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RecruitingNCT07292883Updated Apr 21, 2026

Accelerated dTMS Smoking Cessation

A Phase 2 interventional study of Bilateral deep accelerated repetitive transcranial magnetic stimulation in Tobacco Use Disorder and Addiction Nicotine, sponsored by Waypoint Centre for Mental Health Care. Recruiting at 2 sites in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-21.

Sponsored by Waypoint Centre for Mental Health Care · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to examine whether a 5-day course of bilateral accelerated deep transcranial magnetic stimulation (aTMS) is a feasible treatment to help adults (18-65) with Tobacco Use Disorder to quit smoking. This study aims to enroll 30-40 participants and will examine treatment tolerability, treatment acceptability, participant retention, and adherence to scheduled treatment sessions.

There are two key objectives and hypotheses:

Objective 1: To evaluate whether a 1-week course of bilateral aTMS (4 sessions per day for 5 days) is feasible and tolerable as a smoking cessation treatment.

Hypothesis 1: Feasibility will be demonstrated by acceptable tolerability, acceptability, retention, and adherence, with a practical target of 30 out of 40 participants completing the treatment.

Objective 2: To explore how aTMS affects smoking outcomes, including:

  • Point-prevalence abstinence at end of treatment and at Weeks 3, 5, and 9.
  • Prolonged/continuous abstinence at Weeks 13 and 26.
  • Craving, cigarettes per day, and dependence severity. Hypothesis 2: Participants will show improvements on these outcomes from post-treatment through follow-up.
02

Conditions studied

  • Tobacco Use Disorder
  • Addiction Nicotine

Keywords

  • addiction
  • smoking cessation
  • Transcranial Magnetic Stimulation
  • Accelerated Repetitive Transcranial Magnetic Stimulation
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Aged 18 years or older;
  2. Tobacco use disorder as assessed by DSM-5;
  3. Fagerstrom Test of Nicotine Dependence (FTND) ≥ 4;
  4. Reported motivation to quit within 30 days as assessed using the Contemplation Ladder score of ≥ 7;
  5. Must sign and date the informed consent form;
  6. Stated willingness to comply with all study procedures.
  7. Able to communicate in English.

Exclusion criteria

Exclusion Criteria:

  1. Reported smoking abstinence in the 3 months preceding screening visit;
  2. Current use of other smoking cessation aids;
  3. Contraindication to rTMS;
  4. Pregnancy, trying to become pregnant or breastfeeding;
  5. Current or recent history of cerebrovascular disease;
  6. Unstable major psychiatric disorder(s) (i.e. Axis I Disorders) that would prevent participation in the study at PI (or its delegate) discretion;
  7. Serious current or personal history of medical condition/disease (neurological disorders, brain lesions, multiple sclerosis, head trauma, loss of consciousness, hearing loss, etc.) preventing same inclusion as per PI (or its delegate) discretion;
  8. Current, personal history or family history of seizures;
  9. Concomitant use of medication that lowers seizure threshold, such as clozapine;
  10. Concomitant use of more than 2 mg lorazepam (or an equivalent) or any anticonvulsants.
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Accelerated Repetitive Transcranial Magnetic Stimulation

    Bilateral Accelerated Repetitive Transcranial Magnetic Stimulation targeting the insula and prefrontal cortex using H4 coil

    Device: Bilateral deep accelerated repetitive transcranial magnetic stimulation

Interventions

  • DeviceBilateral deep accelerated repetitive transcranial magnetic stimulation

    Accelerated Repetitive Transcranial Magnetic Stimulation (aTMS) is a type of treatment that will be used to target the bilateral insular cortex and prefrontal cortex using the Health Canada-approved H4 coil. The purpose is to test its feasibility on smoking abstinence. While convention rTMS methods involves one session daily over several weeks, aTMS delivers multiple sessions per day. Using the H4 deep aTMS, this study will implement 20 sessions over five consecutive days (four sessions daily).

