The fight to stamp out cigarettes may be heading in a mind-bending new direction.
Research published this week found that a single dose of a trendy psychedelic drug may be more effective than nicotine patches at helping smokers quit when paired with cognitive behavioral therapy (CBT).
It’s a breakthrough smokers desperately need. Over 16 million Americans live with smoking-related illnesses, and 480,000 deaths in the US each year are linked to a habit that damages nearly every organ in the body.
Across the country, 25.2 million people reported smoking cigarettes in 2024. Surveys show that more than two-thirds of adult smokers say they want to quit for good, but fewer than one in 10 succeed each year, according to the CDC.
Even with tools to help — from nicotine patches, gum, pouches and lozenges to prescription drugs like varenicline and bupropion — many smokers relapse within a few years.
Now, scientists say psilocybin, the psychedelic compound in “magic mushrooms,” could service as a powerful new weapon in the fight against the nation’s leading cause of preventable death.
In the study, researchers at Johns Hopkins University recruited 82 adult smokers who had previously tried to quit and split them into two groups.
One group was instructed to wear a nicotine patch for eight to 10 weeks. The FDA-approved medication delivers a steady dose of nicotine through the skin to reduce withdrawal symptoms and cravings.
The other group received a single, high dose of psilocybin in a controlled, therapeutic setting while being monitored by trained facilitators.
Both groups also took part in 13 weeks of CBT, a form of psychotherapy sometimes used to help smokers identify triggers and break the patterns that drive addiction.
Six months later, 38 participants remained in the psilocybin group and 32 in the nicotine patch group.
When the researchers tested them for signs of smoking, the results were striking: Participants in the psilocybin group had more than six times the odds of quitting. Seventeen were smoke-free at six months, compared with just four in the patch group.
“Participants in the psilocybin group smoked roughly 50% fewer cigarettes per day between the target quit date and six-month follow-up,” the study authors wrote.
This isn’t the first time psilocybin has shown promise for helping smokers quit.
A smaller pilot study with 15 participants found that two or three psilocybin sessions paired with CBT led to roughly 80% abstinence at six months. Roughly 60% of participants were still abstinent a year or more after treatment.
The research suggests that psilocybin therapy may offer a promising new approach to smoking cessation, acting on the brain in a way that differs from traditional addiction treatments.
Instead of targeting nicotine receptors, the Johns Hopkins researchers noted that it appears to help users change the way they think, making it easier to break unhealthy habits.
“Psilocybin’s lack of direct interaction with nicotinic acetylcholine receptors highlights psychedelic therapy as a unique approach, in which the drug does not directly alter reinforcement or withdrawal,” the study authors wrote.
Experts not involved in the study were intrigued by the findings.
“It’s been 20 years since we’ve had a new medication to help people quit smoking. We need something novel, and this is definitely a novel approach,” Megan Piper, director of the University of Wisconsin Center for Tobacco Research and Intervention, said on NPR’s “All Things Considered.”
Still, the study has limits.
There was no placebo, so participants knew they were receiving psilocybin, which could have shaped their experience and expectations.
The participants were also mostly highly educated, lacked racial and ethnic diversity, and many had prior psychedelic experience — all of which may have shaped the study’s outcomes.
“Nevertheless, [the] findings support accelerating development of psychedelic therapies for substance use disorders, including tobacco,” the researchers wrote.
Looking ahead, the team plans to conduct a larger study to gauge psilocybin’s potential as a smoking cessation tool. They also aim to optimize the treatment protocol, evaluate its cost-efficiency and determine whether it can be scaled up successfully.
