It’s notoriously difficult to quit smoking. Nicotine, despite being legal, is of the most addictive recreational drugs you can use, behind only methamphetamine and heroin; as a result, the success rate for quitting nicotine is low. However, promising new clinical trials have found that smokers see success when they take psychedelics for smoking cessation.

Psychedelics are mind-altering drugs that cause hallucinations, altered perception of self, and increased openness to new ways of thinking. Studies suggest that pairing psychedelics with talk therapy may be an effective way to quit smoking.

Here’s a look at the research on psychedelics for smoking cessation, as well as where you can try psychedelic-assisted therapy.

Understanding Nicotine Addiction

Nicotine is the active ingredient in tobacco products (cigarettes, cigars, dip, chew) and vaporizers (vapes). It’s common across cultures and is one of the more widely used drugs in the world.

Because nicotine is legal and widely available, many people don’t realize that it’s also one of the most addictive drugs you can use. A 2007 study ranked 20 common street drugs by their addictive potential; nicotine came in third, behind only heroin and cocaine. 1 Cigarette smoking is also the leading cause of preventable death worldwide. 2

In the United States, about 8.5% of people report being addicted to nicotine. 3 According to a 2018 survey, 55% of U.S. cigarette smokers tried to quit in the last year; of those who tried quitting, only 8% succeeded. 4

Current treatment for nicotine addiction has a low success rate and researchers are looking for new approaches. Psychedelic therapy is one of the most promising ones, although it’s still in its early stages.

Psychedelic Therapy for Smoking Cessation

From the 1950s to the 1970s, researchers conducted a few small studies on psychedelics and addiction. They discovered that giving patients LSD (acid) helped them break their addictions to alcohol and opiates. 5,6

In 2014, researchers at Johns Hopkins University School of Medicine drew inspiration from those early studies on psychedelics and addiction. They ran a pilot study in which they gave 15 cigarette smokers 2-3 moderate doses of psilocybin—the psychoactive compound in psychedelic mushrooms—along with 15 weeks of cognitive behavioral therapy, a type of therapy that is particularly effective for addiction. 7

After 6 months, 80% of smokers had successfully quit using nicotine. A long-term follow-up study found that, after two and a half years, 60% of participants still hadn’t used nicotine. 8

For reference, psilocybin-assisted therapy is about twice as effective as the current first line treatment for nicotine addiction, which combines continuous therapy, nicotine patches, and an antidepressant, and has about a 30% success rate after a year. 9

More follow-up research found that tobacco users who took psilocybin and had a mystical experience—such as meeting God, feeling a sense of oneness with the universe, or experiencing boundless peace, love, joy, etc.—were significantly more likely to quit smoking. 10,11

Other, less controlled research has found a similar link between psilocybin and quitting smoking. In a 2017 survey of psychedelic users who smoked, 38% said that they quit using nicotine on their own after taking a psychedelic (without any kind of therapy). 12

Taken together, this research shows a good deal of promise when it comes to psilocybin-assisted therapy for nicotine addiction.

However, it bears mentioning that these studies are small and aren’t too well-controlled. The research is still young, and it’s too early to draw firm conclusions about psychedelics for nicotine addiction.

Is Psilocybin Therapy Legal?

Psilocybin is currently federally illegal in the United States. Using or possessing psilocybin is a crime punishable by fines and time in prison.

At the time of this article’s publication, the only legal way to try psilocybin therapy for tobacco addiction is to sign up for a registered clinical trial

Alternatives for Smoking Cessation

Currently, there are a few strategies people use to quit smoking.

  • Nicotine replacement therapy (NRT). NRT uses nicotine patches, nicotine gum, and nicotine lozenges as a replacement for tobacco products. The idea is to use replacements throughout the day and gradually decrease the dose, eventually weaning yourself off nicotine entirely. An additional benefit is that nicotine replacements don’t contain the cancer-causing compounds that tobacco does.
  • Cognitive behavioral therapy (CBT). CBT is a special type of therapy that focuses on changing behavioral patterns. It’s one of the more effective types of therapy for addiction. You typically do CBT continuously for several months.
  • Buproprion. Bupropion (brand names Wellbutrin®, Aplenzin®, Forfivo®, and Zyban®) is a type of prescription antidepressant that also helps people quit nicotine. It works for about 20% of nicotine users. 13

Gold standard treatment often combines all three of the above therapies—nicotine replacement, cognitive behavioral therapy, and bupropion. A 2008 study found that using the three together helped about 30% of smokers quit using nicotine. 9

Frequently Asked Questions

Here are a few common questions about using psychedelics for smoking cessation.

