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Pilot study of the 5-HT 2A R agonist psilocybin in the treatment of tobacco addiction
Open accessAbstract
Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.
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“Psychedelic-assisted therapies currently offer one of the most robust experimental models for eliciting ST, frequently occasioning ego-dissolution and mystical-type experiences that are associated with sustained reductions in depression, anxiety, and addictive behaviors (97, 106).”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [106]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A single-arm pilot study of PAT to treat tobacco use disorder found 67% and 60% of people remained abstinent at 12 and ≥16 months of follow-up [54].”
From Psilocybin‐assisted psychotherapy for methamphetamine use disorder: A pilot open‐label safety and feasibility study. (2025) · cites this paper as [54]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
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“These findings demonstrate the likely feasibility of conducting such treatment in a substance use disorder [25,54].”
From Psilocybin‐assisted psychotherapy for methamphetamine use disorder: A pilot open‐label safety and feasibility study. (2025) · cites this paper as [54]
In the citing paper
“In an open-label pilot study, 12 out of 15 treatment-seeking smokers were nicotine abstinent 6 months after two to three administrations of psilocybin (26).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [26]
In the citing paper
“Facilitating the reconnection with their social environment via increased emotional empathy may therefore contribute to clinical efficacy of hallucinogens shown in preliminary studies with addicted patients (24, 26).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [26]
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“Several plausible mechanisms of hallucinogen-facilitated treatments have been proposed (Bogenschutz and Pommy, 2012; Carhart-Harris et al., 2012, 2014; Ross, 2012; Vollenweider and Kometer, 2010).”
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Metadata
- Authors
- Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., & Griffiths, R. R.
- Affiliations
- Johns Hopkins University (US)
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2014-09-11
- Volume
- 28
- Issue
- 11
- Pages
- 983-992
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- PMC
- PMC4286320
- OpenAlex
- W2122459973
- Cited by
- 914
- References
- 63
- Citations by year
- 2026: 71 · 2025: 130 · 2024: 126 · 2023: 112 · 2022: 121 · 2021: 94 · 2020: 70 · 2019: 33 · 2018: 48 · 2017: 45 · 2016: 46 · 2015: 13 · 2014: 3
- FWCI
- 41.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- World Health Organization
- National Institute on Drug Abuse (R01DA003889, T32DA007209)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- psilocybin, tobacco dependence, smoking cessation, nicotine dependence, hallucinogens, 5-HT2A receptor agonists, adjunctive therapy, abstinence, treatment safety and feasibility
- MeSH terms
- Attitude, Carbon Monoxide, Combined Modality Therapy, Cotinine, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Pilot Projects, Psilocybin, Tobacco Use Disorder, Biomarkers, Cognitive Behavioral Therapy, Smoking Cessation, Behavior, Addictive, Treatment Outcome, Serotonin Receptor Agonists, Nicotinic Agonists
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