Empirical estimate for the indirect healthcare costs of sickle cell disease from a retrospective cohort study in England between 2007 and 2019.

Nicotine addiction remains a global public health crisis. As of 2023, an estimated 23% of the global population was addicted to cigarettes, with a smoking prevalence of 13.7% among individuals aged 12 and older in the United States. Although behavioral and pharmacological interventions are effective for some individuals, resumption of smoking following a cessation attempt is common, with rates reaching as high as 83% within six months in some cases, underscoring significant treatment resistance and the urgent need for novel therapeutic interventions. Transcranial magnetic stimulation (TMS) is a widely used, non-invasive brain stimulation technique that modulates neural activity through magnetic pulses. It is FDA-cleared as a safe and effective treatment for several treatment-resistant psychiatric disorders, including major depressive disorder and obsessive-compulsive disorder, and accumulating evidence suggests potential benefits for substance use disorders. Most recently, the FDA cleared deep TMS (dTMS) for short-term smoking cessation, recognizing its potential as a treatment for Tobacco Use Disorder. Despite its promise, abstinence rates with TMS remain modest. For example, in a pivotal trial of dTMS for smoking cessation, only 25% of individuals achieved abstinence beyond 6 weeks. One factor that may limit TMS efficacy is that the optimal neuroanatomical target for treating nicotine addiction remains unclear. Neuroimaging studies of the human brain have identified several neuroanatomical correlates of nicotine addiction. However, these neural correlates are not necessarily causal, an important distinction when identifying therapeutic targets. Brain lesions and brain stimulation sites offer more direct evidence of causal relationships between symptoms and human neuroanatomy. Recently, brain lesion data were used to identify a brain circuit underlying remission from nicotine addiction. The topography of this circuit aligned well with a model of the electric field generated by the TMS coil cleared by the FDA for smoking cessation, suggesting that this lesion-based circuit could serve as a neuroanatomical target for TMS. However, this hypothesis remains to be directly tested.