Quitting smoking successfully thanks to brain stimulation

Alexander Stindt

Woman refuses cigarettes

Smoking takes the lives of many people every year, but smokers often fail to give up their vice. A new treatment in the form of a non-invasive brain stimulation method could change this. (Image: puhhha/stock.adobe.com)

How to stop smoking in the long term?

So-called repetitive transcranial magnetic stimulation can effectively help people quit smoking. This non-invasive method of brain stimulation is associated with a very high rate of abstinence from smoking.

A large smoking cessation study involving the University of South Carolina found that repetitive transcranial magnetic stimulation can be an effective approach to treating tobacco dependence. The results can be read in the English-language journal World Psychiatry.

Germany: More than 120.000 deaths annually due to smoking

In Germany alone, the consequences of smoking cost more than 120.000 people’s lives. Among other treatment approaches, there is so-called repetitive transcranial magnetic stimulation (rTMS), which is currently still in the research stage.

High abstinence rate thanks to brain stimulation

In the study of 262 participants, the non-invasive method of brain stimulation resulted in more than a doubling of the abstinence rate after a period of just six weeks, compared to individuals in the control group. "This is a remarkable result in addition to existing treatment options for tobacco dependence," reports Professor Dr. Walter Paulus of the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) in a press release.

Repetitive transcranial magnetic stimulation (rTMS) could not only be effective in treating psychiatric conditions, but could also play an important role in treating addictive disorders. However, studies on this topic have so far usually involved only a small number of people, the expert said.

Effectiveness of deep TMS for smoking cessation

In the new study, a special form of rTMS was used, called deep TMS. This uses a less focally acting stimulation coil (a so-called. H4 coil). "The randomized and placebo-controlled design of this study meets the highest standards and makes the results more robust compared to previous studies," said Proffessor Dr. Frank Padberg of the Psychiatric University Hospital Munich.

Participants in the new study had already tried to quit smoking at least once without success. Two-thirds of the people who participated had failed as many as three or more attempts.

"Another special feature of the study is that in addition to this special form of rTMS, behavioral brief interventions were also used," explains Professor Padberg. Within the study, addiction-specific symptoms were provoked for a period of five minutes. Participants were asked to imagine the triggers of their addictive cravings. This was supported by an audio file and pictures of smoking.

Following this, brain stimulation (60 three-second sessions of 30 pulses each) was performed with the help of a magnetic coil. This was placed over the regions of the so-called lateral prefrontal cortex and the insular cortex.

However, every second participant was in reality only stimulated as a sham and served as a comparison of efficacy. Brain stimulation was then followed by a brief two-minute intervention in the form of motivational interviewing.

Nearly twenty percent were smoke-free after 18 weeks

During the first three weeks, treatment was given on weekdays, then once a week for three weeks. After 18 weeks, 19.4 percent of the rTMS group had managed to consistently abstain from smoking for at least four weeks, according to a questionnaire. This statement was verified with the help of urine samples for nicotine degradation products. In the comparison group, however, the proportion was only 8.7 percent.

Smoking cravings reduced

After the first six weeks, as many as 28.0 percent of those treated with rTMS had quit smoking, compared with 11.7 percent in the placebo group. People in the treatment group smoked fewer cigarettes on average and also showed a reduced desire to smoke, according to the researchers.

"The study establishes a safe treatment protocol for smoking cessation through stimulation of relevant brain regions," the experts report on the results of their new study. The study results to date have already led to approval of rTMS in the USA for the treatment of people who smoke. The expert notes that further research is needed to assess the significance of the application in Germany.

"Since it is a very special rTMS approach, the procedure is not yet easily available in this country. Despite the clear results of this study, further research is needed to accurately assess its value," adds Prof. Add Padberg. (as)

Author and source information

This text complies with the requirements of medical literature, medical guidelines, and current studies and has been reviewed by medical professionals.

  • Abraham Zangen, Hagar Moshe, Diana Martinez, Noam Barnea-Ygael, Tanya Vapnik, et al.: Repetitive transcranial magnetic stimulation for smoking cessation: a pivotal multicenter double-blind randomized controlled trial; in: World Psychiatry (published 09.09.2021), World Psychiatry
  • German Society for Clinical Neurophysiology and Functional Imaging: Smoking cessation using transcranial magnetic stimulation: efficacy demonstrated for the first time in large study (published 22.10.2021), German Society for Clinical Neurophysiology and Functional Imaging

Important Notice:
This article contains general information only and should not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor.

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