Glitches to growth: Lessons learned from developing and testing an augmented reality smartphone app for substance use treatment.

Augmented reality (AR) is an advanced technology that has emerged as a helpful tool in mobile health interventions for substance use treatment. By superimposing virtual drug-related cues in one's real-world environment, AR could expand the delivery of extinction-based cue exposure therapies while mitigating costs and risks. Previous findings from our team show AR smoking cues elicit cravings like in vivo cues, with evidence of extinction after repeated AR exposure trials. Based on these findings, we developed an AR smoking cessation smartphone app to test as an adjuvant to a state tobacco quitline in an ongoing large-scale randomized controlled trial (NCT06088498). This article describes AR technology and its theoretical relevance to cue exposure therapies, as well as challenges related to app development, trial enrollment, and app engagement. Although some challenges and recommendations unique to AR are discussed (e.g., development of smoking-related AR images), most are relevant to the broader application of other advanced mobile health technologies. Examples include finding and collaborating with industry partners, such as app developers, with sufficient expertise in the relevant technology and in research; potential for selection bias based on smartphone capabilities and participants' technological abilities and affinities; explaining the novel treatment rationale within the app; and maximizing app engagement. Where relevant, these points will be illustrated with data collected during the randomized controlled trial. Recommendations offered may have utility for investigators and clinicians interested in AR and other advanced technologies (e.g., virtual reality, geo-mapping, wearables) to improve the reach and efficacy of treatments for substance use disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).