Transcranial Magnetic Stimulation Treatment for Smoking Cessation: An Introduction for Primary Care Clinicians

Abstract

Tobacco use remains the number one preventable cause of death in the United States, resulting in significant public health and economic costs. Despite progress in reducing tobacco use through pharmacotherapy and psychotherapy smoking cessation interventions, additional treatment options are still needed to improve treatment effectiveness. As an adjunctive treatment, the US Food and Drug Administration recently cleared transcranial magnetic stimulation (TMS), a noninvasive brain stimulation technique, as an aid for smoking cessation in adults. Given that most smoking cessation interventions occur in the primary care setting, this article aims to introduce TMS, to provide an overview of the evidence of TMS for smoking cessation, and to outline the procedures for implementing TMS in the primary care setting when referral to an interventional psychiatrist is not possible. With growing scientific evidence and increasing regulatory approval of TMS for smoking cessation, this novel treatment option is now available for patients who want to quit smoking but have been unsuccessful with pharmacologic approaches.

Keywords: Addiction; Smoking cessation; TMS; Tobacco; Transcranial magnetic stimulation.

Figure 1:

A) Illustration of TMS magnetic field in the head. B) Visual detection of muscle twitch and motor evoked potential used for establishing resting motor threshold. C) BrainsWay TMS System including H4-coil, Magstim TMS stimulator, and treatment chair.