Neuroimaging Correlates and Feasibility of Transcranial Magnetic Stimulation (TMS) to Improve Smoking Cessation Outcomes in Veterans With Comorbid PTSD
VA Office of Research and Development
Summary
Tobacco use is the number one preventable cause of the death in the United States, and is high among US Veterans, and those who have experienced trauma are more likely to smoke. Despite the efficacy of current evidence-based treatments for smoking cessation, there is a critical need for alternative treatments. This project seeks to evaluate the feasibility and effectiveness of a smoking cessation treatment for Veterans with posttraumatic stress disorder (PTSD) who smoke. The treatment combines smoking cessation counseling, nicotine replacement therapy (e.g., nicotine gum), and repetitive transcranial magnetic stimulation (rTMS). rTMS is a noninvasive brain stimulation treatment that has been cleared by the Food and Drug Administration for smoking cessation in adults.
Description
Tobacco use remains the number one preventable cause of death in the United States. Unfortunately, individuals with mental health conditions are disproportionately affected. Tobacco use is also high among US Veterans, and those who have experienced trauma are even more likely to smoke. Successful quitting is especially difficult for individuals who develop posttraumatic stress disorder (PTSD). Despite the efficacy of current evidence-based pharmacotherapies and psychotherapies for smoking cessation, alternative treatments are critically needed. Neuroimaging techniques such as resting-state fun…
Eligibility
- Age range
- 18–75 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Is a US Veteran * Meets DSM-5 criteria for tobacco use disorder * Is between the ages of 18 and 75 * Smokes an average of 10 cigarettes per day for the past 6 months, with carbon monoxide (CO) level \> 6 ppm * Is willing to attempt smoking cessation * Meets DSM-5 criteria for current PTSD diagnosis * Speaks, reads and writes English * Is willing to sign a Duke consent for those portions of the study that occur at Duke * Has been stable on psychotropic medications for at least three months Exclusion Criteria: * Has had a substance use disorder other than tobacco in the…
Interventions
- Deviceactive repetitive transcranial magnetic stimulation
Active rTMS is a non-invasive brain stimulation intervention that is FDA cleared as a treatment for smoking cessation in adults.
- Devicesham repetitive transcranial magnetic stimulation
Sham rTMS involves no brain stimulation, but appears to the participant and provider to be active rTMS.
- Behavioralcognitive behavioral therapy for smoking cessation
All participants will receive five sessions of cognitive behavioral therapy (CBT) for smoking cessation.
- Drugnicotine replacement therapy
All participants will receive nicotine replacement therapy in for the form of 21 mg, 14 mg, and/or 7 mg nicotine patches (based on smoking quantity) and a "rescue" method such as nicotine lozenge or nicotine gum.
Location
- Durham VA Medical Center, Durham, NCDurham, North Carolina