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Cigarette smoking and hearing loss: the epidemiology of hearing loss study
K J Cruickshanks1, R Klein, B E Klein
1Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-2397, USA. cruickshanks@epi.ophth.wisc.edu
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.