Invite Only VR: Evaluation of a Vaping Prevention Game

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. As adolescents transition back to in-person learning within schools, experts are concerned the environment is primed for a surge in vaping rates, indicating the need to invest in vaping prevention efforts.

Funded by the National Cancer Institute, our team is currently optimizing Invite Only VR, a narrative-based virtual reality vaping prevention videogame that teaches adolescents about the risks of 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 test the game with 8th grade middle school students through thorough playtesting sessions, focus groups, and staff focus groups and interviews across schools in Connecticut and Massachusetts.

Findings from this study will inform the optimization of game for larger evaluation and implementation as part of a multi-site cluster randomized trial over the next few years across 20 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 pilot-tested 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 closed the study by implementing the game and collected feasibility and acceptability data from students. Learn more here.

Papers in Preparation

• Camenga, D. R., Weser, V., Kurade, P., Van, S., Shaker, J., Schuster, R. M., DeTore, N. R., & Hieftje, K. (in preparation). From insight to impact: Novel qualitative approaches in the design of virtual reality videogames for substance use prevention. Prevention Science.

Upcoming Presentations

• Camenga, D. R., Hieftje, K., & Kurade, P. (2026, April). Immersive technology–driven strategies to incorporate healthy coping and emotion regulation skills into cannabis and nicotine vaping prevention curricula. Workshop to be presented at the 7th Annual Cannabis (and Other Drugs) Awareness & Prevention Conference, Halpern-Felsher REACH Lab, Stanford Medicine.
• Kurade, P., Camenga, D. R., Weser, V., Shaker, J., Schuster, R. M., DeTore, N. R., & Hieftje, K. (2026). Evaluation and optimization of a virtual reality game for nicotine and cannabis e-cigarette prevention among middle school students. Poster presentation submitted to the Society for Prevention Research Annual Meeting.
• Camenga, D. R., Weser, V., Bartush, S., Shaker, J., Schuster, R. M., & Hieftje, K. (2026). Invite Only VR: Youth vaping prevention through immersive technology in middle schools. Technology demonstration submitted to the Society for Prevention Research Annual Meeting.