Association of Cannabis and Cigarette Use With Eustachian Tube Dysfunction

To examine the associations between cannabis use-individually and in combination with e-cigarettes or cigarettes-and obstructive eustachian tube dysfunction (OETD) among US adults.

Cross-sectional review of participants from the National Health and Nutrition Examination Survey (2015 to 2018) with complete data on tympanometry and drug and smoking questionnaires (n=2777). Cannabis and e-cigarette use were categorized as never, nonregular, or regular use. Cigarette smoking was categorized as never, former, or current use. OETD was defined as middle ear pressure less than -100 Decapascals. Multivariable logistic regression analyses were performed to determine associations.

Among US adults, 4.9% (95% CI: 3.4%-7.0%) had tympanometry findings consistent with OETD. Regular cannabis use, defined as >15 days of use in the last 30 days, was significantly associated with OETD (OR: 1.95, 95% CI: 1.02-3.72) in a multivariable model adjusting for e-cigarette, cigarette use, and other relevant demographic and clinical factors. Both ever and regular cigarette use were significantly associated with OETD (OR: 1.62, 5% CI: 1.02-2.56; OR: 2.18, 95% CI: 1.27-3.74, respectively), while e-cigarette use (ever, nonregular, or regular) was not independently associated with OETD in multivariable models. The combined use of all 3 substances was associated with greater odds of OETD (OR: 2.10, 95% CI: 1.23-3.58).

This study suggests that regular cannabis use and combined use of cannabis, e-cigarettes, and cigarettes are associated with greater odds of OETD. Future research is needed to better understand the effect of cannabis, independently and in combination with other substances, on OETD.