Modulating neural mechanisms of reward processing in tobacco users

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Be between the ages of 18 and 60 years old * Smoke 10 or more cigarettes per day and have a carbon monoxide (CO) level greater than 10 ppm indicative of recent smoking * Have not received substance abuse treatment within the previous 30 days * Meet criteria for Tobacco Use Disorder as determined by the Mini International Neuropsychiatric Interview (MINI): meeting 4 or more of the 11 diagnostic symptoms of Tobacco Use Disorder within a 12-month period * If female, test non-pregnant * Show no evidence of focal or diffuse brain lesions on MRI * Be willing to provide informed consent * Be able to comply with protocol requirements and likely to complete all study procedures * Be motivated to quit smoking, based on a response of "very likely" or "somewhat likely" on the Motivation to Stop Scale (scores 4-7) Exclusion Criteria: * Meeting MINI diagnostic criteria for any non-tobacco substance use disorder other than Caffeine Use Disorder, Cannabis Use Disorder - Mild, or Alcohol Use Disorder - Mild (Mild defined as meeting 2 to 3 of the 11 diagnostic symptoms within a 12-month period) * Contraindications to MRI (e.g., metal in the skull, orbital, or intracranial cavity, or claustrophobia) * Contraindication to repetitive TMS * History of autoimmune, endocrine, viral, or vascular disorders affecting the brain * History or MRI evidence of a neurological disorder causing local or diffuse brain lesions or significant physical impairment * Unstable cardiac disease, uncontrolled hypertension, severe renal or liver insufficiency, or sleep apnea * Lifetime history of major Axis I disorders as confirmed by the MINI, including bipolar affective disorder, schizophrenia, post-traumatic stress disorder, suicidal ideation, or major depression * Current use of tobacco cessation pharmacotherapies, including nicotine patches, electronic cigarettes, gum, nasal spray, inhalers, nicotine lozenges, varenicline, or bupropion * Previous treatment with TMS