The Yale play4REAL Lab has received another gift from Oculus Education to expand its work on smokeSCREEN VR, a virtual reality game created to prevent adolescent e-cigarette use.\nThe play4REAL Lab — a division of the Yale Center for Health and Learning Games — was established in November 2017, after Kimberly Hieftje, its founder and current director, received an initial gift from Oculus Education to develop smokeSCREEN VR. With promising findings from pilot tests, the lab will use the additional funding to continue developing the on the game and will conduct a larger randomized control trial to test its effectiveness. The new contribution will support the lab’s research for the next two years, according to Hieftje.\nThe Center for Health and Learning Games develops and evaluates serious games for use as tools to promote healthy behaviors. Serious games, or interactive programs intended for a purpose other than just entertainment, are being used on a global scale to address various health issues, said Tyra Pendergrass, associate director of the play2PREVENT Lab, another division of the Center for Health and Learning Games.\nThe play2PREVENT Lab created smokeSCREEN — a web-based game aiming to help players resist peer pressure around cigarettes and marijuana. smokeSCREEN, which received a grant from the CVS Health Foundation last April, launched nationwide on Feb. 1 with support from SHAPE America, an organization of health and physical education professionals.\nsmokeSCREEN VR, developed in partnership with PreviewLabs, a game prototyping company, is a separate program that uses virtual reality to educate youth about e-cigarettes. According to Hieftje, students are familiar with the dangers of tobacco and combustible cigarettes but have many misperceptions around the safety of Juuls because they fail to realize how much nicotine the e-cigarettes have.\n“It’s not cool to smoke anymore, but it is cool to Juul, which is a problem,” Hieftje said.\nUnfamiliarity with the dangers of e-cigarettes provides an opportunity to evaluate the effectiveness of the game because there is more room to change people’s attitudes about vaping, according to Lynn Fiellin, director of the Center for Health and Learning Games.\n“In a lot of ways, kids have heard about cigarettes for so long. There’s not a lot of room to change their attitudes around conventional cigarettes,” she said. “But we saw significant changes around their attitudes, beliefs and perceptions around electronic cigarettes.”\nIn smokeSCREEN VR, kids play a student who is trying to get an invitation to a party happening later that day. As they try to obtain the invitation, they are confronted with peer pressure to Juul. Students try to refuse while maintaining their social relationships. This demonstrates to students that they do not have to choose between “maintaining a certain friendship and doing what’s healthy,” according to Bernard François, the founder of PreviewLabs.\nIt’s not cool to smoke anymore, but it is cool to Juul, which is a problemKimberly HieftjeThe use of virtual reality hardware makes the simulation more realistic. Played on an Oculus Go or Oculus Quest, smokeSCREEN VR takes advantage of the Oculus’s voice recognition software to let students practice speaking directly to characters in the game, who respond in real-time.\n“It’s skill-based practice in a safe space,” said Hieftje. “They can make mistakes and see what happens.”\nFiellin noted that it is difficult to directly measure the impact of these interventions on behavior. The data is self-reported by the students, and the effects do not show up immediately.\n“It takes time to see whether kids are going to start smoking,” she said. “More proximally, we can measure if we can change their attitudes.”\nThe randomized control trial, which will start in May, will follow 230 students for six months to learn more about their behaviors after playing the game.\nIn 2018, 20.8 percent of high school students and 4.9 percent of middle school students reported using e-cigarettes in the last 30 days, according to the Centers for Disease Control and Prevention.