ࡱ> >@=7 bjbjUU LH7|7|ldddddddxnnnn z x!!!ceeeeee$  d!"!!!ddm!ddc!cvcddc ` UZyxn.cc0c  cxxddddSmoking damages the inner ear!  As long ago as 1876, in "The Use of Tobacco, It's [sic] Physical, Intellectual, Moral and Social Influences", B.W. Chase stated that the spaces in the skull are more or less connected, so not only the vocal cords but also the nasopharyngeal space and the middle ear can be damaged by the tar-containing blue smoke. Admittedly, he did not yet know anything about the effects on the inner ear. The question of whether there is a direct connection between smoking and labyrinthine deafness was first systematically studied by Dr. Samuel Zelman in 1973 at the Veterans Administration Hospital in Topeka (Canada). He wanted to prove that elderly smokers suffer greater hearing loss than do non-smokers. Despite certain methodological and statistical shortcomings, the study was essentially able to confirm his theories and become a starting point for subsequent research. For instance, Dr. Karen Cruickshanks of the Department of Ophthalmology and Visual Sciences of the University of Wisconsin in Madison (USA) was able to d raw on Zelman's study and others from the early 1970s. In 1998, she and her colleagues published their own paper, entitled "The Epidemiology of Hearing Loss Study". The 5-year study showed that smokers have a 70% greater risk of suffering hearing damage in middle to old age than do non-smokers. The correlation between smoking and impaired hearing still applies even when other factors such as alcohol consumption, exposure to noise, and cardiovascular diseases are taken into consideration. People who become passive smokers because a member of their family smokes are also more frequently affected by hearing problems than others who are not exposed to smoke. The study involved 3,753 inhabitants from 48 to 92 years of age in Beaver Dam, Wisconsin (USA). All of the subjects had been exposed to the same external conditions, so allowance did not have to be made for local factors. Dr. Cruickshanks stresses that her study does not conclusively prove that smoking inevitably damages the hearing. There are also other factors that might explain why hearing deteriorates with age. However, other scientists have endorsed the findings of the Cruickshanks study. One study, amongst others, investigated 10,118 people over a 6-year period at the National Institute on Aging. At the start of the study and annually thereafter, the subjects were asked about their cigarette consumption and loss of hearing. Compared with subjects who had never smoked, the smokers suffered from impaired hearing 20% more often. Over the years, the hearing impairment became 60% more common in the smokers than the non-smokers. The study was published in 1998 in the Journal of the American Medical Association. In November 2000, the American College of Occupational and Environmental Medicine published a new study by Dr. Noriyuki Nakanishi of Osaka University in Japan. In his 5-year study, Dr. Nakanishi looked only at male Japanese employees. None of the 1,554 subjects, aged from 30 - 59 years, initially had any noteworthy hearing loss. In the subsequent 5 years, the effect of smoking on the hearing was observed separately according to high and low frequencies. The effects on the low-frequency range were not significant but they were on the high-frequency range. Furthermore, researchers at the University of Calgary in Alberta found that children who grow up with parents who smoke during the first three years of their life have twice as high a risk of suffering from otitis media and subsequent hearing loss as children who grow up in a smoke-free environment. There appears to be much evidence to suggest that smoking has a considerable effect on hearing in old age, particularly on the high-pitch range. However, the question of the extent to which presbyacusis is a normal phenomenon of ageing or is influenced by other factors such as smoking remains unanswered. All the same, the results of the above studies could be attributed to the carbon monoxide inhaled during smoking reducing oxygen uptake in the blood by its inhibitory effect on haemoglobin, and so leading to hypoxia, particularly of the nervous tissue. As a result, it is possible that the inner ear would also be affected by hypoxia, sclerotic vascular constrictions and vasospasms, which inevitably lead to hearing loss.  !ÿ5\B*CJOJQJ^JaJphjUmHnHu!0JB*CJOJQJ^JaJph!0JB*CJOJQJ^JaJph "Y $a$$a$$a$  1h/ =!"#$%F"[?vLXtlJFIFAJPEG Encoder Copyright 1998, James R. 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