The Connection Between Smoking and Hearing Loss

According to the Centers for Disease Control, tobacco use is the leading cause of preventable disease, disability, and death in the United States. An estimated 30.8 million U.S. adults smoke cigarettes. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. Another 16 million live with a serious illness caused by smoking. Each year, the United States spends more than $225 billion on medical care to treat smoking-related disease in adults.

And while the impact of smoking on the lungs and heart is well-known, did you know that hearing loss is also one of the casualties of smoking?

A new study just published in January 2022 in the Journal of Head and Neck Surgery titled the Association of Cigarette Smoking Patterns Over 30 Years with Audiometric Hearing Impairment and Speech-in-Noise Perception: The Atherosclerosis Risk in Communities Study, found that persistent smoking was associated with worse hearing test results and speech-in-noise perception.

In this cross-sectional study, 3,414 participants’ smoking history over 30 years was classified into three groups: never or former smoking, quit smoking during the study period, and persistent smoking. Persistent smoking was associated with a worse speech-frequency pure-tone average and Quick Speech-in-Noise test score.

The findings suggest that, compared with never or former smoking and quitting smoking during the study period, persistent smoking may be associated with worse hearing impairment in older adults; thus, quitting smoking at any time may be beneficial for hearing health, not to mention other health considerations.

Smoking and hearing facts:

  • Research shows smokers have a 70% greater chance of developing hearing loss compared to nonsmokers.
  • Nonsmokers are twice as likely to develop hearing loss if they live with a smoker.
  • The greater the number of cigarettes smoked, the greater your risk of developing hearing loss.
  • If you work around high levels of occupational noise, smoking increases your risk of noise-induced hearing loss.
  • Secondhand smoke can put adolescents at risk for hearing loss. They are two to three times more likely to develop hearing loss — and they usually aren’t even aware of it.
  • Another study found that smoking accelerates age-related hearing loss.

So, what is it about smoking that causes hearing loss?

It seems that hearing loss and smoking are related to “dose.” Studies have shown the more an individual smokes, the greater the exposure to nicotine, potentially resulting in hearing loss.

Though how smoking actually affects the ear is not completely known, the theory is that smoking may have an ototoxic effect on the cochlea, or the inner ear. It has been suggested that a chemical reaction that occurs during smoking may reduce the oxygen available to the inner ear, resulting in damage to hair cells essential to the function of hearing.

Smoking also reduces the blood supply to the inner ear and can cause narrowing of the blood vessels and blockages, just as it can in the coronary arteries.

Though the exact reasons for hearing loss in smokers are not well understood, it has been documented in several studies and seems to impact high-frequency hearing (voices of women and children) more often than hearing in other ranges.

To protect your hearing, the best advice is to stop smoking or don’t start. Even individuals who don’t smoke themselves, but who are frequently exposed to second-hand smoke at home or at work, are also at risk for hearing loss, so limiting exposure to cigarette smoking is an important way to prevent the problem.

To stop smoking, talk with your healthcare provider regarding a smoking cessation program and the best ways to quit. This may help you avoid the unwanted risk of hearing loss or reduce the risk of hearing loss for friends and family.

If you are a long-time smoker, even if you have quit, monitor your hearing regularly with a comprehensive hearing evaluation. This can help you determine your baseline hearing, and whether you are experiencing any hearing loss.

Schedule a comprehensive hearing evaluation with a doctoral-level audiologist.