Craving Reduction and Smoking Outcomes in Psilocybin-Assisted and Standard Cessation Care.
Lisbeth Strandberg, Thiago P Fernandes, Irina I Shoshina, Natanael A Santos, Nora Saether
Revista Brasileira de Psiquiatria September 9, 2026 DOI: 10.47626/1516-4446-2026-5060 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Longitudinal Peer reviewed |
|---|---|
| Population | Smokers classified as dependence-predominant or affective-predominant |
| Intervention | Psilocybin-assisted care |
| Topics | Psilocybin |
| Keywords | Tobacco use disorder Craving Smoking cessation |
| Key findings | Psilocybin-assisted care was associated with greater smoking reduction at week 12 and greater early reductions in urge, but was not associated with verified abstinence after adjustment. Early craving reduction was associated with abstinence. The authors propose that distinct smoking profiles and early craving trajectories may help inform treatment stratification and individualized cessation strategies. |
Abstract
Smoking cessation outcomes are heterogeneous, and factors associated with these differences are not fully understood. We examined longitudinal smoking trajectories across distinct smoking profiles and evaluated whether early craving and affective symptom changes were associated with verified abstinence. Participants in this observational cohort were classified as dependence-predominant or affective-predominant using measures of smoking severity and affective symptoms. Abstinence was defined as 7-day self-reported abstinence verified by exhaled CO <8 ppm. Psilocybin-assisted care was associated with greater smoking reduction at week 12 (β = 5.56, 95% CI 2.18-8.94, p = .001) and greater urge reductions at T1 (β = -3.26, 95% CI -5.31 to -1.21, p = .002) and T2 (β = -2.74, 95% CI -4.85 to -0.63, p = .011). Psilocybin-assisted care was not associated with abstinence after adjustment (OR = 1.82, 95% CI 0.68-4.86, p = .233). Early craving reduction was associated with the outcome (OR = 1.54, 95% CI 1.17-2.03, p = .002). Distinct patterns of change were observed across treatment pathways and smoking profiles, while early craving reduction was associated with abstinence. Future studies may clarify whether these profiles and early trajectories could help inform treatment stratification and individualized cessation strategies.
Comparable studies
Other observational and cohort studies on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression | 2017 | Observational cohort | n = 19 |
| Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels Healthy volunteers | 2019 | Observational cohort | n = 8 |
| Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans | 2017 | Observational study | |
| Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. USA adult respondents from the National Survey on Drug Use and Health (2008-2012) | 2015 | Observational cohort | n = 190,000 |
| Prediction of Psilocybin Response in Healthy Volunteers Healthy volunteers | 2012 | Observational cohort | n = 409 |