Should musicians smoke?

The short answer is of course not.  What a stupid question! There are very few short term benefits to smoking, and absolutely no benefits to long term smoking.  Don’t smoke!  So why am I writing a blog with such a silly topic?  The short answer is “don’t smoke,” but the long answer is, well, a bit longer.

Many professional organizations such as the American Medical Association have popularized the link between hearing loss and smoking.   Indeed there are numerous studies stemming from the 1970s showing that the lack of oxygen and/or higher levels of carbon dioxide have been implicated in hearing loss.   For example, Ismail et al. (1973) studied the temporary hearing loss (TTS) of workers after a long shift, and again after an 8-month physical fitness training program.  They found that the TTS was less after the physical training program.  Patchett (1992) found that the inhalation of oxygen during noise exposure reduced TTS.  The list goes on and on, that higher levels of oxygen reaching the cochlea (either by cardio vascular exercise or by direct inhalation) can be protective, at least as far as TTS are concerned.  And other studies show that increased carbon dioxide or carbon monoxide are correlated to reduce auditory function and can affect both the cochlea and the auditory cortex.

There appear to be two major explanations of the relationship between hearing loss and low oxygen (and/or high carbon dioxide levels) in the cochlea.  One is “metabolic exhaustion” and is related to the hair cells in the cochlea failing to convert nutrients and expel waste.  Another reason comes from the other side of the coin- a vascular reason where noise constricts blood flow to the necessary structures in the cochlea.  Both of these are hypotheses only despite being studied to great detail for almost 40 years.

Now we turn our attention to the perhaps forgotten work of Dengerink and his colleagues in the 1980s.  Dengerink et al. (1984, 1987{{1}}[[1]]Dengerink, H.A., Lindgren, F., Axelsson, A., and Dengerink, J. (1987).  The effects of smoking and physical exercise on temporary threshold shifts.  Scandinavian Audiology, 16(3), 131-136.[[1]]) showed that the effects of smoking while in cold environments decreased one’s propensity to noise exposure.   They argued that both cold weather and smoking caused a peripheral vasoconstriction thereby making more oxygen available to those organs that are supplied by the central blood supply such as the cochlea.   They also found that exercise and smoking decreased one’s susceptibility to hearing loss as compared with a non-exercising, non-smoking group.  It was argued that more blood (and therefore oxygen) supply was available to the cochlea because of the peripheral vasoconstriction.

The findings of the American Medical Association and those of Dengerink and his colleagues are not necessarily contradictory.  Simply stated, if there is more oxygen (and/or less carbon dioxide) available to the cochlea, then there will be a lower susceptibility for noise (or music) induced hearing loss.

If people do smoke, then they should take every effort to ensure that their cardiovascular systems are as good as possible.  The two don’t normally go hand in hand however.  Smokers do not spend as much time at the gym or in the pool as non-smokers, so it’s safe to say that smokers do indeed have a greater propensity of hearing loss.

If you are a non-smoker however (and in good cardiovascular shape) it’s probably OK to take a puff here and there if you are going to a rock concert.  And perhaps we should, advocate as a field, that more rock concerts should be outdoors in cold northern climates- everyone would benefit… well, at least their ears would benefit.

So, should musicians smoke?  Definitely not, but if they are non-smokers, a few puffs here and there may be protective for the music.


Ismail, A.H., Corrigan, D., MacLeod, D., Anderson, V., Kasten, R., and Elliot, P. (1973).  Biophysiological  and audiological variables in adults, Archives of Otolaryngology, 97, 447-451.

Pachett,  R. (1992). The effects of inhalation of oxygen and carbon dioxide mixtures on noise-induced temporary threshold shift in humans.  Canadian Acoustics, 20(1), 21-25.

Dengerink, H.A., Trueblood, G., and Dengerink, J. (1984).  The effects of smoking and environmental temperature on temporary threshold shifts, Audiology, 23, 401-410.


About Marshall Chasin

Marshall Chasin, AuD, is a clinical and research audiologist who has a special interest in the prevention of hearing loss for musicians, as well as the treatment of those who have hearing loss. I have other special interests such as clarinet and karate, but those may come out in the blog over time.