Relationship of passive cigarette smoking to otitis media

Arch Otolaryngol Head Neck Surg. 1999 Jul;125(7):758-62. doi: 10.1001/archotol.125.7.758.


Objective: To determine the effect of passive smoking on otitis media with effusion (OME) and recurrent otitis media (ROM).

Design: A case-control study of children who received ventilation tubes and who were followed up for 1 year to determine the risk of developing postoperative otorrhea and early extrusion in relation to exposure to passive cigarette smoke.

Setting: Otorhinolaryngology Clinic of Istanbul School of Medicine, Istanbul, Turkey.

Patients: A total of 166 children 3 to 7 years old who required tympanostomy tubes because of OME and ROM (case group) compared with an age-matched control group of 166 children. The control group consisted of children who did not meet and never had met criteria for insertion of tympanostomy tubes.

Main outcome measures: Statistical analysis of factors associated with a higher prevalence of OME or ROM, postoperative otorrhea, and early tube extrusion.

Results: Passive smoking was a significant risk factor for OME and ROM. The case group was exposed to a mean of 19.6 cigarettes per day vs 14.4 cigarettes per day for the control group (P<.004). Only maternal smoking was a significant factor (P<.001); no association was found with paternal smoking. Prospective follow-up of the case group showed no significant difference in the clinical course of OME and ROM between maternally exposed and non-maternally exposed children.

Conclusions: Passive smoking increases the risk of OME and ROM in children between 3 and 7 years old. The avoidance of daily exposure to domestic tobacco smoke could have a public health impact.

Publication types

  • Clinical Trial

MeSH terms

  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Ear Ventilation
  • Otitis Media / etiology*
  • Otitis Media / surgery
  • Otitis Media with Effusion / etiology*
  • Otitis Media with Effusion / surgery
  • Recurrence
  • Risk Factors
  • Tobacco Smoke Pollution / adverse effects*


  • Tobacco Smoke Pollution