Neuroimaging Correlates and Feasibility of Transcranial Magnetic Stimulation (TMS) to Improve Smoking Cessation Outcomes in Veterans With Comorbid PTSD

This study is testing whether a brain stimulation therapy called repetitive transcranial magnetic stimulation (rTMS) — a non-invasive procedure that uses magnetic pulses to stimulate areas of the brain — can improve smoking cessation rates in US military veterans who have both tobacco use disorder and post-traumatic stress disorder (PTSD). The study also uses brain imaging (MRI) to understand how rTMS works. **You may be eligible if...** - You are a US veteran between 18 and 75 years old - You have PTSD and smoke at least 10 cigarettes per day (for the past 6 months) - You are motivated to try to quit smoking - Your psychiatric medications have been stable for at least 3 months - You can read and write English **You may NOT be eligible if...** - You have a substance use disorder (other than tobacco) in the past 3 months - You have had a heart attack in the past 6 months or a condition that makes nicotine replacement unsafe - You have any condition that makes TMS or MRI unsafe (metal implants in the head, seizure history, pacemaker, cochlear implant, deep brain stimulator, etc.) - You are pregnant - You are currently taking bupropion or varenicline (smoking cessation medications) - You have previously received rTMS treatment Talk to your doctor to see if this trial is right for you.