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The evidence reviewed in this report, along with the reviews in prior reports, indicates a complicated relationship between initiation of smoking, continued smoking, and cessation over time

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If these initial laboratory tests fail to uncover the cause of gynecomastia, then additional tests to evaluate for an underlying hormonal balance due to hypogonadism or a testicular tumor should be checked including total and free levels of testosterone, luteinizing hormone, follicle stimulating hormone, estradiol, serum beta human chorionic gonadotropin (-hCG), and prolactin