Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

This long-term, qualitative follow-up study (n=12) dissects the factors that lead to long-term smoking cessation. Vivid insights, rapport with the study team, and good preparation were some factors that led to this effect.

Abstract of Psychedelic therapy for smoking cessation

“Background: Recent pilot trials suggest feasibility and potential efficacy of psychedelic-facilitated addiction treatment interventions. Fifteen participants completed a psilocybin-facilitated smoking cessation pilot study between 2009 and 2015.

Aims: The aims of this study were as follows: (1) to identify perceived mechanisms of change leading to smoking cessation in the pilot study; (2) to identify key themes in participant experiences and long-term outcomes to better understand the therapeutic process.

Methods: Participants were invited to a retrospective follow-up interview an average of 30 months after initial psilocybin sessions. Semi-structured interviews were conducted with 12 of the 15 participants. Data were analysed using thematic analysis.

Results: Participants reported gaining vivid insights into self-identity and reasons for smoking from their psilocybin sessions. Experiences of interconnectedness, awe, and curiosity persisted beyond the duration of acute drug effects. Participants emphasised that the content of psilocybin experiences overshadowed any short-term withdrawal symptoms. Preparatory counselling, strong rapport with the study team, and a sense of momentum once engaged in the study treatment were perceived as vital additional factors in achieving abstinence. In addition, participants reported a range of persisting positive changes beyond smoking cessation, including increased aesthetic appreciation, altruism, and pro-social behaviour.

Conclusions: The findings highlight the value of qualitative research in the psychopharmacological investigation of psychedelics. They describe perceived connections between drug- and non-drug factors, and provide suggestions for future research trial design and clinical applications.”

Authors: Tehseen Noorani, Albert Garcia-Romeu, Thomas C. Swift, Roland R. Griffiths & Matthew W. Johnson

Notes on Psychedelic therapy for smoking cessation

  • At 30 months (2,5 years) after the therapies (counselling, 3x psilocybin at 20 and 30mg/70kg) 60% of participants were still smoking-abstinent
  • Profound personal experiences (during the session) were the reasons each (non-smoking) participant gave for quitting
  • The paper is full of qualitative examples (quotes) that may be useful for future research

This paper builds on Johnson et al. (2014) which was the pilot study on smoking cessation. Also see the quantitative long-term follow-up (Johnson et al., 2017) which showed that at 30 months on average 60% was still abstinent.

“The aims of this study were as follows: (1) to identify perceived mechanisms of change leading to smoking cessation in the pilot study; (2) to identify key themes in participant experiences and long-term outcomes to better understand the therapeutic process.”

An ultimate goal of this is to better understand what in the psychedelic experience helps (or helped the smokers) and see how this can be used or surfaced in future research. “… such experiences can offer insights for improving best practice in the emerging field of psychedelic research and psychotherapy for substance use disorders.”

“A sub-theme that emerged regarding six participants’ prior experiences with smoking was its ability to produce strong feelings of connection.”

Smoking (or cigarettes) was seen as a friend, a companion and/or a way to connect to others.

“All 11 participants reported gaining profound insights into their self-identity or smoking behaviour. Themes of interconnectedness, awe, and curiosity were identified as additional features of psilocybin sessions that helped participants quit smoking. Finally, all participants who successfully quit after their TQD reported marked post-session reductions in cigarette withdrawal symptoms in comparison with previous quit attempts.”

Seven of the participants indicated that they gained valuable insight into themselves. The sessions showed an (earlier) better self. For others, it showed that their identity was not linked to smoking.

Again seven participants said they gained insight into their smoking behavior. They thought about the underlying reasons for smoking (e.g. anxiety) and the commitment to smoking (they wanted to break).

Eight participants experienced feelings of interconnectedness. This was also linked to the negative effects of smoking (pollution, harm to health).

Six participants (of the 11) had sustained feelings of awe (which overshadowed their ‘mundane’ smoking habits).

The participants had reduced withdrawal symptoms and cravings, 7 even experienced no withdrawal symptoms. Importantly this was (after the first session) so for participants with a positive experience, not so for those (2) with a negative experience.

The counseling also positively contributed to the smoking cessation. One specific mentioned was the mantra they made for themselves (mission statement about key motivations to quit smoking). Another was the rapport built up with the councilors themselves.

It’s hard to distill from this study how much this and other ‘normal’ interventions (like keeping a smoking diary) are necessary components. Participants do mention them as needed (especially those with a negative first experience). Yet the amount of counseling is not something that would make this a viable method to help (the general public) to stop smoking.

“…two sessions using ascending doses may represent a good middle-ground for future clinical research in psychedelic-assisted addiction treatment.”

In the discussion, there is a reflection on the number of sessions. A second session may be necessary to gain more insight. A third seems to yield little extra benefit.

Summary of Psychedelic therapy for smoking cessation

Recent research has shown that psilocybin, a naturally occurring psychedelic found in so-called magic mushrooms, may have therapeutic potential in the treatment of tobacco and alcohol use disorders.

Laboratory studies and epidemiological data suggest that psychedelics can occasion lasting changes in mood, behaviours, and attitudes. Observational studies have also shown that religious users of ayahuasca have decreased rates of alcohol and other drug misuse.

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Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

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Cite this paper (APA)

Noorani, T., Garcia-Romeu, A., Swift, T. C., Griffiths, R. R., & Johnson, M. W. (2018). Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Journal of Psychopharmacology32(7), 756-769.

Study details

Compounds studied

Topics studied
Addiction Smoking

Study characteristics
Original Re-analysis Follow-up Interviews Qualitative

12 Humans


Authors associated with this publication with profiles on Blossom

Albert Garcia-Romeu
Albert Garcia-Romeu is one of the principal researchers in the renaissance of psychedelics studies. He is doing his research at Johns Hopkins and focuses on psilocybin and how it can help with treating addiction.

Roland Griffiths
Roland R. Griffiths is one of the strongest voices in psychedelics research. With over 400 journal articles under his belt and as one of the first researchers in the psychedelics renaissance, he has been a vital part of the research community.

Matthew Johnson
Matthew Johnson is an Associate Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University. His research is concerned with addiction medicine, drug abuse, and drug dependence.


Institutes associated with this publication

Johns Hopkins University
Johns Hopkins University (Medicine) is host to the Center for Psychedelic and Consciousness Research, which is one of the leading research institutes into psychedelics. The center is led by Roland Griffiths and Matthew Johnson.

Compound Details

The psychedelics given at which dose and how many times

Psilocybin 20 - 30
mg | 3x

Linked Research Papers

Notable research papers that build on or are influenced by this paper

Long-term follow-up of psilocybin-facilitated smoking cessation
This follow-up study (n=15) found that at 12 months 67% of participants didn't return to smoking (biologically confirmed). This was 60% at an average of 30-month follow-up. This study is the first (very positive) step in seeing if psilocybin-assisted psychotherapy (PAT) may be viable for people to quit smoking.

Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction
This is the first study to use psilocybin and cognitive behavioural therapy (CBT) in concert for smoking cessation in an open-label format. Participants received a moderate (20 mg/70kg) and high (30 mg/70kg) of psilocybin with a 15-week smoking cessation protocol. At the six-month follow-up, 80% of participants were smoking-free.

Linked Clinical Trial

Psilocybin-facilitated Smoking Cessation Treatment: A Pilot Study
The investigators propose to examine psilocybin administration combined with a structured smoking cessation treatment program in nicotine dependent individuals in order to provide preliminary data on the efficacy of this combined treatment for smoking cessation.

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