Long-term follow-up of psilocybin-facilitated smoking cessation: Abstinence outcomes and qualitative analysis of participant accounts

Aims: We assessed long-term (>12 months) outcomes of psilocybin-facilitated smoking cessation, and qualitatively analyzed participants’ accounts to inform potential psychological mechanisms of treatment efficacy.

Methods: Fifteen individuals who completed a pilot study of psilocybin-facilitated smoking cessation were invited for a long-term follow-up. Eleven (73%) returned and were interviewed about their current smoking and treatment experience (mean time since treatment = 30 months, SD = 17, range = 16–57). Exhaled carbon monoxide, and self-report measures of craving, temptation, and smoking abstinence self-efficacy were assessed.

Results: At 6 months, 10 of 11 (91%) participants were smoking abstinent. At long-term follow-up, 9 of 11 (82%) were still abstinent. Craving and temptation were not significantly different between 6-month and long-term follow-ups, and remained significantly lower than at baseline. Smoking abstinence self-efficacy showed significant persisting increases from baseline scores, and remained comparable to those at 6 months. Participants reported profound, insightful psilocybin experiences and good rapport with study staff as factors impacting treatment efficacy.

Conclusions: Psilocybin, administered under controlled conditions in a treatment context, is associated with ongoing smoking abstinence and persisting reductions in craving and temptation. Results were potentially related to personally meaningful experiences and rapport with study staff. Results showed lasting benefits in this sample consistent with prior research on long-term effects of psilocybin. Financial support: Heffter Research Institute, Beckley Foundation, NIDA T32DA07209 and R01DA003889