Which psychedelic drugs help reduce nicotine cravings?

Early research suggests that psilocybin, the active ingredient in psychedelic mushrooms, may help people quit nicotine, particularly when combined with therapy. However, psilocybin is currently federally illegal in the United States.

Buproprion, a non-psychedelic prescription antidepressant, has also been found to reduce nicotine cravings. About 20% of people who take buproprion quit smoking successfully.

Is psilocybin therapy legal?

At the time of this article’s publication, psilocybin is a federally illegal controlled substance in the United States. Possessing or using psilocybin can result in fines or time in prison. Currently, the only legal way to try psilocybin therapy for nicotine addiction is to sign up for a registered clinical trial.

What are tips for someone who wants to quit smoking?

  • The first few days after you quit smoking are the toughest.
  • Withdrawal symptoms peak 1-3 days after your last cigarette. After that, your cravings will drop off considerably.
  • Keep in mind that nicotine cravings only last about 10 minutes. If you can distract yourself for 10 minutes, the craving will likely pass. Have a distraction plan ready for those times when cravings surface.

Final Thoughts

Psilocybin-assisted therapy shows promise as a way to help people quit smoking. Early research is very positive, with successful quitting rates that are almost double the success rates of current leading therapies.

However, research on psychedelics for smoking cessation is still early, and psychedelic drugs are still federally illegal in the United States. Psilocybin therapy for nicotine addiction is not currently a legal option.

That said, psilocybin recently received Breakthrough Therapy status from the FDA for both treatment-resistant depression and major depressive disorder. It’s becoming more mainstream and could be legal for therapeutic use in the coming years.

Until then, if you want to try taking a psychedelic for smoking cessation, your best bet is to sign up for a government-approved clinical trial.

 

 

References

1. Nutt D, King LA, Saulsbury W, Blakemore C. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet. 2007;369(9566):1047-1053. doi:10.1016/S0140-6736(07)60464-4

2. WHO report on the global tobacco epidemic 2021: addressing new and emerging products. Accessed May 27, 2022. 

3. What is the scope of tobacco, nicotine, and e-cigarette use in the United States? | National Institute on Drug Abuse (NIDA). Accessed May 26, 2022. 

4. Creamer MR, Wang TW, Babb S, et al. Tobacco Product Use and Cessation Indicators Among Adults – United States, 2018. MMWR Morb Mortal Wkly Rep. 2019;68(45):1013-1019. doi:10.15585/mmwr.mm6845a2

5. Krebs TS, Johansen P-Ø. Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials. J Psychopharmacol (Oxford). 2012;26(7):994-1002. doi:10.1177/0269881112439253

6. Savage C, McCabe OL. Residential psychedelic (LSD) therapy for the narcotic addict. A controlled study. Arch Gen Psychiatry. 1973;28(6):808-814. doi:10.1001/archpsyc.1973.01750360040005

7. Johnson MW, Garcia-Romeu A, Cosimano MP, Griffiths RR. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol (Oxford). 2014;28(11):983-992. doi:10.1177/0269881114548296

8. Johnson MW, Garcia-Romeu A, Griffiths RR. Long-term follow-up of psilocybin-facilitated smoking cessation. Am J Drug Alcohol Abuse. 2017;43(1):55-60. doi:10.3109/00952990.2016.1170135

9. Killen JD, Fortmann SP, Schatzberg AF, et al. Extended cognitive behavior therapy for cigarette smoking cessation. Addiction. 2008;103(8):1381-1390. doi:10.1111/j.1360-0443.2008.02273.x

10. Garcia-Romeu A, Griffiths RR, Johnson MW. Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Curr Drug Abuse Rev. 2014;7(3):157-164. doi:10.2174/1874473708666150107121331

11. Noorani T, Garcia-Romeu A, Swift TC, Griffiths RR, Johnson MW. Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. J Psychopharmacol (Oxford). 2018;32(7):756-769. doi:10.1177/0269881118780612

12. Johnson MW, Garcia-Romeu A, Johnson PS, Griffiths RR. An online survey of tobacco smoking cessation associated with naturalistic psychedelic use. J Psychopharmacol (Oxford). 2017;31(7):841-850. doi:10.1177/0269881116684335

13. Wilkes S. The use of bupropion SR in cigarette smoking cessation. Int J Chron Obstruct Pulmon Dis. 2008;3(1):45-53. doi:10.2147/copd.s1121