Impact of a Naturalistic Psychedelic Experience on Smoking: A Retrospective Survey

Introduction

Tobacco use disorder remains a major public health problem worldwide and in France specifically, where around 30% of adults smoke and smoking is the leading preventable cause of death. Existing pharmacological treatments (varenicline, bupropion, nicotine replacement) and behavioural therapies produce modest long‑term quit rates (around 15% abstinent at six months in routine conditions). Psychedelic compounds attracted attention as potential treatments for addiction as early as the 1940s, and a recent renaissance has produced controlled studies in disorders such as treatment‑resistant depression and substance use disorders. Mechanistic hypotheses include serotonergic agonism at 5‑HT2A receptors and psychological processes such as increases in psychological flexibility; prior work also links the intensity of the acute psychedelic or ‘‘mystical’’ experience to clinical benefit. Romeo and colleagues set out to examine whether a single naturalistic psychedelic experience, recalled retrospectively, is associated with changes in tobacco consumption among people who were smokers at the time of that experience. Unlike a prior retrospective survey that sampled only individuals who reported smoking reductions, this study aimed to include all respondents who had been daily smokers during a psychedelic episode, and to test whether characteristics of the experience (mystical intensity, motive) and changes in psychological flexibility predict smoking reduction or cessation.