We thank Drs Aggarwal and colleagues for their valuable questions about and remarks on our article in CHEST.1 To start with, we would like to emphasize that the included subjects were heavy smokers drawn from the general population: Non-smoking-related diseases would show a study prevalence equal to that in the population. Asthma would, therefore, be present in the same (low) population percentage in all the groups we formed. As mentioned in the “Materials and Methods” section, the three groups were based on the baseline prebronchodilator FEV1/FVC: either >70%, ≤70% and greater than the lower limit of normal, or less than or equal to the lower limit of normal. Because asthma was neither an inclusion nor an exclusion criterion, asthmatic subjects were fully randomized over the three groups formed. The effect on lung function decline was therefore negligible.