Moderators of the Response to Deep TMS for Smoking Addiction - BrainsWay

Moderators of the Response to Deep TMS for Smoking Addiction

Journal: Frontiers in Psychiatry (Jan 2023)

Authors: Roman Gersner, Noam Barnea-Ygael, Aron Tendler


Recently, the FDA granted clearance for deep repetitive transcranial magnetic stimulation (Deep TMS™) as a short-term smoking cessation treatment. However, there remains uncertainty regarding the characteristics of participants who are more likely to benefit from this treatment.

Objective & Methods:

This study analyzes data from a published randomized controlled trial involving 262 participants aged 22–70, which led to FDA clearance. The aim is to identify demographic and smoking history factors that moderate the efficacy of Deep TMS treatment. The analysis focuses on 75 completers in the active TMS group and 94 completers in the sham TMS group.


The findings reveal that participants under 40 exhibit a fourfold higher quit rate compared to those older than 40. Moreover, individuals who quit post-treatment had a smoking history 10 years shorter than non-quitters. Notably, Caucasian participants demonstrated a twofold higher quit rate than African–American participants. Additionally, participants with more than 12 years of education exhibited a sevenfold higher quit rate than those with less education.


The results indicate that a three-week course of Deep TMS yields a higher smoking addiction quit rate among younger, more educated, Caucasian individuals with a less extensive smoking history. In contrast, older individuals with less education and a more extensive smoking history may require an extended treatment course and/or a combination of treatment modalities. This difference could be attributed to challenges in inducing neuronal modifications in individuals with greater physical and psychological dependence. Further investigation is warranted.

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