In 2022, half of American smokers attempted to quit, with a one in 10 success rate, according to the latest data from the Centres for Disease Control and Prevention.
Existing treatments such as medications, antidepressants, nicotine replacement therapy and counselling typically fail after six months, according to the study published yesterday in JAMA Network Open.
It’s hard to stop smoking because nicotine, a stimulant and the main addictive drug in cigarettes, triggers a chemical in the brain that makes people feel good.
Researchers think psilocybin was effective because it influenced psychological systems, changed self-perception and influenced behaviours, rather than targeting withdrawal or altering the way nicotine acts in the body.
Biologically, psychedelics temporarily alter brain communication patterns and may promote neuroplasticity - the brain’s ability to form new connections, said lead researcher Matthew Johnson, a professor of behavioural pharmacology at Johns Hopkins University.
“During the trip itself, the brain is communicating with itself in a radically different way,” he explained.
While some participants were fascinated by the effects of psychedelics, most were just desperate to quit smoking, Johnson said.
Smoking kills about 480,000 people in the US annually and more than eight million globally, according to data provided in the study.
“They’d say things like, ‘I’ve tried everything but the kitchen sink,’” Johnson said. The results were better than expected, he added.
He emphasised that while psilocybin is not physically addictive, it can be abused and requires careful supervision.
Participants were monitored throughout the five-to-six-hour experience, with medical staff on hand. No serious adverse events were reported, though some experienced temporary spikes in blood pressure or intense anxiety.
“People can be really anxious, even terrified during the experience,” Johnson said.
Growing interest
This was a small study, building off Johnson’s previous pilot, but the findings suggest psilocybin-assisted therapy for smoking cessation warrants larger, more diverse trials.
Still, funding for psychedelic-assisted therapy has lagged. From 2006 to 2020, the United States National Institutes of Health did not provide direct grant support for standalone clinical trials of therapeutic psychedelic use.
“This whole psychedelic industry didn’t exist when I started this line of work,” he said.
Now, several companies are working to shed psychedelics’ countercultural image and pursue FDA approval for psilocybin-based treatments.
Political interest has also increased. US Health Secretary Robert F. Kennedy jnr has voiced support for expanding psychedelic access for veterans with post-traumatic stress disorder and has said the Trump Administration wants to make such treatments available in clinical settings this year.
Johnson said responsible commercial development is likely necessary to fund the large trials required for FDA approval.
While some academics are wary of profit motives in psychedelic medicine, he argues industry participation could accelerate access if safety standards are upheld.
“It could help potentially millions of people, but we have to be cautious and follow the FDA path,” he said.
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