Data suggest psychedelics such as psilocybin and lysergic acid diethylamide (LSD) may hold therapeutic potential in the treatment of addictions, including tobacco dependence. This retrospective cross-sectional anonymous online survey characterized 358 individuals (52 females) who reported having quit or reduced smoking after ingesting a psychedelic in a non-laboratory setting ⩾1 year ago. On average, participants smoked 14 cigarettes/day for 8 years, and had five previous quit attempts before their psychedelic experience. Of the 358 participants, 38% reported continuous smoking cessation after psychedelic use (quitters). Among quitters, 74% reported >2 years’ abstinence. Of the 358 participants, 28% reported a persisting reduction in smoking (reducers), from a mode of 300 cigarettes/month before, to a mode of 1 cigarette/month after the experience. Among reducers, 62% reported >2 years of reduced smoking. Finally, 34% of the 358 participants (relapsers) reported a temporary smoking reduction before returning to baseline smoking levels, with a mode time range to relapse of 3–6 months. Relapsers rated their psychedelic experience significantly lower in personal meaning and spiritual significance than both other groups. Participants across all groups reported less severe affective withdrawal symptoms (e.g. depression, craving) after psychedelic use compared with previous quit attempts, suggesting a potential mechanism of action for psychedelic-associated smoking cessation/reduction. Changes in life priorities/values were endorsed as the most important psychological factor associated with smoking cessation/reduction. Results suggest psychedelics may hold promise in treating tobacco addiction as potentially mediated by spiritual experience, changed priorities/values, and improved emotional regulation.

References

Albaugh, BJ, Anderson, PO ( 1974 ) Peyote in the treatment of alcoholism among American Indians . Am J Psychiatry 131: 1247 – 1250 .

Google Scholar Crossref | Medline | ISI

Bagby, RM, Parker, JD, Taylor, GJ ( 1994 ) The 20-item Toronto Alexithymia Scale: 1. Item selection and cross-validation of the factor structure . J Psychosom Res 38: 23 – 32 .

Google Scholar Crossref | Medline | ISI

Barrett, FS, Johnson, MW, Griffiths, RR ( 2015 ) Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin . J Psychopharmacol 29: 1182 – 1190 .

Google Scholar SAGE Journals | ISI

Bergman, RL ( 1971 ) Navajo peyote use: Its apparent safety . Am J Psychiatry 128: 695 – 699 .

Google Scholar Crossref | Medline | ISI

Blum, K, Futterman, SFL, Pascarosa, P ( 1977 ) Peyote, a potential ethnopharmacologic agent for alcoholism and other drug dependencies: Possible biochemical rationale . Clin Toxicol 11: 459 – 472 .

Google Scholar Crossref | Medline | ISI

Bogenschutz, MP, Forcehimes, AA, Pommy, JA. ( 2015 ) Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study . J Psychopharmacol 29: 289 – 299 .

Google Scholar SAGE Journals | ISI

Bogenschutz, MP, Pommy, JM ( 2012 ) Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: From indirect evidence to testable hypotheses . Drug Test Anal 4: 543 – 555 .

Google Scholar Crossref | Medline | ISI

Burrai, L, Nieddu, M, Palomba, M. ( 2014 ) Identification and quantitation of 4-bromo-2, 5-dimethoxyamphetamine in seized blotters . Leg Med (Tokyo) 17: 56 – 59 .

Google Scholar Crossref | Medline

Cahill, K, Stevens, S, Lancaster, T ( 2014 ) Pharmacological treatments for smoking cessation . JAMA 311: 193 – 194 .

Google Scholar Crossref | Medline | ISI

Calabrese, J ( 1997 ) Spiritual healing and human development in the Native American Church: Toward a cultural psychiatry of peyote . Psychoanal Rev 84: 237 – 255 .

Google Scholar Medline

Carhart-Harris, RL, Erritzoe, D, Williams, T. ( 2012 ) Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin . Proc Natl Acad Sci USA 109: 2138 – 2143 .

Google Scholar Crossref | Medline | ISI

Carhart-Harris, RL, Muthukumaraswamy, S, Roseman, L. ( 2016 ) Neural correlates of the LSD experience revealed by multimodal neuroimaging . Proc Natl Acad Sci USA 113: 4853 – 4858 .

Google Scholar Crossref | Medline | ISI

D’Agostino, RB, Belanger, A, D’Agostino, RB ( 1990 ) A suggestion for using powerful and informative tests of normality . Am Stat 44: 316 – 321 .

Google Scholar ISI

de Rios, MD, Grob, CS, Baker, JR ( 2002 ) Hallucinogens and redemption . J Psychoactive Drugs 34: 239 – 248 .

