Magic mushrooms could help people quit smoking
Nicotine is highly addictive, but new research is showing that psychedelics can shift people’s worldview in ways to help them give up cigarettes.
Tobacco is one of the toughest drugs to quit. The nicotine it contains is as addictive as cocaine and heroin – perhaps even more so. In surveys, around 70% of adult smokers say they want to quit. Yet of those who try, less than one in ten succeed in any given year.
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Evidence is growing, however, that certain psychedelic drugs might offer some people an off-ramp from smoking. In a 2017 survey, for example, 781 people said that tripping on LSD, magic mushrooms or another psychedelic had either allowed them to reduce smoking or quit altogether.
Why? The solution seems to be of the philosophical kind. Nearly all of those who managed to kick their nicotine habit reported a common insight: they suddenly felt that their life priorities or values had changed – specifically, that smoking no longer served them.
“The magnitude of the experience kind of overshadowed this previously insurmountable psychological challenge of quitting smoking,” says Matthew Johnson, lead author of the study and a professor of psychiatry and behavioural science at Johns Hopkins University, in the US.
Psychedelics to treat addiction
Psychedelic drugs have long been explored for their potential ability to alleviate various types of addiction. In the 1950s, researchers used LSD to treat alcoholism – sometimes successfully. MDMA has helped clinical trial participants with alcohol use disorder to significantly reduce or quit drinking. Anecdotal evidence and pilot studies, meanwhile, suggest that ibogaine, a psychoactive alkaloid from the Central African iboga shrub, can reduce opioid withdrawal symptoms and allow some people to stop using those drugs entirely.
When it comes to reductions in preventable mortality, though, Johnson and his colleagues’ work on psilocybin for smoking cessation “represents one of the most compelling and potentially impactful lines of inquiry in psychedelic science”, says Lynn Marie Morski, the executive director of the Psychedelic Medicine Association, who was not involved in the research.
A potential way out
In the latest study, Johnson and his colleagues recruited 82 participants and randomly assigned them to receive either a high dose of psilocybin – a capsule with about 30mg of the drug according to body weight – or a nicotine patch to wear for several weeks. During the trip, some people reflected on their smoking habits, while others didn’t. All of the participants also then received 10 sessions of cognitive behavioural therapy spread over 13 weeks, each about a week apart, in which they talked to a therapist about quitting smoking.
At the six-month mark, 52% of participants in the psilocybin group remained abstinent from cigarettes, compared with 25 per cent in the nicotine patch group.
Dominique Morisano, a clinical psychologist and adjunct professor at the University of Toronto, Canada, who was not involved in the work, says the new findings are “incredibly interesting”.
Why tripping works
Gül Dölen, a neuroscientist at the University of California, Berkeley, US, says that the new findings are consistent with her and her colleagues’ 2023 discovery that psychedelics can reopen “critical periods” in the brain – finite windows of heightened sensitivity and malleability that are usually restricted to childhood, when the individual is primed to learn new things.
In this case, psilocybin is creating “a window of opportunity for learning new habits around smoking, via cognitive behavioural therapy,” Dölen says. Ultimately, the durability of the therapeutic response is likely the lasting consequence of reconfiguring old brain patterns.
Morisano similarly suggests that therapists working with patients with psilocybin could take even greater advantage of the drug’s induced neuroplastic effects by introducing other coping mechanisms for smoking cessation, which can enhance and help to maintain the antidepressant benefits. Exercise and grounding practices such as mindfulness and meditation have been shown, for example, to help some people quit smoking. These could be integrated into psychotherapy before, during, and after a patient’s psilocybin session, Morisano says.
“Addiction is a complicated outcome that is exacerbated by many factors, and any truly successful treatment will likely need to entail multiple factors as well,” Morisano says. “In today’s complicated world, we need to be increasingly creative regarding the interventions that we provide to individuals who are struggling.”
