Effects of transcranial direct current stimulation on nicotine use disorder: a systematic review and meta-analysis.
Cindy P S Niap, Na Ooi, Hui E Ang et al.
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In 30 seconds
This systematic review and meta-analysis assessed transcranial direct current stimulation (tDCS) for smoking-related outcomes in people with nicotine use disorder. Across 21 studies, random-effects analyses compared tDCS with sham for craving (6 comparisons) and consumption (13 comparisons). tDCS was associated with a small reduction in craving (Hedges' g = -0.26, 95%CI [-0.51, -0.01]; moderate certainty) and a moderate reduction in consumption (Hedges' g = -0.48, 95%CI [-0.79, -0.17]; low certainty). Effects were observed within the first day after stimulation. Electrode-placement moderator analyses did not identify an effective placement.
Key findings
- Compared with sham, tDCS produced a small reduction in craving: Hedges' g = -0.26, 95%CI [-0.51, -0.01], with moderate certainty.
- Smoking consumption showed a moderate reduction versus sham: Hedges' g = -0.48, 95%CI [-0.79, -0.17], with low certainty.
- Both outcome effects were reported within the first day post-stimulation.
- Moderator analyses did not identify specific electrode placements that effectively reduced craving or intake.
Why it matters
The findings suggest that brain stimulation may influence short-term craving and smoking consumption, but the certainty differs by outcome and the evidence does not establish sustained cessation benefit. The distinction between short-term changes and successful smoking cessation is important when interpreting tDCS as a potential intervention. Neuroimaging findings from five studies offer additional insight into possible mechanisms, but further research is needed.
What to keep in mind
The reported effects were limited to the first day post-stimulation. Evidence certainty was low for consumption, and moderator analyses did not establish effective electrode placements.