We have previously recorded that tobacco smoking is associated with an increase in serum PSA levels in a mixed cohort of men consisting of healthy individuals as well as those with urology disease including PC [13].There is a notable involvement of the aldo-keto reductase 1C enzymes in the metabolic activation of chemical carcinogens such as those derived from tobacco constituents consisting of polycyclic aromatic hydrocarbons [14, 15]. The gene discussed is KLK3; the disease is pachyonychia congenita.