokers exposed to these messages with respect to their perceptions of e-cigarettes and their motivation to use these products to reduce or quit smoking. Aims and Methods A controlled experimental design was used to investigate the effects of an FDA-distributed youth-targeted anti-vaping public service announcement (PSA), "Vaping is an Epidemic," upon adult smokers. We randomized 161 daily smokers to view either the FDA PSA or a matched video absent of e-cigarette content, and we hypothesized that the PSA would impact variables related to harm reduction usage of e-cigarettes, including cognitive expectancies, perceived harm, smoking cessation effectiveness, and reported likelihood of switching from smoking to vaping. Results The PSA produced increases in both health risk and potency expectancies. Viewing the PSA compared to the control video resulted in overall more negative expectancies about e-cigarettes and all other variables related to harm reduction usage. Those who viewed the PSA rated e-cigarettes as more harmful (p  < .001) and less effective for smoking cessation (p  < .01), and they reported lower switching motivation (p  < .001). Conclusions Findings indicated that adult smokers who viewed the PSA were less likely to consider e-cigarettes for smoking cessation, thus reducing acceptance of a potential cessation aid with growing empirical support. Sensationalized youth-oriented anti-vaping messages may have unintended public health consequences upon adult audiences. Implications This study is the first controlled experiment examining the effects of youth-oriented anti-vaping PSAs upon adult smokers' cognitive expectancies and beliefs about e-cigarettes. Exposure to the PSA resulted in overall more negative expectancies about e-cigarettes, as well as increased perceived harmfulness and reduced effectiveness of e-cigarettes for smoking cessation. Findings showed that these PSAs could deter adult smokers from the utilization of e-cigarettes as a smoking cessation or harm reduction strategy. [ABSTRACT FROM AUTHOR]

Objective: Cue-exposure therapy (CET) aims to extinguish conditioned cue reactivity (CR) to aid in smoking cessation. A key disadvantage of extant CET is its limited ability to generalize extinction to the real world. Our team developed a set of augmented reality smoking-related and neutral cues that can appear in real-time in smokers' natural environments as viewed through a smartphone screen. Prior to deployment as a clinical tool, the present study tested the ability of AR smoking cues to extinguish CR in a controlled laboratory study with an AR smartphone application developed for this project. We hypothesized that daily smokers who completed a single session of cue exposure with AR smoking cues (extinction condition) would demonstrate lower cue-provoked urge to smoke at posttest compared to those who viewed AR neutral cues (control condition). Method: Daily smokers (N = 129, 46.5% female, Mage = 47.6, Mcigarettes/day = 19.1) in acute abstinence were randomized to either the extinction or control condition comprising 28 AR trials. Results: As hypothesized, we found a Time × Condition interaction indicating that posttest urge ratings were lower in the extinction condition than in the control condition (p = .034). A secondary hypothesis that participants in the extinction condition would show a longer latency to smoke when provided a cigarette was not supported. Conclusions: These laboratory findings provide evidence supporting the potential clinical efficacy of AR cues for cue-exposure trials, setting the stage for testing in smokers' naturalistic environments. [ABSTRACT FROM AUTHOR]

Background: Cue exposure for extinguishing conditioned urges to smoking cues has been promising in the laboratory, but difficult to implement in natural environments. The recent availability of augmented reality (AR) via smartphone provides an opportunity to overcome this limitation. Testing the ability of AR to elicit cue-provoked urges to smoke (ie, cue reactivity [CR]) is the first step to systemically testing the efficacy of AR for cue exposure therapy., Objectives: To test CR to smoking-related AR cues compared to neutral AR cues, and compared to in vivo cues., Methods: A 2 × 2 within-subject design comparing cue content (smoking vs. neutral) and presentation modality (AR vs. in vivo) on urge response. Seventeen smokers viewed six smoking-related and six neutral cues via AR smartphone app and also six smoking and six neutral in vivo cues. Participants rated their urge to smoke and reality/co-existence of the cue., Results: Average urge to smoke was higher following smoking-related AR images (Median = 7.50) than neutral images (Median = 3.33) (Z = -3.44; p = .001; d = 1.37). Similarly, average urge ratings for in vivo smoking-related cues (Median = 8.12) were higher than for neutral cues (Median = 2.12) (Z = -3.44; p = .001; d = 1.64). Also, greater CR was observed for in vivo cues than for AR cues (Z = -2.67, p = .008; d = .36). AR cues were generally perceived as being realistic and well-integrated., Conclusions: CR was demonstrated with very large effect sizes in response to AR smoking cues, although slightly smaller than with in vivo smoking cues. This satisfies the first criterion for the potential use of AR for exposure therapy., Implications: This study introduces AR as a novel modality for presenting smoking-related stimuli to provoke cue reactivity, and ultimately to conduct extinction-based therapy. AR cues presented via a smartphone have the advantage over other modes of cue presentation (pictures, virtual reality, in vivo, etc.) of being easily transportable, affordable, and realistic, and they can be inserted in a smokers' natural environment rather than being limited to laboratory and clinic settings. These AR features may overcome the generalizability barriers of other methods, thus increasing clinical utility for cue exposure therapies., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)