TMS For Smoking Cessation

Cigarette smoking is one of the leading causes of death in the United States. The mortality rate for smokers is three times higher than that of non-smokers. Both smoking and smokeless tobacco lead to a number of fatal conditions, such as cancer, respiratory failure, and heart disease. Approximately 480,000 people die of smoking related illness each year, if you include deaths due to second-hand smoke. Overall, the life expectancy for smokers is 10 year shorter than that of non-smokers.

 The good new is that quitting smoking immediately decreases the chances of dying from a smoking-related illness. People who quit before the age of 40 reduce their risk of smoking-related death by over 90%. Despite these sobering statistics, it remains exceedingly difficult to quit smoking.  80% of people who attempt to quit without help return to smoking within a month.  Only 3% of smokers quit successfully each year.  Many products exist to people quit smoking, but their effectiveness is extremely limited. The dire need for effective treatments against nicotine dependency led to the development of new TMS technology specifically for smoking cessation.

TMS for Smoking Cessation

The Brainsway H4 Deep TMS Coil was developed specifically for smoking cessation and nicotine addiction. Transcranial magnetic pulses, generated by the coil, stimulate the neuronal pathways in the brain connected with the control of motivation, reward, and pleasure. By stimulating these pathways, TMS therapy helps to undo the addictive processes that have built up over time, due to smoking and nicotine usage. Parts of the brain targeted in TMS therapy are the prefrontal cortex, the nucleus accumbens and ventral tegmental area (VTA), and the neuronal structures to the left and right insula. Transcranial magnetic stimulation to those areas, when someone is craving a cigarette, has been shown to significantly improve the success rate of smoking cessation.

TMS therapy for smoking cessation consists of 18 treatments using transcranial magnetic stimulation. Clinical studies found that 2 out of 3 smokers considered “highly addicted” remained abstinent 18 weeks after the course of treatment. Those who were unable to quit entirely, reduced their average weekly cigarette consumption from 128 to 32. Treatment courses longer than 18 sessions have the potential to yield greater efficacy, and patients can receive maintenance treatments monthly or as needed. Brainsway H4 Deep TMS treatment can be combined with other smoking cessation treatments to ensure greater long term success. These include acupuncture, nicotine replacement products, and medications like buproprion (Wellbutrin) and Chantix (varenicline), all also available at the Delray Center for Healing.

How TMS Works

The Brainsway H4 Deep TMS Coil specifically targets the prefrontal cortex, and the fibers connecting the cingulate or prefrontal cortex with the nucleus accumbens and ventral tegmental area, as well as the neuronal structures in the left and right insula.  H4 dTMS is performed 5 days per week for 3 weeks, followed by 1 day a week for 3 weeks, for a total of 18 sessions. This includes an initial brain mapping session, where the motor threshold and treatment location are determined.  Each treatment starts with a smoking related stimulus, referred to as a provocation, to activate the addictive neuronal pathways.  The provocation is then followed by the magnetic pulse treatment.  The entire session takes only 25-30 minutes. 

There are no activity restrictions after treatment (such as driving or operating heavy machinery).  Any medication infusions, such as ketamine, should always be done after TMS.  Regular prescribed medications that are due to be taken close to the time of TMS are best taken after the session is completed. TMS is usually combined with appropriate pharmacotherapy to achieve the best results.