The Treatment of Mild Hypertension Study-Reply

In Reply. —Although the nutritional-hygienic advice given participants in TOMHS was targeted at weight loss, reduction in sodium and alcohol intake, and increase in physical activity and not specifically at smoking cessation, 1 27% of the smokers at entry reported smoking cessation after 4 years of follow-up. Cessation rates were similar for those given placebo (28%) and those in a drug treatment group (27%). We attribute this cessation in part to the general emphasis of our intervention, which sought to increase health awareness and to promote sustained changes in lifestyle, and in part to changes in smoking behavior that were taking place in the US population during the time of our study. 2 Consistent with a large body of data, a higher percentage of smokers than nonsmokers experienced at least one major clinical event (6.1% vs 5.6%). Similarly, the incidence of first major or other clinical events was higher among