The effects of phenylpropanolamine on dietary intake, physical activity, and body weight after smoking cessation This investigation evaluated the effect of phenylpropanolamine on the weight gain associated with 2 weeks of abstinence from smoking. Subjects were 57 adult female cigarette smokers who were randomly assigned, in a double-blind procedure, to chew gum with phenylpropanolatnine or placebo gum, or to chew no gum. After a baseline assessment, subjects were paid to quit smoking for a period of 2 weeks. Forty-one (72%) of the 57 subjects were successful in quitting smoking for the 2-week period. Results indicated that, relative to the other two conditions, abstinent subjects receiving phenylpropanolamine gained 1.5 to 1.9 pounds less weight (p < 0.05). In addition, abstinence rates were higher (p < 0.03) and dietary intake lower for subjects receiving phenylpropanolamine (p < 0.05) relative to the other two conditions. No changes in physical activity were observed. It is concluded that phenylpropanolamine may help reduce weight gain associated with smoking abstinence and in this way may enhance smoking cessation efforts in certain individuals. (CLIN PHARMACOL THER 1990;47:747-54.) Robert C. Klesges, PhD, Lisa M. Klesges, BA, Andrew W. Meyers, PhD, Mary L. Kkm, MS, and Terry Isbell, MS Memphis, Tenn. The health consequences and medical costs associ- ated with cigarette smoking are well established. There are more than 50,000 studies that link cigarette smoking to increased morbidity and mortality from cardiovas- cular diseases, various forms of cancer, and chronic obstructive lung diseases.'"2 As many as one third of heavy smokers who are now 35 years old will die before age 85 of diseases caused by their smoking.' Despite this evidence, approximately 26% of the adults in the United States continue to smoke.' Very few effective strategies for smoking cessation have been developed, and up to 80% of smokers who initially stop smoking relapse within 6 months to 1 year.5'6 From the Center for Applied Psychological Research, Department of Psychology, Memphis State University, and the Department of Biostatistics and Epidemiology, University of Tennessee at Memphis, Supported by a grant awarded to Dr. Klesges and Dr. Meyers (HL-39332) by the National Heart, Lung, and Blood Institute (Be- thesda, Md.). Support was also received from a Centers of Ex- cellence grant awarded to the Department of Psychology, Memphis State University, by the state of Tennessee. Schering-Plough Cor- poration provided both the phenylpropanolamine and the placebo gum for this investigation. Received for publication Oct. 10, 1989; accepted Feb. 26, 1990. Reprint requests: Robert C. Klesges, PhD, Center For Applied Psy- chological Research, Department of Psychology, Memphis State University, Memphis, TN 38152. 13/1/20498 Recent reviews have confirmed that the overwhelm- ing majority of smokers (78%)7'8 gain weight after ces- sation. The 1988 Surgeon General's Report' reviewed 43 studies that studied smoking and body weight status over time. Smokers who quit in the longitudinal studies gained an average of 6.16 pounds (range, 1.76 to 18.07 pounds) after cessation. Unfortunately, fear of weight gain after smoking cessation appears to be a significant reason for continued smoking." At least one third of smokers report that they continue to smoke primarily for the weight-related benefits.' It also appears that some individuals, particularly women, are likely to ini- tiate smoking because of the weight reduction prop- erties of cigarettes." Few effective treatment methods for reducing weight gain after smoking cessation are available. Behavioral methods, which are effective in weight control in gen- eral, have not yet been successful in the prevention or even the reduction of postcessation weight gain.'2"3 Some investigators have advocated pharmacologic in- tervention in the form of nicotine chewing gum to aid in reducing postcessation weight gain. Reports of the effectiveness of nitocine gum on weight gain are vari- able,''6 with the gum appearing to be effective only if the individual is a heavy smoker and the individual uses large amounts of nicotine chewing gum.' As such, its use as an aid to primarily reduce postcessation weight gain has been questioned.' 747