reHASHED VR: Nicotine and Marijuana Vaping Prevention

One of the top preventable risk factors for premature death among today’s adolescents is the widespread use of e-cigarettes. E-cigarette use exposes adolescents to nicotine and carcinogenic toxins and is associated with a five-fold increase in the likelihood of initiating conventional cigarette smoking, which puts youth at a higher risk for developing cancer, cardiovascular disease, and lung disease. Although e-cigarettes primarily deliver nicotine, they also can deliver cannabis. Use of high potency cannabis oils (i.e., which are typically vaped) is associated with increased risk of experiencing anxiety, depression, and schizophrenia. As adolescents transition back to in-person learning within schools, experts are concerned the environment is primed for a surge in e-cigarette use rates, indicating the need to invest in e-cigarette prevention that incorporates both nicotine and cannabis prevention.

Funded by the National Cancer Institute,  our team is currently pilot-testing Invite Only VR reHASHed - a narrative-based videogame that teaches adolescents about the risks of marijuana use and vaping while providing a virtual environment to practice refusing peer pressure and self-management skills, such as coping and stress management. In the game, the player follows a group of friends as they prepare for the end of their freshman year in high school.  As the player role plays different characters and plays through different scenarios, new chapters are unlocked, creating a larger meta-story.

Our team has partnered with schools in Connecticut and Massachusetts to pilot-test the game with 8th grade middle school students through thorough playtesting sessions, focus groups, and staff focus group and interviews across schools in Connecticut and Massachusetts.

Yale-Connecticut Principal Investigators

• Kimberly Hieftje, PhD
  Associate Professor of Pediatrics (General Pediatrics)
• Deepa Camenga, MD, MHS, FAAP
  Associate Professor of Emergency Medicine

Massachusetts General Brigham - Massachusetts Principal Investigator

• Randi Schuster, PhD
  Associate Professor of Psychology in the Department of Psychiatry

Under funding from the CT Department of Public Health, our team evaluated the prototype version of Invite Only VR. Our team partnered with local schools in CT to create the game based on school administration (i.e. teachers, school counselors) and adolescent feedback. In Fall 2025, we implemented the game and collected feasibility and acceptability data.