RTMS Targets Neural Circuits for Smoking Cessation

Inclusion Criteria

• Be between the ages of 22 and 70 years old.
• Smoke 10 or more cigarettes per day and have a carbon monoxide (CO) level \> 10 ppm indicative of recent smoking.
• Have not received substance abuse treatment within the previous 30 days.
• Meet the criteria for tobacco use disorder as determined by DSM-5.
• Be in stable mental and physical health.
• If female, test non-pregnant and use adequate birth control.
• Show no evidence of focal or diffuse brain lesions on MRI.
• Be willing to provide informed consent.
• Be able to comply with protocol requirements and likely to complete all study procedures.
• Be motivated to quit smoking (based on responses of "very likely," or "somewhat likely" in the motivation questionnaire).

Exclusion Criteria

• Current moderate to severe substance use of any psychoactive substances other than nicotine or caffeine, as defined by DSM-V criteria.
• Contraindications to MRI (e.g., presence of metal in the skull, orbital or intracranial cavity, or having claustrophobia).
• Contraindication to rTMS.
• History of autoimmune, endocrine, viral, or vascular disorders affecting the brain.
• History or MRI evidence of neurological disorder that would lead to local or diffuse brain lesions or significant physical impairment.
• Unstable cardiac disease, uncontrolled hypertension, severe renal or liver insufficiency, or sleep apnea.
• Lifetime history of major Axis I disorders such as: bipolar affective disorder (BPAD), schizophrenia, post-traumatic stress disorder (PTSD), dementia, suicidal ideation or major depression.
• Self-report of \>21 standard alcohol drinks per week in any week in the 30 days prior to screening.
• Use of other forms of nicotine delivery, such as nicotine patches, electronic cigarettes, gum, nasal spray, inhalers, and nicotine lozenges.
• Use of other tobacco products, including cigars, cigarillos, chew, snuff, and pouches/snus.
• Previous treatment with TMS.