Cigarette smoking and hearing loss: lessons from the young adult periodic examinations in Israel (YAPEIS) database

Some studies have indicated a possible link between cigarette smoking and hearing loss. To analyze the association between smoking and hearing loss, other than that induced by noise, and to characterize the type of HL impairment found in smokers. We conducted a retrospective cross-sectional study in 13,308 men aged 20-68 (median 34.6 years) who underwent a hearing test as part of a routine periodic examination. For each subject, age, smoking status (current, past or non-smokers) and number of cigarettes per day were noted and a hearing test was performed. The test was performed in a sealed, soundproof room by an experienced audiologist and included pure tone audiometry of 250-8,000 Hz. The audiograms were analyzed and subjects were accordingly divided into two groups: those with HL and at least one of the following impairments in at least one ear: sensorineural, conductive or mixed; and those with no hearing loss (control). Audiograms showing HL typical to noise exposure were excluded. The prevalence of any type of HL among subjects < 35 years was 4.5%, compared to 10.5% among those > 35 years (P < 0.0001). A significantly higher incidence of any type of HL was found in current (11.8%) and past smokers (11.7%) than in non-smokers (8.1%) (P < 0.0001). The risk increment of the smoking status for developing HL among subjects under age 35 was 43%, and 17% among those above 35 years. Both mild, flat, sensorineural impairment and conductive impairment were found to be associated particularly with smoking (odds ratio 2.2 and 1.9, respectively). The incidence of HL unrelated to noise exposure is higher in smokers than in non-smokers, and in young adults the effect is greater.