Date of Degree


Document Type

Capstone Project

Degree Name





Carol Silverman

Subject Categories

Speech and Hearing Science | Speech Pathology and Audiology


hearing, smoking, cigarette, hearing loss, nicotine, tobacco


Objective: The goal of this paper was to systematically review literature in order to investigate the effects of active and passive cigarette smoke on auditory function when assessing outcome measures including pure tone audiometry, otoacoustic emissions, high-frequency audiometry, and auditory evoked potentials.

Methods: A comprehensive search using the Medline Complete database was conducted to identify relevant studies published after 2005. Inclusion criteria included the use of pure tone audiometry, high-frequency audiometry, otoacoustic emissions, and/or auditory evoked potentials to examine the effect of primary or secondary cigarette smoke. Studies involving noise exposure or other confounding factors were excluded.

Results: A total of 19 studies were selected for review based on their research design, publication date, and inclusion criteria. All included studies achieved a significant negative correlation between cigarette smoking and auditory function for both active and passive smokers. Additionally, a dose effect was noted as poorer outcomes were achieved as smoking behavior, such as packs per year or years smoking, increased.

Discussion: Significant effects of smoking on auditory function were noted across outcome measures suggesting a negative effect across levels of the auditory system. Effects on auditory function were noted even in those who had quit smoking suggesting long term side effects of the behavior on auditory function. A dose effect was noted with negative effects increasing across groups from never smokers, to passive smokers, to current smokers. The dose effect was further stratified within the current smoking group as negative effects increased with an increase in smoking behavior.

Conclusion: Smoking behavior should be avoided due to its effects on auditory function, as well as the myriad of other heavily researched deleterious side effects. It would be advantageous to include the question of smoking behavior in an audiologic evaluation intake form. This question should also include systematic exposure to secondhand smoke. Additionally, smoking cessation can be recommended to reduce effects on auditory function.

Key Words: “smoking,” “hearing loss,” “cigarette,” “auditory evoked potentials,” “otoacoustic emissions,” “audiometry.”