Nicotine Addiction


Addiction to nicotine is the single issue that prevents millions from stopping smoking.

There is no doubt nowadays that smoking is extremely harmful, yet once the habit has formed, it is very difficult to break.

The Royal College of Physicians’ 2000 report on nicotine addiction states that

“…it is reasonable to conclude that nicotine delivered through tobacco smoke should be regarded as an addictive drug, and tobacco use as the means of self-administration”

“…Cigarettes are highly efficient nicotine delivery devices and are as addictive as drugs such as heroin or cocaine.”

Smoking tobacco (i.e. cigarettes, cigars, pipes) is the fastest way of delivering nicotine to the bloodstream and this makes it all the more potentially addictive. Furthermore, tobacco smoke includes a range of other chemicals which enhance the addictive nature of nicotine.

Smoking Health Risks

Smoking is one of the biggest causes of death and illness in the UK and accounts for around 100,000 deaths in the UK each year.

Smoking increases the risk of developing over 50 serious health conditions; some of which can be fatal while others can cause irreversible long-term health damage.


  • Smoking causes about 90% of lung cancers
  • Also causes cancer in many other parts of the body, including the: mouth, lips, throat, voice box (larynx), oesophagus (food pipe), bladder, kidney, liver, stomach, pancreas


  • Smoking while pregnant can endanger the health of both mother and unborn baby
  • Increases the risk of miscarriage, premature (early) birth, a low birth weight baby, stillbirth


  • Smoking damages your heart and your blood circulation
  • Increases risk of coronary heart disease, peripheral vascular disease (damaged blood vessels), cerebrovascular disease
  • Increase risk of heart attack and stroke

Lung Damage

  • Smoking damages the lungs
  • Increases risk of chronic obstructive pulmonary disease (COPD), which incorporates bronchitis and emphysema
  • Increases risk of pneumonia

Conventional Treatments

Stopping smoking is hard, but there is support. Some of this is available on the NHS, while other options are private

  • GPs can provide advice, nicotine replacement, stop smoking medication or referrals to stop smoking clinics
  • Stop smoking advisers are provided by the NHS
  • Nicotine patches, gums or sprays are available to help patients stop smoking through substitution
  • e-cigarettes (vaping) are also now available
  • Complementary therapies such as acupuncture or hypnotherapy can be helpful

Nicotine addiction is strong and none of these work without determined effort on the part of the patient. However, the rewards are almost immediate improvement to health and life expectancy.

rTMS Treatment to Stop Smoking

On the basis of research, we believe that rTMS – Repetitive Transcranial Magnetic Stimulation could offer an alternative treatment option for nicotine addiction.

Transcranial magnetic stimulation works directly on the associated areas of the brain and has shown excellent results in a variety of treatment areas, including helping people to stop smoking.

RTMS Treatment Centres

rTMS for nicotine addiction is available at an expanding network of Smart TMS clinics in the UK and Ireland.

Smart TMS was the first UK clinic to offer Transcranial Magnetic Stimulation therapy for anything other than depression and now offer treatment for addiction and a host of other mental health conditions.

For more information, please get in touch with us. You will be in contact with one of our patient advisors who will provide you with more information about the treatment programme and prices.

Stop Smoking

Nicotine Addiction and TMS Treatment

Evidence, Research and Studies

Research Studies

In the first double-blind cross-over study, 11 smoking dependent individuals who hoped to stop smoking were administered either active or sham rTMS over the left DLPFC at 90% of Resting Motor Threshold.

In the individuals who received active high-frequency rTMS over the DLPFC reported significantly reduced levels in smoking cravings, 30 minutes following the treatment, as compared to those who received sham stimulation.

(Johann et al., 2003)

In the second double-blind cross-over design study, 14 individuals who wished to stop smoking were administered 2 active, and 2 placebo-control sham rTMS in a randomized order for 4 consecutive days. High-frequency rTMS was applied to the left DLPFC at an intensity of 90% RMT, and smoking cravings were measured at baseline and 30 minutes after the rTMS session. During this 6 hour time period, the number of cigarettes smoked following rTMS applied to the left DLPFC was significantly decreased, with no change in the level of cravings. Treatment with high-frequency rTMS was, therefore, found to reduce the level of cravings for cigarettes in this study

(Eichammer et al, 2003)

In the third study with 10 session of high frequency rTMS to the left DLPFC over 2 weeks.  48 nicotine dependent individuals (>20 cigarettes daily) were randomized into 4 groups.  The study found that rTMS reduces but does not completely abolish craving and consumption of cigarettes

(Amiaz et al, 2009).

In the fourth study 15 volunteer smokers were recruited to investigate the effects of rTMS on subjective responses to smoking versus neutral cues and to controlled presentations of cigarette smoke. On different days, participants were exposed to three conditions: 1) high-frequency (10 Hz) rTMS directed at the superior frontal gyrus 2) low-frequency (1 Hz) rTMS directed at the superior frontal gyrus and 3) low-frequency (1 Hz) rTMS directed at the motor cortex (control condition).  Craving ratings in response to smoking versus neutral cues were differentially affected by the 10-Hz versus 1-Hz superior frontal gyrus condition. Craving after smoking cue presentations was elevated in the 10-Hz superior frontal gyrus, whereas craving after neutral cue presentations was reduced.  Upon smoking in the 10-Hz superior frontal gyrus condition, ratings of immediate craving reduction were attenuated

(Rose at al, 2011).

In the fifth study 16 non-treatment seeking, nicotine-dependent participants were randomized to receive either real high-frequency rTMS (10 Hz, 100% resting motor threshold, 5 second-on, 10 second-off for 15 minutes; 3000 pulses) or active sham TMS over the DLPFC in two visits with one week between visits. The participants received cue exposure before and after rTMS and rated their craving after each block of cue presentation. Stimulation of the left DLFPC with real, but not sham, rTMS reduced craving significantly from baseline (64.1± 5.9 vs. 45.7±6.4, t = 2.69, p = 0.018). When compared to neutral cue craving, the effect of real TMS on cue craving was significantly greater than the effect of sham TMS (12.5 ±10.4 vs. −9.1±10.4; t = 2.07, p = 0.049). More decreases in subjective craving induced by TMS correlated positively with higher Fagerström Test for Nicotine Dependence (FTND) score (r = 0.58, p = 0.031) and more cigarettes smoked per day (r = 0.57, p = 0.035)

(Xingbao et al 2013).

In a sixth study 37 smokers who failed to quit with the usual treatments were randomly assigned to two treatment groups to receive either active (n = 18) orsham (n = 19) low frequency rTMS of the right dorsolateral prefrontal cortex. The day after quitting smoking, each patient combined Nicotine patches with active or sham rTMS (10 sessions) for 2 weeks. Cessation support was then continued with nicotine patches alone using lower-dose patches.  At the end of the combined treatment, there were significantly more abstinent participants in the active rTMS group (n = 16) than in the sham rTMS group (n = 9) (P = 0.027). The craving scales analysis revealed that active rTMS  (P = 0.011) but not sham rTMS (P = 0.116) led to a significant decrease in the compulsive factor

(Trojak et al, 2015).

More recently a meta analysis was conducted on 4 of these studies.  This revealed a large and significant treatment effect size (Maita et al, 2016).