Vaping and hearing loss: Is there a link?

Studies have shown smoking cigarettes can damage your hearing, but what about vaping?

There's no conclusive research yet, but it appears that vaping indeed carries similar risks to smoking. And depending on the chemicals found in the vape juice flavoring, it may even be more harmful.

Here's what we do know:

• Nicotine—regardless of where it came from—has known negative health impacts on your ears and blood supply. If you smoke, it can affect your hearing.
• The flavors used for vaping are largely unregulated and unchecked, and some are linked to hearing loss.
• Anecdotal reports indicate a direct link between vaping and hearing loss, such as this musician's report of vaping and sudden hearing loss, and this forum thread on tinnitus and vaping.

Little government oversight of vaping chemicals

E-cigarettes, vaping pens and mod boxes are devices that allow users to inhale a vapor containing varying levels of nicotine, along with other substances. They are battery operated and use a heating element to heat up a substance called e juice or vape juice, which is contained in a cartridge. The vapor is then released and inhaled by the user. There are hundreds of brands and thousands of vape juice flavors currently on the market.

While the FDA has implemented more regulations during the last several years, there is still more to be done when it comes to oversight so that healthcare professionals or consumers to know precisely how vaping affects your health, including your hearing health.

Nicotine restricts blood flow

Nicotine, a substance also found in regular cigarettes, carries unique health risks. Nicotine is an addictive substance that tightens your blood vessels, including the ones in your ears. This restricts the blood flow oxygen to the inner ear, which leads to damage in the tiny hair cells in the cochlea that translate sound vibrations into electrical impulses for the brain.

Although some e-cigarette cartridges contain no nicotine, others contain nicotine in varying amounts, from a little to a lot.

"When you're exposed to nicotine from these products you can experience both the short-term and long-term harms of nicotine use," said Dr. Suchitra Krishnan-Sarin, a professor of psychiatry at the Yale School of Medicine, at a 2019 media briefing on vaping. Her research is focused on understanding substance-use behaviors in adult and adolescent substance users. "The nicotine in the newer Juul products are much higher than older products. It's very possible you're exposed to much higher levels of nicotine." 

A study done in 2014 found there was often a significant difference in the amount of nicotine present in the cartridge and what was presented on the label.

In 2022 research funded by the National Institutes of Health found that chronic use of e-cigarettes impaired blood vessel function and increased the risk of cardiovascular disease compared to people who did not vape.

Hidden dangers in vape juice

But you can always choose a zero-nicotine option, which should be trouble free, right? Not necessarily.

Even if you go with the zero-nicotine option, the vape juice bears examination. It's what gives the e-cigarette its “flavor,” and contains at the very least a mixture of flavorings, colorings, other unknown chemicals—and often a substance called propylene glycol.

Propylene glycol is an alcohol-based solvent that, while not having yet been studied in terms of its use in e-cigarettes, has been studied in relation to products such as ear drops. Research has proven that when used topically, propylene glycol is ototoxic (i.e. harmful to the inner ear).

"One of the big concerns we have: What are people using these e-cigarettes and and products being exposed to when they try these products?" Krishnan-Sarin pointed out. "We learn everyday about new things that are being put into these products."

The risk to teens and young adults

When it comes to vaping and hearing health, younger people may be at an elevated risk. Studies have shown mechanisms within the hearing nerve are not fully developed until late adolescence, which means the hearing nerve pathways of teens are particularly vulnerable to any toxins such as nicotine.

In response to this, state and federal governments have taken several steps to try and reduce vaping among teenagers.

In late 2019, the Federal Food, Drug, and Cosmetic Act was amended to raise the federal minimum age for sale of tobacco products from 18 to 21 years. Known as Tobacco 21, this change in the law applies to e-cigarettes as well because they are considered a tobacco product due to the fact that they can contain nicotine that's derived from tobacco. 

In 2020, the FDA banned most flavored e-cigarettes apart from menthol and tobacco, in large part to curb vaping's appeal to younger people. However, the Supreme Court is scheduled to hear arguments on this case and make a decision as to legality of the FDA's ban in June of 2025.

Vaping among youth down, but still a problem

The good news is that vaping is down among young people. The Centers for Disease Control and Prevention (CDC) reported that in 2024 the number of youth who currently used e-cigarettes was roughly one third of what it was at its peak of over five million in 2019.

However, the report also indicated that over a quarter of young people who vape do so every day, and the vast majority reported using flavored products.

How is that possible? Even though flavored vape products are supposed to be illegal in the U.S., many teens still find ways to access them through stores that ignore or find loopholes to the bans, online purchases, or getting them from friends, keeping these appealing flavors in circulation.

Get immediate help if you experience sudden hearing loss

Some claim that e-cigarettes are a safer alternative to cigarettes, and can even help individuals stop smoking. The jury is still out on that as well. If you do vape, and experience symptoms such as blockage, ear pressure, sudden hearing loss or tinnitus, stop vaping immediately and consult an ENT or hearing healthcare professional.