Leanness and Smoking

To the Editor.—  The article by Garrison et al (1983;249:2199) showed that among participants in the Framingham Heart Study, men under desirable weight (lean men) were more likely to be cigarette smokers than men at or above desirable weight. The authors concluded that previously observed excess mortality in lean men may be caused, at least in part, by the confounding effect of cigarette smoking. Leanness was expressed as "Metropolitan relative weight" based on tables from the Metropolitan Life Insurance Company that list desirable weights by height. The possible separate influences of height and weight were not analyzed. Such influences may be of interest because of Lee and Kolonel's¹ recent observation of an excess relative risk of lung cancer in tall men, even though smoking was controlled by category restriction.We recently analyzed current smoking habits of 3,393 male oil refinery employees and found a consistent trend for increasing cigarette