Shah SS, et al. - Among smokeless tobacco, smoking tobacco users and healthy controls, researchers examined the correlation of kisspeptin with total testosterone levels. They analyzed a total of 180 individuals. Compared with the control group, smokers and smokeless tobacco users showed significantly high total testosterone, while only smokeless tobacco users showed significantly high level of kisspeptin. Furthermore, smokeless tobacco users vs control group showed a significantly low level of cholesterol, but significantly high HDL and triglycerides. Findings thereby suggest that tobacco use via altering kisspeptin level impacts HPG axis. Hypothalamic function can be affected by an increase in kisspeptin level which can lead to pituitary and gonadal dysfunction along with impairment of reproduction. Significant raising of kisspeptin in relation with smokeless tobacco reinforces the idea that smokeless tobacco use has more potent effects centrally compared with smoking.