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In Reply: We agree with Dr Hughes that tobacco use is a serious public health problem throughout the world. Indeed, the WHO Tobacco Free Initiative is designed precisely to address this problem. However, most of the countries in the WHO World Mental Health (WMH) Survey Initiative have independent epidemiological data reporting tobacco use and dependence. Consequently, these countries did not include the WMH tobacco module in their surveys, leading us to exclude tobacco use and dependence from our article. However, we will present data on the prevalence and correlates of tobacco use and dependence in the countries with the WMH tobacco module in future reports.

Ronald C. Kessler, PhD
kessler@hcp.med.harvard.edu
Department of Health Care Policy
Harvard Medical School
Boston, Mass

T. Bedirhan Üstün, MD
World Health Organization
Geneva, Switzerland

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:1022.

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