Google Scholar Crossref | Medline

Doblin, R ( 1991 ) Pahnke’s Good Friday experiment: A long-term follow-up and methodological critique . J Transpersonal Psy 23: 1 – 28 .

Google Scholar

Fagerström, K ( 2012 ) Determinants of tobacco use and renaming the FTND to the Fagerström test for cigarette dependence . Nicotine Tob Res 14: 75 – 78 .

Google Scholar Crossref | Medline | ISI

Garcia-Romeu, A, Griffiths, RR, Johnson, MW ( 2015 ) Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction . Curr Drug Abuse Rev 7: 157 – 164 .

Google Scholar Crossref

Garcia-Romeu, A, Kersgaard, B, Addy, PH ( 2016 ) Clinical applications of hallucinogens: A review . Exp Clin Psychopharmacol 24: 229 – 268 .

Google Scholar Crossref | Medline | ISI

Garrity, JF ( 2000 ) Jesus, peyote, and the holy people: Alcohol abuse and the ethos of power in Navajo healing . Med Anthropol Q 14: 521 – 542 .

Google Scholar Crossref | Medline | ISI

Glisky, ML, Tataryn, DJ, Tobias, BA. ( 1991 ) Absorption, openness to experience, and hypnotizability . J Pers Soc Psychol 60: 263 – 272 .

Google Scholar Crossref | Medline | ISI

Gonzales, D, Redtomahawk, D, Pizacani, B. ( 2007 ) Support for spirituality in smoking cessation: Results of pilot survey . Nicotine Tob Res 9: 299 – 303 .

Google Scholar Crossref | Medline | ISI

Griffiths, RR, Johnson, MW, Richards, WA. ( 2011 ) Psilocybin occasioned mystical-type experiences: Immediate and persisting dose-related effects . Psychopharmacology (Berl) 218: 649 – 665 .

Google Scholar Crossref | Medline | ISI

Griffiths, RR, Richards, WA, Johnson, MW. ( 2008 ) Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later . J Psychopharmacol 22: 621 – 632 .

Google Scholar SAGE Journals | ISI

Griffiths, RR, Richards, WA, McCann, U. ( 2006 ) Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance . Psychopharmacology (Berl) 187: 268 – 283 .

Google Scholar Crossref | Medline | ISI

Halpern, JH ( 1996 ) The use of hallucinogens in the treatment of addiction . Addict Res 4: 177 – 189 .

Google Scholar Crossref | ISI

Heatherton, TF, Kozlowski, LT, Frecker, RC. ( 1991 ) The Fagerström test for nicotine Dependence: A revision of the Fagerström tolerance questionnaire . Br J Addict 86: 1119 – 1127 .

Google Scholar Crossref | Medline

Johnson, MW, Garcia-Romeu, A, Cosimano, MP. ( 2014 ) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction . J Psychopharmacol 28: 983 – 992 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Richards, WA, Griffiths, RR ( 2008 ) Human hallucinogen research: Guidelines for safety . J Psychopharmacol 22: 603 – 620 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Sewell, RA, Griffiths, RR ( 2012 ) Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers . Drug Alcohol Depend 123: 132 – 140 .

Google Scholar Crossref | Medline | ISI

Kraehenmann, R, Preller, KH, Scheidegger, M. ( 2014 ) Psilocybin-induced decrease in amygdala reactivity correlates with enhanced positive mood in healthy volunteers . Biol Psychiatry 78: 572 – 581 .

Google Scholar Crossref | Medline | ISI

Krebs, TS, Johansen, PØ ( 2012 ) Lysergic acid diethylamide (LSD) for alcoholism: Meta-analysis of randomized controlled trials . J Psychopharmacol 26: 994 – 1002 .

Google Scholar SAGE Journals | ISI

MacLean, KA, Johnson, MW, Griffiths, RR ( 2011 ) Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness . J Psychopharmacol 25: 1453 – 1461 .

Google Scholar SAGE Journals | ISI

MacLean, KA, Leoutsakos, JMS, Johnson, MW. ( 2012 ) Factor analysis of the mystical experience questionnaire: A study of experiences occasioned by the hallucinogen psilocybin . J Sci Study Relig 51: 721 – 737 .

Google Scholar Crossref | Medline | ISI

McCambridge, J, Mitcheson, L, Winstock, AR. ( 2005 ) Five-year trends in patterns of drug use among people who use stimulants in dance contexts in the United Kingdom . Addiction 100: 1140 – 1149 .

Google Scholar Crossref | Medline | ISI

Miller, WR ( 2004 ) The phenomenon of quantum change . J Clin Psychol 60: 453 – 460 .

Google Scholar Crossref | Medline | ISI

Miller, WR, C’de Baca, J ( 2001 ) Quantum Change When Epiphanies and Sudden Insights Transform Ordinary Lives. New York : The Guilford Press .

