%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 8
%N 
%P e54817
%T Adding Virtual Reality Mindful Exposure Therapy to a Cancer Center’s Tobacco Treatment Offerings: Feasibility and Acceptability Single-Group Pilot Study
%A Jackson,Riley Walton
%A Cao-Nasalga,Ann
%A Chieng,Amy
%A Pirkl,Amy
%A Jagielo,Annemarie D
%A Xu,Cindy
%A Goldenhersch,Emilio
%A Rosencovich,Nicolas
%A Waitman,Cristian
%A Prochaska,Judith J
%+ Stanford Prevention Research Center, Department of Medicine, Stanford University, 3180 Porter Drive, Palo Alto, CA, 94304, United States, 1 650 724 3608, jpro@stanford.edu
%K tobacco cessation
%K virtual reality
%K exposure therapy
%K cancer care
%K mobile phone
%D 2024
%7 23.7.2024
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Smoking contributes to 1 in 3 cancer deaths. At the Stanford Cancer Center, tobacco cessation medication management and counseling are provided as a covered benefit. Patients charted as using tobacco are contacted by a tobacco treatment specialist and offered cessation services. As a novel addition, this study examined the acceptability of a virtual reality (VR) mindful exposure therapy app for quitting smoking called MindCotine. Objective: The objective of this study was to determine the feasibility and acceptability of offering 6 weeks of MindCotine treatment as a part of Stanford’s Tobacco Treatment Services for patients seen for cancer care. Methods: As part of a single-group pilot study, the MindCotine VR program was offered to English- or Spanish-speaking patients interested in quitting smoking. Given the visual interface, epilepsy was a medical exclusion. Viewed from a smartphone with an attachable VR headset, MindCotine provides a digital environment with audiovisual content guiding mindfulness exercises (eg, breathing techniques, body awareness, and thought recognition), text-based coaching, and cognitive behavioral therapy-based self-reflections for quitting smoking. Interested patients providing informed consent were mailed a MindCotine headset and asked to use the app for 10+ minutes a day. At the end of 6 weeks, participants completed a feedback survey. Results: Of the 357 patients reached by the tobacco treatment specialist, 62 (17.3%) were ineligible, 190 (53.2%) were not interested in tobacco treatment services, and 78 (21.8%) preferred other tobacco treatment services. Among the 105 eligible and interested in assistance with quitting, 27 (25.7%) were interested in MindCotine, of whom 20 completed the informed consent, 9 used the program, and 8 completed their end-of-treatment survey. Participants using MindCotine completed, on average, 13 (SD 20.2) program activities, 19 (SD 26) journal records, and 11 (SD 12.3) coaching engagements. Of the 9 participants who used MindCotine, 4 (44%) reported some dizziness with app use that resolved and 7 (78%) would recommend MindCotine to a friend. In total, 2 participants quit tobacco (22.2% reporting, 10% overall), 2 others reduced their smoking by 50% or more, and 2 quit for 24 hours and then relapsed. Conclusions: In a feasibility and acceptability pilot study of a novel VR tobacco treatment app offered to patients at a cancer center, 4 of 9 (44%) reporting and 4 of 20 (20%) overall substantially reduced or quit using tobacco after 6 weeks and most would recommend the app to others. Further testing on a larger sample is warranted. Trial Registration: ClinicalTrials.gov NCT05220254; https://clinicaltrials.gov/study/NCT05220254 
%R 10.2196/54817
%U https://formative.jmir.org/2024/1/e54817
%U https://doi.org/10.2196/54817