A Study Of Vagal Nerve Stimulation In Conjunction With NRT For Smoking Cessation

Overview

About this study

The purpose of this study is to provide preliminary evidence for the efficacy of 12 weeks of vagal nerve stimulation (VNS) and nicotine replacement therapy (NRT) for increasing smoking abstinence rates.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

* 18 years of age or older at the time of consent.
* Currently smoking at least 10 cigarettes/day
* Motivated to stop smoking (on a scale of 0 to 10, motivation must be 3 or above);
* Ability to participate fully in all aspects of the study.
* Have the ability to provide informed consent.
* Have no contraindicating comorbid health conditions that would interfere with study participation, as determined by the clinical investigators.

Exclusion Criteria:

* Patients with a current moderate/severe depression as assessed by a score of ≥10 on the Patient Health Questionnaire-9 (PHQ-9).
* Patients who are or have used an investigational drug within the past 30 days.
* Patients who are currently using medication(s) known to interact with varenicline.
* Patients who have clinically significant acute/chronic progressive or unstable neurologic, hepatic, renal, cardiovascular, psychological, respiratory, or metabolic disease.
* Patients with a known allergy to nicotine patches or varenicline.
* Patients with a personal history of acute pancreatitis, hypoglycemia, acute kidney injury or impairment of renal function, type 1 diabetes or diabetic ketoacidosis, and/or severe gastrointestinal disease such as gastroparesis.
* Patients with an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device.
* Patients diagnosed with narrowing of the arteries (carotid atherosclerosis)
* Patients who have had surgery to cut the vagus nerve in the neck (cervical vagotomy)
* Patients with clinically significant hypertension, hypotension, bradycardia, or tachycardia
* Patients who have a metallic device such as a stent, bone plate, or bone screw implanted at or near your neck
* Patients who are using another device at the same time (e.g., TENS Unit, muscle stimulator) or any portable electronic device (e.g., mobile phone).
* Women who are pregnant or lactating, or who are of childbearing potential and are likely to become pregnant during the medication phase but are not willing to use a reliable form of contraception, will also be excluded.

1. Reliable forms of contraception include oral contraception, diaphragm or condom (with spermicide), injections, intrauterine devices, surgical sterilization, and abstinence. The study does not include vulnerable populations.
2. Specifically, the study does not include fetuses, neonates, pregnant women, children (<18 years of age), prisoners, institutionalized individuals, or other vulnerable populations.

i. All female participants of childbearing potential must have a negative pregnancy test and must agree to use approved contraception during study participation.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 09/09/2026. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Ryan Hurt, M.D., Ph.D.

Open for enrollment

Contact information:

Shawn Fokken

5072932740

GIMResearchStudies@mayo.edu

More information

Publications

  • Conventional cigarette smoking remains a leading preventable cause of morbidity and mortality despite declining prevalence, yet evidence-based treatments remain underused. This narrative review examines guideline-supported therapies and emerging approaches, including digital tools, neuromodulation, and harm-reduction strategies. Standard care typically combines FDA-approved pharmacotherapy with behavioral counseling. Digital interventions can extend access and support adherence, particularly when integrated with pharmacotherapy and follow-up. Repetitive transcranial magnetic stimulation (rTMS) can be considered as an adjunctive option for patients who do not respond to pharmacotherapy and is FDA-approved. For patients unable to quit, structured harm-reduction strategies may help reduce risk while supporting progression toward eventual abstinence. These approaches should be used alongside, not in place of, guideline-recommended pharmacotherapy and behavioral counseling, which remain the gold standard for care. This review outlines a pragmatic, primary care-oriented model that integrates stepped-care with harm-reduction strategies. Read More on PubMed