Google Scholar

Mottillo, S, Filion, KB, Bélisle, P. ( 2009 ) Behavioural interventions for smoking cessation: A meta-analysis of randomized controlled trials . Eur Heart J 30: 718 – 730 .

Google Scholar Crossref | Medline | ISI

Pahnke, W ( 1963 ) Drugs and Mysticism: An Analysis of the Relationship between Psychedelic Drugs and the Mystical Consciousness [Unpublished doctoral dissertation]. Boston, MA : Harvard University .

Google Scholar

Palhano-Fontes, F, Andrade, K, Tofoli, LF. ( 2015 ) The psychedelic state induced by ayahuasca modulates the activity and connectivity of the default mode network . PLos One 10: e0118143.

Google Scholar Crossref | Medline

Pascarosa, P, Futterman, S ( 1976 ) Ethnopsychedelic therapy for alcoholics: Observations in the peyote ritual of the Native American Church . J Psychoactive Drugs 8: 215 – 221 .

Google Scholar Crossref

Petri, G, Expert, P, Turkheimer, F. ( 2014 ) Homological scaffolds of brain functional networks . J R Soc Interface 11: 20140873.

Google Scholar Crossref | Medline

Piper, ME ( 2015 ) Withdrawal: Expanding a key addiction construct . Nicotine Tob Res 17: 1405 – 1415 .

Google Scholar Crossref | Medline

Preller, KH, Pokorny, T, Hock, A. ( 2016 ) Effects of serotonin 2A/1A receptor stimulation on social exclusion processing . Proc Natl Acad Sci USA 113: 5119 – 5124 .

Google Scholar Crossref | Medline | ISI

Prue, B ( 2013 ) Indigenous supports for recovery from alcoholism and drug abuse: The Native American Church . J Ethn Cult Divers Soc Work 22: 271 – 287 .

Google Scholar Crossref

Ross, S ( 2012 ) Serotonergic hallucinogens and emerging targets for addiction pharmacotherapies . Psychiatr Clin North Am 35: 357 – 374 .

Google Scholar Crossref | Medline | ISI

Roy, C ( 1973 ) Indian peyotists and alcohol . Am J Psychiatry 130: 329 – 330 .

Google Scholar Crossref | Medline | ISI

Sessa, B, Johnson, MW ( 2015 ) Can psychedelic compounds play a part in drug dependence therapy? Br J Psychiatry 206: 1 – 3 .

Google Scholar Crossref | Medline | ISI

Stolaroff, M ( 2004 ) The Secret Chief Revealed: Conversations with Leo Zeff, Pioneer in the Underground Psychedelic Therapy Movement. Sarasota, FL : Multidisciplinary Association for Psychedelic Studies .

Google Scholar

Studerus, E, Gamma, A, Kometer, M. ( 2012 ) Prediction of psilocybin response in healthy volunteers . PLoS One 7: e30800 .

Google Scholar Crossref | Medline | ISI

Sutherland, MT, Carroll, AJ, Salmeron, BJ. ( 2013 ) Insula’s functional connectivity with ventromedial prefrontal cortex mediates the impact of trait alexithymia on state tobacco craving . Psychopharmacology (Berl) 228: 143 – 155 .

Google Scholar Crossref | Medline

Tellegen, A, Atkinson, G ( 1974 ) Openness to absorbing and self-altering experiences (“absorption”), a trait related to hypnotic susceptibility . J Abnorm Psychol 83: 268 – 277 .

Google Scholar Crossref | Medline | ISI

Thomas, G, Lucas, P, Capler, NR. ( 2013 ) Ayahuasca-assisted therapy for addiction: Results from a preliminary observational study in Canada . Curr Drug Abuse Rev 6: 30 – 42 .

Google Scholar Crossref | Medline

Tiffany, ST, Drobes, DJ ( 1991 ) The development and initial validation of a questionnaire on smoking urges . Br J Addict 86: 1467 – 1476 .

Google Scholar Crossref | Medline

Ungerleider, JT, Fisher, DD, Fuller, M. ( 1968 ) The ‘bad trip’: The etiology of the adverse LSD reaction . Am J Psychiatry 124: 1483 – 1490 .

Google Scholar Crossref | Medline | ISI

Vollenweider, FX, Kometer, M ( 2010 ) The neurobiology of psychedelic drugs: Implications for the treatment of mood disorders . Nat Rev Neurosci 11: 642 – 651 .

Google Scholar Crossref | Medline | ISI

Winstock, AR, Kaar, S, Borschmann, R ( 2014 ) Dimethyltryptamine (DMT): Prevalence, user characteristics and abuse liability in a large global sample . J Psychopharmacol 28: 49 – 54 .

Google Scholar SAGE Journals | ISI