Maternal prenatal smoking and hearing loss among adolescents

Although smoking and secondhand smoke exposure are associated with sensory hearing loss in children and adults, the possible association between prenatal smoke exposure and hearing loss had not previously been investigated. More than 12% of US children experience prenatal exposure to nicotine. Hearing test data were examined for 964 adolescents aged 12 to 15 years from the National Health and Nutrition Examination Survey 2005-2006. All children had undergone standardized audiometric testing. Blood tests and self-reports were used to identify adolescents exposed to secondhand smoke or active smokers. Prenatal exposure was defined as an affirmative parental response to, “Did the biological mother smoke at any time while she was pregnant with the child?” Standard criteria were used to define hearing loss.

Study Results: Parental responses affirmed prenatal smoke exposure in 16.2% of 964 adolescents. Prenatal smoke exposure was associated with at least some degree of hearing loss in the high frequencies. As well, prenatal tobacco exposed children had a higher rate of single sided low-frequency sensory hearing loss.

Conclusions and Relevance. Prenatal smoke exposure is independently associated with higher pure-tone hearing thresholds and an almost 3-fold increase in the odds of unilateral low-frequency hearing loss among adolescents. These findings suggest that in utero exposure to tobacco smoke may be injurious to the auditory system.


  1. Maternal prenatal smoking and hearing loss among adolescents., Weitzman, Michael, Govil Nandini, Liu Ying Hua, and Lalwani Anil K. , JAMA Otolaryngol Head Neck Surg, 2013 Jul, Volume 139, Issue 7, p.669-77, (2013)