Intralesional tumour necrosis factor combined with interferon gamma in metastatic melanoma.

build and muscularity.27 In general our results accord with observations from the United States of a clustering of negative health habits among smokers, which may have become more pronounced in recent years.8 We can only speculate why the characteristics of smokers in Finland seem to be changing. In the past smoking was considered to be a "normal" habit; but with the Finnish antismoking legislation from 1977, increased antismoking education, and changing public attitudes smoking is being regarded more as a deviant behaviour. Thus today smokers may be personalities more prone to risk taking and unhealthy behaviours than earlier. It may be hypothesised that the hard core of current smokers, who hitherto have resisted antismoking campaigns, consist of an increasing selection of people with unfavourable health behaviour. In another Finnish study28 persistence in smoking was associated with greater use of alcohol and coffee, possibly due to a common pathophysiology of dependence.29 On the other hand, the average number of cigarettes smoked daily by current smokers did not increase from 1982 to 1987 as one would expect for the hypothesis of an increasing cluster of negative health habits. In conclusion our population based data from large samples of middle aged Finnish men and women suggest that the metabolic effects of smoking are apparently increasingly overridden by the present behavioural characteristics of smokers such as high alcohol and saturated fat consumption and little exercise. The earlier generally accepted notion that smokers weigh less than non-smokers" may thus soon turn out to be anachronistic. It also seems plain that antismoking health education aimed at young and middle aged men should place more emphasis on correcting an unhealthy lifestyle as a whole.

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