Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Colorado, USA.
Department of Applied Mathematics, University of Colorado Boulder, Boulder, Colorado, USA.
Ear Hear. 2022;43(5):1582-1592. doi: 10.1097/AUD.0000000000001219. Epub 2022 Apr 4.
A relationship between tobacco smoking and hearing loss has been reported; associations with cannabis smoking are unknown. In this cross-sectional population-based study, we examined relationships between hearing loss and smoking (tobacco, cannabis, or co-drug use).
We explored the relationship between hearing loss and smoking among 2705 participants [mean age = 39.41 (SE: 0.36) years] in the National Health and Nutrition Examination Survey (2011 to 12; 2015 to 16). Smoking status was obtained via questionnaire; four mutually exclusive groups were defined: nonsmokers, current regular cannabis smokers, current regular tobacco smokers, and co-drug users. Hearing sensitivity (0.5 to 8 kHz) was assessed, and two puretone averages (PTAs) computed: low- (PTA 0.5,1,2 ) and high-frequency (PTA 3,4,6,8 ). We defined hearing loss as threshold >15 dB HL. Multivariable logistic regression was used to examine sex-specific associations between smoking and hearing loss in the poorer ear (selected based on PTA 0.5,1,2 ) adjusting for age, sex, race/ethnicity, hypertension, diabetes, education, and noise exposure with sample weights applied.
In the age-sex adjusted model, tobacco smokers had increased odds of low- and high-frequency hearing loss compared with non-smokers [odds ratio (OR) = 1.58, 95% confidence ratio (CI): 1.05 to 2.37 and OR = 1.97, 95% CI: 1.58 to 2.45, respectively]. Co-drug users also had greater odds of low- and high-frequency hearing loss [OR = 2.07, 95% CI: 1.10 to 3.91 and OR = 2.24, 95% CI: 1.27 to 3.96, respectively]. In the fully adjusted multivariable model, compared with non-smokers, tobacco smokers had greater odds of high-frequency hearing loss [multivariable adjusted odds ratio = 1.64, 95% CI: 1.28-2.09]. However, in the fully adjusted model, there were no statistically significant relationships between hearing loss (PTA 0.5,1,2 or PTA 3,4,6,8 ) and cannabis smoking or co-drug use.
Cannabis smoking without concomitant tobacco consumption is not associated with hearing loss. However, sole use of cannabis was relatively rare and the prevalence of hearing loss in this population was low, limiting generalizability of the results. This study suggests that tobacco smoking may be a risk factor for hearing loss but does not support an association between hearing loss and cannabis smoking. More definitive evidence could be derived using physiological measures of auditory function in smokers and from longitudinal studies.
已有研究报道吸烟与听力损失之间存在关联，但吸烟与大麻之间的关联尚不清楚。在这项基于人群的横断面研究中，我们研究了听力损失与吸烟（烟草、大麻或共同药物使用）之间的关系。
我们探索了 2705 名参与者（平均年龄=39.41（SE：0.36）岁）在国家健康和营养检查调查（2011 年至 12 年；2015 年至 16 年）中听力损失与吸烟之间的关系。吸烟状况通过问卷获得；定义了四个互斥的组：非吸烟者、当前定期吸食大麻者、当前定期吸烟者和共同药物使用者。听力敏感度（0.5 至 8 kHz）进行了评估，并计算了两个纯音平均值（PTA）：低频（PTA 0.5、1、2）和高频（PTA 3、4、6、8）。我们将听力损失定义为阈值>15 dB HL。多变量逻辑回归用于调整年龄、性别、种族/民族、高血压、糖尿病、教育和噪声暴露等因素后，基于较差耳的 PTA 0.5、1、2 检查吸烟与听力损失之间的性别特异性关联，并应用样本权重。
在年龄和性别调整模型中，与非吸烟者相比，吸烟者发生低频和高频听力损失的几率增加[比值比（OR）=1.58，95%置信区间（CI）：1.05 至 2.37 和 OR=1.97，95%CI：1.58 至 2.45]。共同药物使用者也有更高的低频和高频听力损失的几率[OR=2.07，95%CI：1.10 至 3.91 和 OR=2.24，95%CI：1.27 至 3.96]。在完全调整的多变量模型中，与非吸烟者相比，吸烟者发生高频听力损失的几率更高[多变量调整比值比=1.64，95%CI：1.28-2.09]。然而，在完全调整的模型中，大麻吸烟或共同药物使用与听力损失（PTA 0.5、1、2 或 PTA 3、4、6、8）之间没有统计学上的显著关系。
单独吸食大麻而不伴有烟草消费与听力损失无关。然而，大麻的单独使用相对较少，且该人群的听力损失患病率较低，限制了结果的普遍性。本研究表明，吸烟可能是听力损失的一个危险因素，但不能支持听力损失与大麻吸烟之间的关联。使用吸烟者的听觉功能生理测量值和纵向研究可以获得更明确的证据。
