We thank the authors for raising an interesting point about potential gender differences in the effectiveness of counseling by medical students. In Indian medical schools, approximately half the students are female (1), and we agree that there may have been a difference in counseling styles between male and female students. (2) It is well known that numerous student and patient characteristics affect patient outcomes. (3) However, we unfortunately did not collect data on student gender. We did note in our subgroup analysis (Table 3) that students with lower knowledge scores in the post training survey had a lower effect size for achieving the primary quit outcome (RR 1.31 (0.66, 2.58), vs 1.70 (1.19, 2.43) for students with a high knowledge score). This suggests that the effectiveness of medical student counselling is likely heterogenous, and may vary by characteristics of the student and the patient. These disparities present both challenges and opportunities. For example, it is worth noting that even students with a low knowledge score at baseline still had an effect size consistent with a positive effect of counselling. Additionally, student performance can be enhanced by providing more opportunities to role play, counseling patients more frequently and/or counseling more patients. While it is prudent to be aware of disparities in outcomes, we believe that there is likely a benefit to training all medical students, irrespective of baseline student characteristics.