Researchers studied 1,040 stroke patients to understand why some lose their hearing. They found that smokers who had strokes were more likely to experience hearing loss than non-smokers. The study discovered that several factors working together—like smoking, high blood pressure, being overweight, low vitamin D, and poor sleep—significantly increased the risk of hearing problems in stroke patients. This research suggests that stroke patients who smoke face a double threat to their hearing health and should pay special attention to these risk factors.

The Quick Take

  • What they studied: Whether smoking, alcohol use, sleep problems, and mental health issues are connected to hearing loss in people who have had strokes
  • Who participated: 1,040 men and women between ages 25 and 65 who had experienced a stroke. About 22% of them were smokers.
  • Key finding: Smokers who had strokes were significantly more likely to have hearing loss. Eight specific factors—including dizziness, obesity, vitamin D deficiency, metabolic problems, low calcium, migraines, and high blood pressure—were strong predictors of hearing loss in smoking stroke patients.
  • What it means for you: If you’ve had a stroke and smoke, you should be especially aware of your hearing health. Managing weight, blood pressure, vitamin D levels, and sleep quality may help protect your hearing. Talk to your doctor about hearing tests and these risk factors.

The Research Details

This was a cross-sectional study, which means researchers looked at a large group of people at one point in time rather than following them over years. The 1,040 stroke patients underwent several types of tests: physical exams to measure body weight and health markers, imaging scans (like CT or MRI), blood tests to check vitamin and mineral levels, and special hearing tests called pure-tone audiometry that measure how well someone can hear different sounds.

The researchers compared three groups: smokers with hearing loss, smokers without hearing loss, and non-smokers without hearing loss. They used statistical analysis to identify which factors were most strongly connected to hearing problems. This approach allowed them to spot patterns and relationships between smoking, various health conditions, and hearing loss.

This study design is useful for identifying risk factors and patterns in a population quickly. By examining stroke patients specifically, the researchers could understand how smoking affects hearing in people who already have cardiovascular disease. The combination of physical exams, blood tests, and hearing tests provides a comprehensive picture of each patient’s health status.

The study included a reasonably large sample size (1,040 patients), which makes the findings more reliable. The researchers used objective measurements like blood tests and hearing tests rather than relying only on what patients reported. However, because this is a cross-sectional study, it shows associations but cannot prove that smoking directly causes hearing loss—only that they occur together. The study was conducted at one point in time, so we don’t know if these patterns continue over time.

What the Results Show

Among the 1,040 stroke patients studied, 219 smokers (about 22%) had hearing loss. The researchers found major differences between smokers with hearing loss, smokers without hearing loss, and non-smokers. These differences appeared in multiple health markers including body weight, physical activity levels, blood pressure, use of loud music devices (MP3 players), ringing in the ears (tinnitus), dizziness, vertigo, and headaches.

When the researchers focused specifically on smokers with strokes, they identified eight key factors that predicted hearing loss: experiencing vertigo (spinning sensations), obesity, vitamin D deficiency, metabolic syndrome (a cluster of conditions affecting metabolism), low calcium levels, migraines or headaches, and high blood pressure. These factors working together were much stronger predictors than any single factor alone.

The study also found that smokers had worse levels of several blood markers compared to non-smokers, including vitamin D, calcium, magnesium, potassium, blood sugar control, and signs of kidney stress. These nutritional and metabolic differences may help explain why smokers experience more hearing problems.

The research revealed that MP3 player use was significantly different between groups, suggesting that loud noise exposure combined with smoking may increase hearing loss risk. Sleep problems (sleepiness) were also notably different between groups. The study found that metabolic syndrome—a condition involving high blood pressure, high blood sugar, and excess body fat—was strongly connected to hearing loss in smokers. Vitamin and mineral deficiencies (vitamin D, calcium, and magnesium) appeared in smokers with hearing loss more frequently than in other groups.

This research adds to growing evidence that smoking damages hearing health, particularly in people with existing health conditions like stroke. Previous studies have linked smoking to hearing loss in the general population, but this study specifically examines stroke patients, a group at higher risk for multiple health complications. The connection between metabolic problems and hearing loss is increasingly recognized in medical research. The finding that vitamin D deficiency is associated with hearing loss aligns with recent studies suggesting vitamin D plays a protective role in hearing health.

This study has several important limitations. Because it’s a snapshot in time (cross-sectional), we cannot determine whether smoking causes hearing loss or if other factors cause both. The study doesn’t include information about how much or how long people smoked, which would help clarify the smoking-hearing connection. The research doesn’t fully explore alcohol consumption or mental health issues mentioned in the title, focusing mainly on smoking. We don’t know if these findings apply to stroke patients in other countries or populations. Additionally, the study cannot explain the exact biological mechanisms explaining why these factors increase hearing loss risk.

The Bottom Line

If you’ve had a stroke and smoke, consider quitting smoking as a priority for your hearing and overall health (high confidence). Get your hearing checked regularly with a doctor (high confidence). Have your vitamin D, calcium, and magnesium levels tested and corrected if low (moderate confidence). Maintain a healthy weight through diet and exercise appropriate for your condition (high confidence). Keep your blood pressure controlled as directed by your doctor (high confidence). Avoid prolonged exposure to loud sounds, including loud music (moderate confidence). Ensure you’re getting adequate sleep and discuss any sleep problems with your doctor (moderate confidence).

This research is most relevant for stroke patients, especially those who smoke. If you’ve had a stroke, these findings suggest you should pay special attention to your hearing health and the risk factors mentioned. People with high blood pressure, obesity, or metabolic syndrome should also be aware that these conditions may affect hearing. However, these findings don’t necessarily apply to people without a history of stroke. Non-smokers should not assume they have no hearing risk, as other factors also play a role.

Hearing loss typically develops gradually over time, so you may not notice changes immediately. It could take weeks to months of managing these risk factors before you notice improvements in hearing. Regular hearing tests every 6-12 months can help track changes. If you quit smoking, some hearing-related symptoms like tinnitus (ringing) might improve within weeks to months, though permanent hearing loss cannot be reversed.

Want to Apply This Research?

  • Track weekly: smoking status (cigarettes per day or quit date), blood pressure readings, weight, sleep hours per night, vitamin D supplement intake, and any hearing symptoms (ringing, difficulty understanding speech, dizziness). Create a simple daily checklist: Did I take my vitamin D? Did I exercise? Did I get 7+ hours of sleep? Did I avoid smoking?
  • Set a specific quit-smoking goal with a target date. Use the app to log daily cravings and triggers, then identify healthier alternatives (gum, water, walks). Track weight loss progress with weekly weigh-ins. Log blood pressure readings at the same time each day. Record sleep quality and identify patterns affecting sleep. Set reminders for vitamin D and calcium supplement intake.
  • Create a monthly health dashboard showing trends in smoking status, weight, blood pressure, and sleep quality. Schedule quarterly hearing check-ups and log results in the app. Track any new hearing symptoms (tinnitus, difficulty hearing conversations, dizziness) with dates and severity. Share monthly reports with your doctor to monitor progress on these interconnected risk factors.

This research describes associations between smoking, health conditions, and hearing loss in stroke patients but does not prove direct causation. These findings should not replace professional medical advice. If you have had a stroke, smoke, or are experiencing hearing problems, consult with your doctor or an audiologist for personalized evaluation and treatment recommendations. Do not make changes to medications or smoking cessation without discussing with your healthcare provider first. This study was conducted on a specific population and may not apply to all individuals. Always seek professional medical guidance before making health decisions based on research findings.