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Local reduction of dopamine could lead to over-production of prolactin by lactotroph cells.[21] Hyperprolactinemia in men typically leads to hypogonadism resulting in decreased libido, erectile dysfunction, and abnormal semen quality.[22] Hyperprolactinemia impairs male gonadal functions by acting at various levels, possibly by decreasing GnRH pulse generator activity and/or by decreasing LH and FSH secretion, and might be inhibiting testosterone secretion at the level of Leydig cells as well.[23] Prolactin receptors have been demonstrated in the spermatogonia, seminiferous epithelium, and spermatocytes, suggesting that prolactin might have a role to play in normal spermatogenesis.[24] Hence, abnormalities in sperm quality and decreased libido observed in the previous study can also be attributed to the increased in serum prolactin since hyperprolactinemia is attributed to impaired germ cell function due to low FSH and decreased intra-testicular testosterone.[25] The increased serum prolactin level observed in this group is consistent with other earlier studies[26] but contrary to that of Anderson group.[19] However, some scientists have reported a reduction of prolactin in rats due to the short term effects of cigarette smoke on prolactin[27] or no effects at all.[28] Jurasovicx et al .,[29] found that smoking was significantly associated with a decrease in serum prolactin

The World Health Organization (WHO) notes the stark difference between women in various geographic locations as it states that "[a]bout 22 percent of women in developed countries and 9 percent of women in developing countries smoke tobacco"