Efficacy of Transcranial Magnetic Stimulation in Tobacco Abstinence Among Adult Tobacco Users Compared to Usual Care or no Treatment – A Systematic Review

Abstract

Objective: This study aimed to systematically identify and assess randomized controlled trials (RCTs) that evaluated the efficacy of transcranial magnetic stimulation (TMS) for increasing tobacco abstinence. Methods: Five electronic databases were searched from inception to May 2021 to identify RCTs evaluating the efficacy of TMS interventions for tobacco cessation or abstinence. Using predetermined eligibility criteria, two reviewers screened literature and assessed the quality of included studies using the Critical Appraisal Skills Programme tool. Results: Out of 222 records, six RCTs with TMS intervention were shortlisted. Two studies assessed TMS in conjunction with other active tobacco cessation treatment, while other four studies used TMS as only active form of treatment. The limited number of included studies had short follow-ups, large dropout rates, and heterogeneous interventions and comparators, which precluded clear detection of treatment effect of TMS interventions. Conclusions: TMS intervention differed significantly from comparator group in their effects on tobacco use. However, low-quality limited evidence with variability in study design among existing studies suggests the need for high-quality, long follow-up and robust RCTs to be conducted.