Association of Smoke and Nicotine Product Consumption With Sensorineural Hearing Loss: A Population-Level Analysis

Objective To test the hypothesis that use of cigarettes or other products with either cigarette-like smoke profile or high nicotine content by young populations increases the odds of developing sensorineural hearing loss (SNHL). Study Design Retrospective cohort study. Setting TriNetX US Collaborative Network (2003–2022). Patients Approximately 3.6 million patients at least 18 years old. Intervention None. Main Outcome Measures The primary outcome of interest was diagnosis of SNHL, defined using medical billing codes ( International Classification of Diseases, Tenth Revision , Current Procedural Terminology , etc.). Cohort inclusion criteria included electronic health record entry after 2003, age 18 to 54 or 55+ years at index, and status of cigarette, noncigarette nicotine, or cannabis use. Covariates were controlled via 1:1 propensity score matching for SNHL-related conditions, including diabetes mellitus and ischemic diseases. Odds for developing SNHL were calculated against control subjects aged 18 to 54 years who have no record of nicotine/cannabis use. Results Odds for developing SNHL are higher for people 18 to 54 years old who use any nicotine product (odds ratio [95% confidence interval], 5.91 [5.71–6.13]), cigarettes only (4.00 [3.69–4.33]), chewing tobacco only (9.04 [7.09–11.63]), or cannabis only (3.99 [3.60–4.44]) compared with control. People 55+ years old who use no products also showed increased odds for SNHL (4.73 [4.63–4.85]). Conclusions Both nicotine and smoke exposure seem to be strongly associated with increased odds for developing SNHL, with chewing tobacco having the strongest association.