Association between cigarette smoking and hearing loss: A cross-sectional study from the NHANES database

Using data from the National Health and Nutrition Examination Survey (NHANES), this study aimed to assess the association between smoking and hearing loss and explore its heterogeneity across gender and age groups. This secondary dataset analysis used a cross-sectional design and included NHANES data from 2005-2012 and 2015-2018. The study population consisted of adults without hearing-related disorders. Hearing loss was assessed by pure tone audiometry (PTA) and included low-frequency (LFHL), speech-frequency (SFHL) and high-frequency hearing loss (HFHL), expressed as continuous and categorical variables, respectively. Linear and logistic regression models were used to analyze the association between hearing loss and the exposure variable smoking status. A total of 4217 adult subjects were included. It was found that smokers had a higher prevalence of LFHL, SFHL and HFHL than non-smokers (LFHL: 15.62% vs 8.51%, SFHL: 23.22% vs 12.98%, HFHL: 53.48% vs 36.95%). In males, in Models 1 (unadjusted), 2 and 3 (adjusted), there were statistically significant differences (p<0.05) in LFHL (β=4.24; 95% CI: 3.32-5.17; β=1.65; 95% CI: 0.80-2.49; β=1.52; 95% CI: 0.66-2.38) in SFHL (β=5.63; 95% CI: 4.56-6.70; β=1.95; 95% CI: 1.05-2.84; β=1.62; 95% CI: 0.72-2.52) and in HFHL (β=10.20; 95% CI: 8.21-12.19; β=2.85; 95% CI: 1.33-4.37; β=2.19; 95% CI: 0.69-3.70) between smokers and non-smokers, for continuous variables of hearing loss. In male hearing loss, categorical variables also showed statistically significant differences between smokers and non-smokers (p<0.05). In the middle-aged group, compared with non-smokers, logistic regression of smoking with all three types of hearing loss showed statistically significant differences (p<0.05) in Models 1, 2 and 3. There was a significant association between smoking and hearing loss, with maybe more significant associations with all three types of hearing loss in male smokers and a significant relationship between smoking and hearing loss in the middle-aged group.