Virtual Smoke Signals How VR Reveals the Unexpected Effects of Antitobacco Advertising

Objectives: Health promotion campaigns suffer from a lack of systematic evaluation and do not always impact the target population as intended. Our research adopted immersive virtual reality (iVR) to systematically evaluate preventive antitobacco messages in a controlled setting while mimicking a naturalistic and ecological environment. We investigated the effect of incidental exposure to preventive antitobacco billboard posters on attitudes and cravings toward tobacco and poster recognition. Methods: Participants were undergraduate students (n = 157), mostly female (85%). They were immersed in a virtual environment incidentally exposing them to preventive posters or in an environment without any preventive posters. Their gaze was eye-tracked during the entire procedure. Results: Results indicate that incidental exposure to preventive antitobacco posters, relative to no posters, led to more favorable attitudes toward tobacco. Incidental exposure to posters did not impact their explicit memorization. No significant effect was found on craving. Conclusions: We advise health campaign designers to consistently evaluate campaigns before launching them as incidental antitobacco messages may inadvertently soften attitudes toward smoking.