A Clinical Trial to Assess the Role of Repetitive Transcranial Magnetic Stimulation in Smoking Cessation in an Egyptian Sample

Objective: The objective of this study was to assess whether repetitive transcranial magnetic stimulation (rTMS) increases the likelihood of smoking cessation after 6 months of treatment Methods: A randomized, double-blind controlled clinical trial is conducted by enrolling 54 tobacco users divided into 2 equal groups; one group receiving active rTMS and the other group receiving a sham rTMS. Both groups were followed up for 24 weeks after treatment for abstinence using the Nicotine Use Inventory, cigarette consumption, cravings by Arabic Tobacco Craving Questionnaire-12. Results: Fifty-four subjects received the full intervention and were analyzed. Carbon monoxide was significantly less in the study group after the last treatment session. At week 24, the percentage of point prevalence abstinent subjects was 25.9% in the active group and 18.5% in the sham group, however, the difference was not statistically significant. Arabic Tobacco Craving Questionnaire-12 measures at different time points showed a statistically significant decrease in emotionality, expectancy, and purposefulness measures. However, this appears to be due to the effect of time, not treatment. Treatment response was higher in the study group, yet the difference was statistically insignificant. Conclusions: In a study that simulates real-life conditions in Egyptian smokers, 6 sessions of high-frequency active rTMS over the left dorsolateral prefrontal cortex did not produce a statistically significant increase in abstinence over sham rTMS at the same site. However, an effect on carbon monoxide measures and treatment response warrants further research.