Trial PaperTobacco/Nicotine Use Disorder (TUD)Substance Use Disorders (SUD)Interpersonal Functioning & Social ConnectednessPsilocybin

Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

A qualitative follow-up of 12 participants in a psilocybin-facilitated smoking cessation pilot found that lasting abstinence was attributed to profound, vivid insights into self-identity and smoking motives produced by psilocybin, alongside enduring feelings of interconnectedness, awe and curiosity that outweighed withdrawal. Participants also emphasised preparatory counselling, strong rapport with the study team and treatment momentum as vital non‑drug factors, and reported broader lasting positives such as increased aesthetic appreciation and prosocial behaviour, offering guidance for future trials and clinical applications.

Authors

  • Albert Garcia-Romeu
  • Roland Griffiths
  • Matthew Johnson

Published

Journal of Psychopharmacology
individual Study

Abstract

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.

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Research Summary of 'Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts'

Introduction

Recent work with classic serotonergic 2A agonist hallucinogens has renewed interest in their potential as treatments for substance use disorders. Noorani and colleagues note that pilot trials and observational data have suggested psilocybin and other psychedelics can produce lasting changes in mood, behaviour and attitudes, and that prior open-label work combining psilocybin with psychological support produced promising smoking cessation rates relative to typical pharmacotherapies. However, the psychological mechanisms by which psychedelic-facilitated interventions produce change remain poorly understood, and quantitative measures (for example of mystical-type experiences) provide only part of the picture. This qualitative study aimed to characterise participant-reported mechanisms of change and to identify recurring themes in the lived experiences and longer-term outcomes of individuals who took part in a prior open-label psilocybin-facilitated smoking cessation pilot. The investigators sought to describe how drug-related experiences and non-drug treatment elements (for example preparatory counselling and rapport with guides) were perceived to contribute to quitting, and to surface participant suggestions relevant to future clinical research and protocol design.

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Study Details

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