Low Intensity Focused Ultrasound for Tobacco Use Disorder: High Resolution Targeting of the Human Insula

Inclusion Criteria: 1. Male and female veterans aged 18-75 years 2. Meet the Diagnostic and Statistical Manual, Fifth edition (DSM-5) criteria for current TUD (moderate to severe) as diagnosed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 3. Currently smoking \> 10 cigarettes per day with no period of abstinence \> 3 months in the last year 4. Current use of tobacco in last year is limited to cigarettes 5. Currently in Contemplation Stage of motivation for behavior change with respect to smoking as assessed by the University of Rhode Island Change Assessment Scale Exclusion Criteria: 1. Not under current treatment for smoking cessation. 2. No history of head injury, seizures, neurologic disorders including cerebrovascular disease, multiple sclerosis, or neurodegenerative diseases or major medical illness 3. Current substance use disorder for a psychoactive substance (except nicotine) 4. DSM-5 psychiatric disorder requiring current treatment 5. Ferromagnetic implants or other contraindications for MRI 6. Taking any psychotropic medication such as antidepressants, anxiolytics and antipsychotics. 7. any medication other than psychotropic medications that is known to cross the blood brain barrier and achieve brain penetrance such that it will alter BOLD signal or lower seizure threshold, such as antibiotics, antihistamines or muscle relaxants. 8. currently pregnant or breast feeding