[Reading Science] Advanced Science and Technology Helping 'Jaksim Samil' Smoking Cessation

Attention on Transcranial Magnetic Stimulation (TMS)
Approved by US FDA in 2020
Effective for Treating Smoking, Depression, and Various Addiction Disorders

[Image source=Getty Images Bank]

Smoking is one of the leading causes of death. As of 2019, about 14% of global deaths were due to smoking-related diseases. While the risks of smoking have been increasingly emphasized, the global smoking rate has recently been declining, dropping from 28% in 1990 to 20% in 2019. However, due to population growth, the number of smokers has actually increased. Many smokers still cannot break free from addiction and often relapse after quitting. Recently, scientists have attracted attention by steadily improving a technology that helps smoking cessation by repeatedly stimulating the brain with magnetic fields.

The international scientific journal Nature published a special issue on smoking on the 7th of last month, focusing on this brain stimulation technology. The U.S. Food and Drug Administration (FDA) approved the TMS (transcranial magnetic stimulation) procedure in August 2020, which repeatedly stimulates addiction-related areas of the human brain with magnetic fields to aid smoking cessation. At that time, the TMS procedure demonstrated reliability by showing effects similar to bupropion, a chemical smoking cessation treatment that blocks nicotine receptors in the brain.

Scientists have continued research to develop the technology with the goal of standardization and widespread use in actual clinical settings. In particular, increased understanding of the brain structures and functions related to addiction has contributed to enhancing the effectiveness of TMS procedures. Some researchers are also studying methods that utilize brain imaging for personalized treatments tailored to individuals.

In this regard, a 2021 study on TMS procedures by a research team from Ben-Gurion University in Israel was an important finding. The team conducted clinical trials on 262 long-term smokers, administering TMS treatments every weekday for the first three weeks, then once a week for the following three weeks. Half of the participants received actual magnetic stimulation to the brain, while the other half were given a placebo treatment that produced similar sounds but no magnetic stimulation. After the clinical trial, the team observed the participants' smoking behavior for four weeks through self-reports and urine tests.

The results showed that 28% of those who received the actual TMS treatment maintained smoking cessation, more than twice the 12% rate of the placebo group. Additionally, more participants reported a decrease in smoking cravings. Although the smoking cessation success rate was lower than other FDA-approved therapies such as smoking cessation aids, most other treatments relied on relatively less reliable methods like self-reporting or carbon monoxide tests to determine cessation. In contrast, TMS procedures applied strict criteria, so despite the lower numbers, the results were clinically significant.

Side effects were minimal. Only a very small number of participants reported headaches or discomfort during the procedure. No participants experienced seizures, the most concerning side effect. However, there have been reports that TMS procedures for other treatments can cause seizures at a rate of about 1 in 5,000. Therefore, TMS treatments for smoking cessation are currently only available under medical supervision. In the U.S., some insurance companies cover TMS treatments for depression but not yet for smoking cessation. Currently, TMS procedures are available at about 50 hospitals and psychiatric clinics worldwide, mainly in the U.S., as well as in Europe and India.

TMS was originally approved in 2008 for depression treatment and later, in 2018, for obsessive-compulsive disorder. However, its use for treating addiction disorders such as smoking is still in the early stages. Scientists believe that TMS could be used to treat various addiction patients, including those addicted to other drugs. Michael Fox, a professor of neurology at Harvard Medical School, stated, "Targeting the brain regions responsible for symptoms has already been proven effective for treating various brain disorders," and expressed a positive outlook that TMS will help treat addiction patients such as smokers.