Association of Cigarette Smoking Patterns Over 30 Years With Audiometric Hearing Impairment and Speech-in-Noise Perception

Abstract

IMPORTANCEThe implications of cigarette smoking and smoking cessation for hearing impairment remain unknown. Many studies on this topic have failed to account for attrition among smokers in their findings.OBJECTIVE To assess the association of cigarette smoking patterns with audiometric and speech-in-noise hearing measures among participants of the Atherosclerosis Risk in Communities Study. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included participants of the Atherosclerosis Risk in Communities Study from 4 US communities. The analysis includes data from visit 1 (1987-1989) through visit 6 (2016-2017); data were analyzed from March 16 through June 25, 2021. Audiometric hearing and speech-in-noise testing was offered to all participants at visit 6. Participants with incomplete audiometric data or missing data for educational level, body mass index, drinking status, a diabetes or hypertension diagnosis, or occupational noise were excluded. In addition, individuals were excluded if they self-reported as having other than Black or White race and ethnicity, or if they self-reported as having Black race or ethnicity and lived in 2 predominantly White communities.MAIN OUTCOMES AND MEASURES Smoking behavior was classified from visit 1 (1987)(1988)(1989) to visit 6 (2016-2017) using group-based trajectory modeling based on self-reported smoking status at each clinic visit. Hearing was assessed at visit 6. An audiometric 4-frequency (0.5, 1, 2, 4 kHz) pure-tone average (PTA) was calculated for the better-hearing ear and modeled as a continuous variable. Speech-in-noise perception was assessed via the Quick Speech-in-Noise Test (QuickSIN) and modeled continuously. Attrition during the 30 years of follow-up was addressed by inverse probability of attrition weighting.RESULTS A total of 3414 participants aged 72 to 94 years (median [IQR] age, 78.8 [76.0-82.9] years; 2032 [59.5%] women) when hearing was measured at visit 6 (2016-2017) were included in the cohort; 766 (22.4%) self-identified as Black and 2648 (77.6%) as White individuals. Study participants were classified into 3 smoking groups based on smoking behavior: never or former smoking at baseline (n = 2911 [85.3%]), quit smoking during the study period (n = 368 [10.8%]), and persistent smoking (n = 135 [4.0%]). In fully adjusted models, persistent smoking vs never or former smoking was associated with an average 2.69 (95% CI, 0.56-4.81) dB higher PTA (worse hearing) and 1.42 (95% CI, −2.29 to −0.56) lower QuickSIN score (worse performance). Associations were stronger when accounting for informative attrition during the study period (3.53 [95% CI, 1.14-5.93] dB higher PTA; 1.46 [95% CI, −2.52 to −0.41] lower QuickSIN scores). Smoking cessation during the study (vs never or former smoking) was not associated with changes in hearing. CONCLUSIONS AND RELEVANCEIn this cross-sectional study, persistent smoking was associated with worse audiometric hearing and speech-in-noise perception. Hearing measures among participants who quit smoking during the study ...

Machine Learning Prediction of Objective Hearing Loss With Demographics, Clinical Factors, and Subjective Hearing Status

“…Observed feature impacts on PTA align closely with reported results from prior clinical studies. In the abbreviated model, 4 of the 5 most influential features on an increased PTA were known risk factors for the development of HL: older age, male gender, cigarette smoking, and obesity 32‐36 . With the rising prevalence of obesity and diabetes mellitus, the impact of these conditions on HL remains an important consideration 37‐39 .…”

Is COVID‐19 to Blame for Sensorineural Hearing Deterioration? A Pre/Post COVID‐19 Hearing Evaluation Study

“…Among the aforementioned risk factors, evidence has been accumulated regarding the relationship between smoking and hearing loss in both cross-sectional 16 and longitudinal studies. 17 Furthermore, although diabetes mellitus is considered a risk factor for hearing loss, some studies have reported that no such relationship exists when the associations are adjusted for age, biological sex, and hypertension. 18 However, others have found that diabetes is an independent risk factor for hearing impairment.…”

“…Our second research question was regarding whether the risk factors associated with hearing loss, such as smoking, hypertension, and diabetes mellitus, along with the severity of the COVID‐19 infection would exacerbate the deterioration in hearing thresholds post‐COVID‐19. Among the aforementioned risk factors, evidence has been accumulated regarding the relationship between smoking and hearing loss in both cross‐sectional 16 and longitudinal studies 17 . Furthermore, although diabetes mellitus is considered a risk factor for hearing loss, some studies have reported that no such relationship exists when the associations are adjusted for age, biological sex, and hypertension 18 .…”

“…(a) The first question was as follows: among COVID‐19 patients, is there greater sensorineural hearing loss (SNHL) post‐COVID‐19 compared with the pre‐infection hearing status after controlling for age effects? (b) It has been shown that hypertension, diabetes mellitus, and smoking are risk factors for hearing loss 16–20 . Thus, we aimed to address an additional question in this study: do these risk factors also increase the likelihood of hearing deterioration in COVID‐19 patients?…”

“…(b) It has been shown that hypertension, diabetes mellitus, and smoking are risk factors for hearing loss. [16][17][18][19][20] Thus, we aimed to address an additional question in this study: do these risk factors also increase the likelihood of hearing deterioration in COVID-19 patients?…”