(2D) RATIONALE Alcohol has been shown to produce both acute and chronic increases in BP, suggesting that restricting alcohol intake would lower BP. In a systematic review of four trials,53 restricting alcohol intake in the general population resulted in a 3.8 mm Hg reduction (95% CI 1.4 6.1) in systolic BP and a 3.2 mm Hg reduction (95% CI 1.4 5.0) in diastolic BP, with no evidence of heterogeneity among the results. No data specific to CKD patients were found, but the effects are expected to be similar. Most data suggest that up to two standard drinks per day for a man and 1 standard drink per day for a woman are likely to be safe. The definition of a standard drink varies from 8 to 19.7 g of alcohol in different countries (see http://whqlibdoc. 10 g of alcohol is equivalent to 30 ml of spirits, 100 ml of wine, 285 ml of full- strength beer, and 425 ml of light beer. The benefits of alcohol moderation on BP and on general health appear likely to be similar in the CKD and the general population, with no strong rationale for different recommendations. On this basis, Recommendation 2.3.4 was graded 2D. OTHER INTERVENTIONS Cigarette smoking. Cigarette smoking and exposure to environmental tobacco smoke are clearly among the most potent modifiable risk factors for CVD in the general population and in patients with CKD. Although it does not have a clear, direct impact on long-term BP, the avoidance of exposure to cigarette smoke is a critical aspect of cardiovas- cular risk reduction but as yet there are no RCTs in the CKD population. Dietary supplementation. 