In Reply.— We appreciate the point raised
by Dr Melhus regarding the influence of smoking on vitamin E requirements.
However, this factor is not a confounder in our study because smoking was
an exclusion criterion for the study subjects. Unfortunately, we neglected
to mention this in the article.
Dr Herbert's suggestion that the financial contribution to our study
by Hoffmann-LaRoche, Inc, biased its design and interpretation and caused
us to omit the occurrence of adverse effects is made without evidence or merit.
As our full disclosure to JAMA noted, none of the authors has any financial
interest in Hoffmann-LaRoche or vitamin E supplements. As indicated in our
article, major support for this study was from the US Department of Agriculture,
along with a grant from Hoffman-LaRoche, Inc.