Up In Smoke: How Smoking Can Leave You With Ringing Ears

A person's hand holding a cigarette

Tinnitus is a hearing health condition that causes the sensation of ringing, rushing, or pulsing within the ear. Tinnitus is often accompanied by hearing loss, but hearing loss is not necessary for a diagnosis. While smoking a cigarette may not immediately seem related to hearing issues, there is sufficient evidence to suggest that smoking–and even second hand smoke–can contribute to the onset of hearing problems in both older adults and younger populations. How is the auditory system related to smoking? To understand that, we’ll have to take a look at how this system works, and how cigarette smoke interacts with auditory processing.

Is Smoking A Risk Factor For Tinnitus?

Research has demonstrated that there is an association between smoking and tinnitus. Specific conditions have been shown to change or damage cochlear hair cells–among them, hypoxia (not enough oxygen) and ischemia (inadequate blood supply). Nicotine and other components of cigarette smoke may promote negative changes in the function of blood vessels, affecting blood flow, which may in turn result in hearing loss and/or tinnitus. Smoking is considered a risk factor for the development of tinnitus, according to recent evidence, both in adults and even in younger populations such as college students and adolescents.

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Smoking cessation is essential to improve various health challenges, ranging from a higher risk of lung conditions to an increased risk of immunodeficiency. Because the body as a whole is negatively affected by smoking, there are countless ways in which the body can experience damage in an otherwise healthy system, including the inner ear, and the auditory nerve and auditory pathways that carry out normal, robust hearing health.

While a significant amount of research studies did indicate a significant relationship between smoking and the development of tinnitus, the precise reason behind the link is still not known. There does not seem to be a distinction between lighter smokers and heavy smokers, but those who do not smoke have a substantially reduced risk. Smoking may impact the eustachian tube, as well as other parts of our body by constricting blood vessels and hampering optimal function, and there may be a link to tinnitus between the immunity level differences between smokers and non smokers. However, further research is needed to determine the exact relationship.

What Other Conditions Has Smoking Been Linked To?

Cigarette butts

As we stated above, smoking leads to an increased risk of numerous conditions. The time and circumstances of smoking will also impact the type of risks presented. Pregnancy-related conditions, for instance, include problems during and after birth and in normal childhood development. Some of the most significant risks of smoking include:

  • Infant loss and harm. Smoking during pregnancy has been linked to both short-term and long-term problems, such as preterm birth and intellectual impairment. Additionally, exposure to cigarette smoke increases the risk of sudden infant death syndrome (SIDS).
  • Cancer. Smoking has been linked to not only lung cancer, but a variety of other cancers such as esophageal, stomach, liver, bladder, kidney, colorectal, prostate, and pancreatic cancers.
  • Lung diseases, such as COPD. Smoking results in limited airflow, which can result in a variety of symptoms such as breathlessness, cough, sputum production, wheeze, and chest tightness. The presence of these symptoms can make the lungs susceptible to infection and damage.
  • Hypertension. High blood pressure has been associated with persistent smoking in certain populations. High blood pressure is subsequently linked to cardiovascular disease, heart attack, stroke, and other issues affecting blood vessels.
  • Hearing loss. Smokers were shown to be 1.69 times as likely to have hearing loss compared to nonsmokers. Smokers are also determined to be at higher risk for noise induced hearing loss. Hearing impairment may not initially seem like a risk when smoking, but because smoking damages cells, it can lead to damages to middle ear lining and increase the risk of hearing loss.

Do E-Cigarettes Have The Same Effects As Regular Cigarettes?

Many individuals who want an alternative to smoking will pursue electronic cigarettes, also called “e-cigarettes or vapes. This method allows individuals to inhale an aerosol mixture into their lungs instead of smoke. Although this seems to be, at least on the surface, preferable to traditional smoking, the possible negative effects of vaping are not fully understood. The aerosol mixture does include nicotine, which has been shown to constrict blood vessels, in addition to other potentially harmful components. There are also concerns about reduced oxygen levels in the blood. Ultimately, not enough is known about the long-term effects of electronic cigarettes at this time to determine whether it is a safer alternative to cigarette smoking.

Does Secondhand Smoke Cause Tinnitus?

2 people sitting on a bench smoking cigarettes

Although the presence of secondhand smoke and noise exposure may interact to form a relationship to tinnitus, secondhand smoke itself was not shown to have a direct effect on tinnitus. Smoke alone, then, is not enough to cause hearing loss or damage to the inner ear, though it does have ties to immune system damage.

Secondhand smoke has resulted in abnormal results in specialized hearing tests called “evoked potentials” that provide information about the hearing pathways through the ears and brain. While little or no exposure to cigarette smoking directly may not increase the risk of developing tinnitus, tobacco smoke along with other risk factors may increase the risk of experiencing auditory issues.

Does Quitting Smoking Have Hearing Or Tinnitus-Related Benefits?

There is evidence of a positive association between smoking cigarettes and hearing loss. It has been suggested that quitting smoking may be a potential strategy for maintaining healthy hearing. Individuals who smoke are often encouraged to stop smoking by their healthcare providers for a variety of reasons, the risk of hearing loss usually low among them. Quitting smoking may reduce risk factors involved in hearing loss and improve the hearing health, both of which can be excellent reasons to give up a smoking habit.

Other Causes Of Tinnitus

Tinnitus does have other causes unrelated to smoking. The most common causes of tinnitus include all of the following:

  • Exposure to loud noises. This type of hearing loss is linked to tinnitus, and comes about when an individual is chronically exposed or even acutely exposed to loud or high-pitched noises. Frequent concert goers can experience bouts of tinnitus, as can those who work in loud or mechanical fields or those who shoot firearms without hearing protection.
  • Illness. Although not every infection that occurs will result in tinnitus, infection and other illnesses can result in the onset of tinnitus. The precise factors at play will determine how great the risk is.
  • Trauma. Whether physical or emotional, trauma can also have an impact on the development of tinnitus. From a physical trauma like an injury or even a seemingly unrelated neck surgery, to emotional trauma, your auditory system can be negatively impacted by traumatic exposure.
  • Tinnitus has also been linked to different types of hearing loss, including high frequency hearing loss.


Hearing health is not always directly or even significantly impacted by the presence of cigarette smoke, but by not smoking or avoiding secondhand smoke, you are reducing your risk of damaging sensitive auditory structures that can lead to tinnitus and or hearing loss. Those who smoke are more likely to develop hearing loss compared to individuals who don’t. If tinnitus does not significantly improve after smoking cessation, there are other tinnitus treatment avenues to explore to help manage symptoms and experience a greater quality of life. 

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