Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts

In a follow-up study of a psilocybin-facilitated smoking cessation pilot, 12 of 15 original participants were interviewed about 30 months after their psilocybin sessions. Participants described gaining vivid insights into their self-identity and reasons for smoking, and reported that experiences of interconnectedness, awe, and curiosity persisted long after the drug's acute effects. The content of the psilocybin experience overshadowed short-term withdrawal symptoms. Participants also emphasized the importance of preparatory counseling, strong rapport with the study team, and a sense of momentum from being engaged in the treatment. Beyond quitting smoking, many reported lasting positive changes such as increased aesthetic appreciation, altruism, and pro-social behavior.

Study at a glance

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.