Psilocybin More Effective Than Nicotine Patch for Smoking Cessation: Study
Researchers have found in a pilot randomized trial that a single high-strength dose of psilocybin helped over 40% of smokers quit by 6 months, compared with about 10% of those using nicotine patches. No serious adverse events were reported; the most common effects were temporary increases in blood pressure and nausea. Researchers suggest psilocybin may aid cessation by enhancing “mental flexibility,” enabling patients to rethink and change their relationship with addiction. The study was published in JAMA Network Open by Matthew W. and colleagues.
Tobacco consumption is one of the top preventable causes of death worldwide. Estimates have shown that tobacco consumption leads to 480,000 deaths each year in the USA and almost 8 million worldwide. The rate is higher than that of any other substance abuse. Despite all the efforts made towards tobacco cessation with the aid of various pharmacological agents like nicotine replacement therapy, most cessation techniques have only shown modest results for long-term success rates. Cognitive Behavioral Therapy is one of the most commonly used techniques to aid smokers who are trying to quit.
The study was carried out in a pilot randomized clinical trial among psychiatrically healthy adult smokers. The participants and researchers were aware of the treatment received, indicating that the study was not blinded. However, rigorous methods of verification were employed in measuring outcomes of smoking abstinence. The study also employed an optional crossover approach following completion of the primary endpoint, offering participants a chance of receiving the other treatment.
Data collection was carried out between January 20, 2015, and May 8, 2023, in an academic medical center and teaching hospital located in Baltimore, Maryland, United States, referred to as Johns Hopkins Bayview Medical Center.
Key findings:
In this pilot randomized clinical trial, a total of 82 psychiatrically healthy adult smokers were recruited, with a mean age of 47.6 ± 12.0 years, and 59.8% were males.
Participants were randomized into one of two conditions: a high dose of psilocybin (30 mg/70 kg) or 8–10 weeks of nicotine patch therapy, and both conditions received a 13-week course of cognitive behavioral therapy.
At 6 months post quit day, 40.5% of participants in the psilocybin arm had prolonged abstinence, compared with 10.0% in the nicotine patch arm, with an odds ratio of 6.12 (95% CI, 1.99–23.26; P = 0.003).
For 7-day point prevalence, 52.4% of participants in the psilocybin arm were abstinent, compared with 25.0% in the nicotine patch arm, with an odds ratio of 3.30 (95% CI, 1.32–8.70; P = 0.01). Of the total participants, 68 (82.9%) had reached the 6-month follow-up, with no serious adverse events reported for either intervention.
A single high dose of psilocybin with cognitive behavioral therapy has been found to result in a significant increase in long-term smoking abstinence compared to the combination of nicotine patch therapy with CBT. The high rates of abstinence achieved with the psilocybin treatment indicate that psychedelic therapy could be a new approach to the treatment of tobacco smoking.
Reference:
Johnson MW, Naudé GP, Hendricks PS, Garcia-Romeu A. Psilocybin or Nicotine Patch for Smoking Cessation: A Pilot Randomized Clinical Trial. JAMA Netw Open. 2026;9(3):e260972. doi:10.1001/jamanetworkopen.2026.0972
