Abstract
INTRODUCTIONHearing loss and cigarette smoking are major challenges that affect public health in China. Revealing the effect of smoking on hearing loss in the Chinese general population is critical for hearing health protection. We investigated the relationship between smoking status and hearing loss in China, especially in stratified sex and age groups.METHODSA cross-sectional study was conducted on 4685 individuals aged 20– 80 years in Zhejiang province from 2016 to 2018, with audiometric testing for hearing loss and a structured questionnaire for collecting smoking status and covariates. Logistic regression was used to estimate the association between smoking and hearing loss.RESULTSCigarette smoking was not significantly associated with hearing loss in females and young males. In middle-aged males, after adjusting for covariates, current smokers and past smokers had a significantly higher prevalence of speech-frequency loss (OR=1.65; 95% CI: 1.17–2.33 and OR=1.88; 95% CI: 1.11–3.17; respectively) and high-frequency hearing loss (OR=2.01; 95% CI: 1.43–2.84 and OR=2.64; 95% CI: 1.50–4.66; respectively). In older males, only past smokers had a significantly higher prevalence of speech-frequency hearing loss than never smokers (OR=2.58; 95% CI: 1.38–4.85). Regarding middle-aged and older current smokers, a dose-dependent relationship between smoking intensity and hearing loss was found. Passive smoking was not significantly associated with an increased hearing loss risk in all the three male groups.CONCLUSIONSThe relationship between cigarette smoking and hearing loss varied according to gender and age. Therefore, the interventions for smoking need to be tailored according to age in males.
Highlights
Hearing loss and cigarette smoking are major challenges that affect public health in China
We selected a large sample of the general population, collected smoking status and other factors previously reported to be associated with hearing loss, and measured nine hearing frequency bands
Age, education status, personal income, cigarette smoking, alcohol consumption, workplace noise, frequency of use of headphones, hypertension, diabetes and hyperlipidemia were significantly associated with speech-frequency and high-frequency hearing loss
Summary
Hearing loss and cigarette smoking are major challenges that affect public health in China. Revealing the effect of smoking on hearing loss in the Chinese general population is critical for hearing health protection. According to the Summary of the 2015 China Adult Tobacco Survey Report delivered by Chinese Center for Disease Control and Prevention, the age-standardized smoking prevalence was 37.5% for males and 2.2% for females[14], and in China, the distribution of smoking status varies among different age groups[10] This is likely to be the case for other potential factors that influence health. We selected a large sample of the general population, collected smoking status and other factors previously reported to be associated with hearing loss, and measured nine hearing frequency bands. We investigated the relationship between smoking status and hearing loss in China, especially in stratified gender and age groups
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