    Also known as: Deep TMS, Accelerated TMS, Repetitive TMS

05

What researchers measure

Primary outcomes

  1. Percentage of Participants Who Discontinue Accelerated dTMS Due to Side Effects

    Tolerability will be assessed by calculating the percentage of participants who discontinue the 5-day accelerated dTMS treatment course due to side effects.

    Time frame: From week 1 day 1, to week 1 day 5 of treatment week.

  2. TMS Experience Questionnaire Acceptability Scores (Units on a Scale)

    Acceptability will be assessed using scores on the TMS Experience Questionnaire.

    Time frame: From week 1 day 1, to week 1 day 5 of treatment week.

  3. Percentage of Participants Completing the 5-day Accelerated dTMS Treatment Course

    Retention will be measured by the percentage of enrolled participants who complete the full 5-day accelerated dTMS treatment protocol (4 sessions per day for 5 days). The aim is 30 out of 40 participants (75%) completing the course.

    Time frame: From week 1 day 1, to week 5 day 5 of treatment week.

  4. Percentage of Treatment Sessions Attended

    Adherence will be measured by calculating the percentages of planned accelerated dTMS treatment sessions attended (20 sessions total over 5 days). For each participant, adherence will be calculated as number of sessions attended divided by 20, and then calculating a mean percentage.

    Time frame: From week 1 day 1, to week 1 day 5 of treatment week.

Secondary outcomes

  1. The percentage of participants achieving continuous short-term abstinence at follow up

    Measuring the percentage of participants who achieved 7-day point prevalence abstinence at the end of treatment, week 3, week 5, week 9, week, 13, week 26.

    Time frame: From week 1 day 5 of treatment to week 26.

  2. The percentage of participants achieving continuous long-term abstinence at follow up

    Calculating the percentage of participants who achieved prolonged and continuous absence at week 13 (3 months) and week 26 (6 months).

    Time frame: From week 1 day 1 of treatment to week 26.

  3. Change in Tobacco Craving Questionnaire-Short Form (TCQ-SF) Total Score (Units on a Scale)

    This outcome will examine changes in self-reported cravings using the TCQ-SF. TCQ-SF total scores will be compared from baseline to the end of treatment (week 26) and across follow-up visits (week 3, 5, 9, 13, 26).

    Time frame: From baseline to week 26.

  4. Change in Dependence Severity (Units on a Scale)

    This outcome will examine changes in nicotine dependence severity from baseline to the end of treatment (week 26) and during follow-up visits (week 3, 5, 9, 13) using the Fagerstrom Test for Nicotine Dependence (FTND).

    Time frame: From baseline to week 26.

  5. Change in Daily Cigarette Use (Number of Cigarettes per Day)

    This outcome will examine changes in self-reported cigarette consumption using the Timeline Follow Back method from baseline through follow-ups (week 3, 5, 9, 13) to the end of the study (week 26).

    Time frame: From baseline to week 26.

06

Study locations

1 of 2 sites recruiting
  • Waypoint Centre for Mental Health Care
    Penetanguishene, Ontario, Canada
    Recruiting
  • Sunnybrook Health Sciences Centre
    Toronto, Ontario, Canada
    Not yet recruiting
07

References and documents

Study documents

  • Study protocol · Nov 5, 2025
  • Informed consent form · May 20, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — There are no plans for use of your study data in other research.

08

Registry details

Key details

Study ID
NCT07292883
Lead sponsor
Waypoint Centre for Mental Health Care
Responsible party
Sponsor
First posted
Dec 18, 2025
Start date
Feb 24, 2026
Primary completion
Jan 2028 (estimated)
Completion
Jan 1, 2028 (estimated)
Last update
Apr 21, 2026

Study contacts

Florence Tang, MA
Contact
ftang@waypointcentre.ca
705-549-3181 ext. 3040
Vincent Wang, MD
Contact
xi-yu.wang@camh.ca
647-522-3415
Bernard Le Foll, MD, PhD, MCFP (AM) FCAHS
principal investigator · Waypoint Centre for Mental Health Care

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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