The dangerous links between smoking and hearing loss

Smoking is a well-established risk factor for hearing loss. Studies have shown that time and again exposure to cigarette smoke—whether directly, secondhand, or even in utero—can have a big impact on a person's hearing health.

Most recently, a January 2022 study found links between persistent smoking and hearing problems. The study, published in JAMA Otolaryngology-Head & Neck Surgery, looked at patterns of hearing loss over 30 years among three groups: never/former smokers, smokers who quit during the study period or smokers who continued to smoke for the duration of the study. Those who never stopped smoking scored poorer on hearing tests.

Older studies have found similar patterns—and the elevated risk even applies to non-smokers living with a smoker, who were twice as likely to develop hearing loss as those who were not exposed at all, according to this JAMA study. 

Young smokers’ hearing health is at risk, too. Teens exposed to cigarette smoke are to two to three times as likely to develop hearing loss compared to those with little or no exposure, one study showed. What's more, 80 percent of the participants in the study had no idea their hearing health had been affected.

Smoking is strongly linked to tinnitus, dizziness and vertigo, as well.

How does smoking affect hearing? 

Both nicotine and carbon monoxide lower oxygen blood levels and constrict blood vessels all over your body–including those in your inner ear responsible critical for how we hear. Also nicotine and cigarette smoke are thought to:

• interfere with neurotransmitters in the auditory nerve, which are responsible for telling the brain which sound you are hearing.
• irritate the eustachian tube and lining of the middle ear.
• trigger the release of free radicals that can damage DNA and cause disease.
• make you more sensitive to loud noises and therefore more susceptible to developing noise-induced hearing loss.

Can smoking cause tinnitus (ringing in the ears)?

Most likely, yes, though more research is needed to know for sure. A review of 20 studies looking at the topic found there was "sufficient evidence" to conclude that smoking is at least associated with tinnitus. Meaning, rates of tinnitus are higher in smokers than non-smokers, but a direct cause-and-effect relationship hasn't yet been investigated. The review researchers concluded that "people suffering from tinnitus should be educated about the potential impact of smoking." 

Why would smoking cause tinnitus? For many of the same reasons that smoking is linked to hearing loss (see above), researchers explained.

Is smoking linked to ear infections?

Yes, for both adults and kids. The cause is two-fold: Smoking weakens the immune system and it damages tissues in the nose and throat, making them more susceptible to infections that affect the ears, too. 

But because of their ear anatomy, children are at higher risk of ear infections to begin with. This risk is even higher if they are exposed to secondhand smoke. As the CDC explains, secondhand smoke causes numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome (SIDS). In some cases, middle ear infections in kids can lead to hearing loss. 

Smoking while pregnant may affect baby's hearing

Children born to mothers who smoked while pregnant are also at elevated risk of developing hearing loss. The risk spans childhood—studies have found an increased risk among younger children and even in the later years, when children develop hearing loss as teens.

What about vaping?

Vaping has become a common substitute for smoking, even though it still contains some of the same dangerous chemicals found in cigarettes. Is it safer for your hearing? The jury's still out on this one, as we explore in the the vaping and hearing loss controversy.

The good news about smoking and hearing loss

The 2022 JAMA study mentioned above revealed some good news: Former smokers measured better on hearing tests that persistent smokers, showing that quitting is indeed beneficial to your hearing.

According to the American Lung Association, 20 minutes after your last cigarette, your blood pressure decreases and your circulation improves. Within 8 hours, your carbon monoxide and oxygen levels return to normal. In 48 hours, your sense of smell and taste improve and your nerve endings begin to regenerate.

Additional health benefits of quitting, according to the CDC, include:

• Lowered risk of lung cancer and other types of cancer,
• Reduced risk of coronary heart disease (which can also affect hearing), stroke, and peripheral vascular disease,
• Reduced respiratory symptoms, such as coughing, wheezing, and shortness of breath,
• Reduced risk of developing chronic obstructive pulmonary disease (COPD) and
• Reduced risk for infertility of women of reproductive age.

While you can’t reverse any sensorineural hearing loss you’ve developed during your smoking years, you can prevent any future nicotine-related damage to your hearing once you quit.

How to quit

If you’re ready to quit and don’t know where to start, visit smokefree.gov for tips on creating a quit plan and how to handle your first day without cigarettes. The American Lung Association also offers an online Freedom From Smoking program, which teaches skills and techniques proven to help smokers quit, once and for all.

If you have hearing loss

If you smoke, make quitting your first priority since it will quickly improve your health. If you're worried about your hearing, your next step should be to visit a local hearing healthcare professional from our directory of hearing clinics near you for a hearing test today.