Cigarette smoking and hearing loss: the epidemiology of hearing loss study

JAMA. 1998 Jun 3;279(21):1715-9. doi: 10.1001/jama.279.21.1715.


Context: Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults.

Objective: To evaluate the association between smoking and hearing loss.

Design: Population-based, cross-sectional study.

Setting: Community of Beaver Dam, Wis.

Participants: Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study.

Main outcome measures: The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear.

Results: After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non-age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74).

Conclusions: These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Hearing Disorders / epidemiology
  • Hearing Disorders / etiology*
  • Hearing Loss, Noise-Induced
  • Hearing Tests
  • Humans
  • Male
  • Middle Aged
  • Noise, Occupational
  • Presbycusis
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Tobacco Smoke Pollution


  • Tobacco Smoke Pollution