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New Treatment Shows Promise for Helping Veterans With PTSD Quit Tobacco

Published on Thu Sep 07 2023Verstreute Zigaretten auf Schwarz: Symbol für die Gesundheitsgefahren des Rauchens | Kostenlose Bilder mit KI on Flickr Verstreute Zigaretten auf Schwarz: Symbol für die Gesundheitsgefahren des Rauchens | Kostenlose Bilder mit KI on Flickr

Tobacco use remains a dire public health challenge, especially among U.S. veterans where it is compounded by the high prevalence of posttraumatic stress disorder (PTSD). Traditional smoking cessation methods have fallen short, particularly for these veterans whose quitting success rate lags at a mere 4.5%. Addressing this critical gap, a bold new study proposes a novel multimodal treatment—combining transcranial magnetic stimulation (TMS), cognitive behavioral therapy (CBT), and nicotine replacement therapy (NRT). This approach aims to disrupt the entrenched addiction by targeting the brain’s insula region to facilitate smoking cessation. With the initiation of a feasibility randomized controlled trial (RCT), there is renewed hope that this innovative therapy could significantly raise abstinence rates among veterans battling both nicotine addiction and PTSD.

This RCT spearheaded by researchers from Duke University School of Medicine, as well as several other institutions, seeks to explore the insula’s role in addiction and manipulate its activity to aid in quitting smoking. Dysregulated functional connectivity between the brain's salience network and executive control network, both of which involve the insula, has been associated with a heightened focus on craving states. By modulating this connectivity using intermittent theta burst stimulation (iTBS) applied to a specific brain region, the researchers believe they can improve the efficacy of smoking cessation treatments.

The trial will enroll 50 veterans with coexisting PTSD and tobacco use disorder, randomly assigning them to an active treatment group (receiving iTBS) or a control group (receiving a sham procedure). Both groups will also undergo CBT and use NRT. The researchers hope to prove that this integrated treatment enhances quitting success far beyond existing methods by providing the support necessary for sustained abstinence. This study represents a potential paradigm shift in how we approach addiction among individuals with psychiatric comorbidities and has the potential to translate into widespread clinical practice if proven effective.

Understanding this research's implications is vital, as successful interventions could save countless lives and significantly reduce the healthcare burden associated with smoking-related diseases. As this trial embarks on its journey, it stands as a testament to the relentless pursuit of better treatment options for those who have served their country and now face the battle of overcoming addiction.


Written by Young, J. R., Galla, J. T., Polick, C. S., Deng, Z.-D., Dannhauer, M., Kirby, A., Dennis, M., Papanikolas, C. W., Evans, M. K., Moore, S. D., Dedert, E. A., Addicott, M. A., Appelbaum, L. G., Beckham, J. C.
Tags: Medicine | Medicine:Addiction

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