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• Evidence for repetitive transcranial magnetic stimulation (rTMS) for smoking cessation is increasing. • One rTMS coil has recently received regulatory approval, signaling the potential for clinical adoption. • Implementation and dissemination into clinical practice requires planning and preparation. • Accessibility, technological, economical, and social challenges remain to be addressed. • Real-world effectiveness studies are needed, including the prevalence of comorbidities and vaping. Tobacco smoking is a significant determinant of preventable morbidity and mortality worldwide. It is now possible to modulate the activity of the neurocircuitry associated with nicotine dependence using repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive neurostimulation approach, which has recently demonstrated efficacy in clinical trials and received regulatory approval in the US and Canada. However there remains a paucity of replication studies and real-world patient effectiveness data as access to this intervention is extremely limited. There are a number of unique challenges related to the delivery of rTMS that need to be addressed prior to widespread adoption and implementation of this treatment modality for smoking cessation. In this paper, we review the accessibility, scientific, technological, economical, and social challenges that remain before this treatment can be translated into clinical practice. By addressing these remaining barriers and scientific challenges with rTMS for smoking cessation and delineating implementation strategies, we can greatly reduce the burden of tobacco-related disease worldwide. [ABSTRACT FROM AUTHOR]