Effectiveness and safety of repeated transcranial magnetic stimulation for smoking cessation: A systematic review and meta-analysis

Objective

To evaluate the effectiveness and safety of Repeated Transcranial magnetic stimulation (rTMS) for smoking cessation.

Methods

Randomized Controlled Trials (RCT) with rTMS on smokers were included. The meta-analysis was performed using R 4.3.2 software. GRADE method was used to evaluate the quality of the evidence.

Results

15 RCTs involving 967 smokers were included. The meta-analysis showed that, comparing with the control group, active rTMS significantly decreased the average daily number of cigarettes smoked (MD = −6.72, 95 % CI [−9.47, −3.97], very low quality) and FTND score (MD = −2.57, 95 % CI [−3.84, −1.29], very low quality). Meanwhile it significantly improved the smoking cessation rates (OR = 2.77, 95 % CI [1.56, 4.92], moderate quality). 10 Hz had a better effect on the three outcomes than 0 Hz. When the treatment was ≥20 sessions, it was more helpful to quit smoking, reduce smoking and nicotine dependence. People with schizophrenia were more likely to reduce smoking and nicotine dependence. Adverse reactions were mild, with only the incidence of headache being significantly increased (P < 0.05).

Conclusion

rTMS might provide effective support for people trying to stop smoking. Meanwhile, population characteristics, stimulation frequency, sessions, and duration will affect the treatment effect of rTMS.