Smoking is good. Why and how?

Dear editor,

The potential of virtual reality in health^1,2 is an exciting topic of discussion in the Journal of Public Health. We intend to highlight smoking behavior in the global community and relate it to virtual reality. Generally, we support research on the harmful effects of substances contained in cigarettes, whether filtered cigarettes^3–5 or electronic cigarettes^6–8, that could endanger the body.

According to the latest World Health Organization (WHO) report in 2021, the percentage of adult smokers worldwide is trending downward. However, due to the increasing global population, the actual number of adult smokers is still on the rise. In 2020, it was estimated that there were around 1.1 billion adult smokers worldwide. Although this number has decreased from the previous year, it is still huge. Additionally, according to the WHO, the use of e-cigarettes among adolescents is continuing to increase and has become a serious global public health issue.

Several studies have shown that individuals experiencing high levels of stress,^9,10 anxiety,^11,12 or uncontrolled emotions¹³ tend to smoke more or more frequently. When experiencing these conditions, the body’s autonomic nervous system reacts and causes respiration, heart rate and blood pressure changes. One physical response that occurs when experiencing negative emotions is shallow and rapid breathing.^14–17 Smoking behavior, and intense inhalation, can help stabilize breathing disturbed by negative emotions.

Taking a long breath while smoking provides a relaxing and calming sensation, but there are harmful effects of the dangerous substances contained in cigarettes. Instead, many breathing techniques can be done without smoking and can help reduce stress, such as yoga,¹⁸ mindfulness meditation¹⁹ and breathing exercises.²⁰ In counseling, a ‘deep breathing’ technique is used as part of relaxation and stress management strategies aimed at helping individuals overcome anxiety, depression and other negative emotions. These techniques (yoga,²¹ mindfulness meditation,^22,23 breathing exercises²⁴) can be integrated into virtual-reality technology.

During the COVID-19 pandemic, virtual reality has brought significant changes in providing highly realistic experiences, such as visiting inaccessible places and doing physical and mental exercises. We are confident that smoking innovations can be discovered through virtual reality technology that emphasizes long and deep-breathing activities without the need for tobacco or other harmful substances. Therefore, smoking is good ‘if it is not lit’.