Article type
Year
Abstract
Background: Transcranial magnetic stimulation (TMS) is concerned for smoking cessation for a long time. Many studies have explored its effectiveness in smoking cessation because of its convenience and operability.
Objectives: To evaluate the effectiveness and safety of TMS for assisting people to quit smoking.
Methods: This review searched six databases in December 2019. The randomized controlled trials (RCTs) on TMS for smoking cessation amongst smokers were included. The Cochrane Risk of Bias (CROB) tool was used to assess the risk of bias of the included trials. RevMan 5.3 software was used to perform meta-analysis on the number of daily smoking, the quitting rate, Fagerstrom Test of Nicotine Dependence (FTND) Scores, positive and Negative Syndrome Scale (PANSS) scores, Montgomery Asberg Depression Rating Scale (MADRS) scores and adverse event. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method was used to evaluate the quality of evidence.
Results: Six trials involving 303 smokers were included, which were conducted in China (4, 75%), Israel and Czech Republic. All studies were rated as unclear risk of bias. The results of meta-analysis shown that, comparing with the sham TMS, TMS significantly decreased the average daily number of cigarettes smoked (6 trials, WMD=-7.35, 95% CI [-8.16, -6.53], P＜0.05), PANSS score (WMD=-2.85, 95% CI [-5.29, -0.41], P＜0.05), MADRS score (WMD=-3.18, 95% CI [-8.22, -3.34], P＜0.05) and FTND Score (WMD=-0.89, 95% CI [-1.30, -0.48], P＜0.05), and significantly improved the smoking cessation rates (OR=3.94, 95% CI [1.09, 14.19], P＜0.05). Adverse event was only reported a mild headache. As for the quality of evidence, two outcomes (the number of daily smoking and quitting rate) were rated as Low, the others were rated as Very Low.
Conclusions: TMS might provide effective support to people trying to stop smoking. However, this conclusion is based on low-certainty evidence, limited by risk of bias and imprecision. We need higher quality research to explore these conclusions.
Objectives: To evaluate the effectiveness and safety of TMS for assisting people to quit smoking.
Methods: This review searched six databases in December 2019. The randomized controlled trials (RCTs) on TMS for smoking cessation amongst smokers were included. The Cochrane Risk of Bias (CROB) tool was used to assess the risk of bias of the included trials. RevMan 5.3 software was used to perform meta-analysis on the number of daily smoking, the quitting rate, Fagerstrom Test of Nicotine Dependence (FTND) Scores, positive and Negative Syndrome Scale (PANSS) scores, Montgomery Asberg Depression Rating Scale (MADRS) scores and adverse event. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method was used to evaluate the quality of evidence.
Results: Six trials involving 303 smokers were included, which were conducted in China (4, 75%), Israel and Czech Republic. All studies were rated as unclear risk of bias. The results of meta-analysis shown that, comparing with the sham TMS, TMS significantly decreased the average daily number of cigarettes smoked (6 trials, WMD=-7.35, 95% CI [-8.16, -6.53], P＜0.05), PANSS score (WMD=-2.85, 95% CI [-5.29, -0.41], P＜0.05), MADRS score (WMD=-3.18, 95% CI [-8.22, -3.34], P＜0.05) and FTND Score (WMD=-0.89, 95% CI [-1.30, -0.48], P＜0.05), and significantly improved the smoking cessation rates (OR=3.94, 95% CI [1.09, 14.19], P＜0.05). Adverse event was only reported a mild headache. As for the quality of evidence, two outcomes (the number of daily smoking and quitting rate) were rated as Low, the others were rated as Very Low.
Conclusions: TMS might provide effective support to people trying to stop smoking. However, this conclusion is based on low-certainty evidence, limited by risk of bias and imprecision. We need higher quality research to explore these conclusions.