Popular psychedelic may be more effective than nicotine patches for quitting smoking

A Johns Hopkins study found a single high dose of psilocybin combined with cognitive behavioral therapy led to higher six-month quit rates than nicotine patches in a small trial; researchers plan a larger study to test the approach further.

A small Johns Hopkins trial compared a single high dose of psilocybin plus cognitive behavioral therapy with an eight-to-ten week nicotine patch regimen for adult smokers. The study enrolled 82 adults who had previously tried to quit and provided 13 weeks of CBT to all participants. At six months, a larger share of the psilocybin group was confirmed smoke-free than the patch group. The authors noted several limitations, including the absence of a placebo control and a participant group that lacked racial and ethnic diversity. Key findings: - The trial enrolled 82 adult smokers and assigned them to either psilocybin-assisted therapy or nicotine patch treatment, with both groups receiving CBT. - Participants in the psilocybin arm received a single, high dose in a supervised therapeutic setting while the other arm used an FDA-approved nicotine patch for eight to ten weeks. - At six months, 17 people in the psilocybin group were smoke-free compared with 4 in the patch group. - Researchers reported the psilocybin group smoked about 50% fewer cigarettes per day between the target quit date and the six-month follow-up. - The study had no placebo control and the sample was mostly highly educated, less racially and ethnically diverse, and included many with prior psychedelic experience. Summary: The results suggest psilocybin-assisted therapy could be a different approach to smoking cessation, acting through psychological change rather than direct interaction with nicotine receptors. Findings are preliminary and limited by study design and sample characteristics. The research team plans a larger trial to evaluate effectiveness, refine treatment protocols, and assess cost and scalability.