Smoking has long been recognised as a global health crisis, primarily due to its strong association with lung cancer and a multitude of respiratory diseases. Images of smoke-filled lungs and the alarming statutory warnings and statistics on lung cancer incidence constantly bombard us to stay deeply ingrained in public awareness.
However, the health hazards of smoking stretch far beyond its more common link with lung cancer. What often remains hidden in the shadow is the equally significant effect that smoking has on the health of our ear, nose, and throat (ENT) systems.
ENT specialists speak about the wider effects of smoking on our other systems.
Effects of smoking on the ear
According to Dr H K Susheen Dutt, senior consultant, ENT, Fortis Hospital, Nagarbhavi, Bengaluru, smoking has a detrimental effect on the ear and can contribute to various problems, including hearing loss and tinnitus. He says, “Nicotine and other toxic substances in cigarette smoke restrict blood flow to the delicate structures of the ear, impairing their functionality and leading to hearing difficulties.” Smoking can damage the auditory nerves and exacerbate hearing issues.
Dr Dutt lists a few ear health conditions that can be caused or worsened by smoking.
Chronic exposure to cigarette smoke can cause sensorineural hearing loss, which happens due to inner ear damage. It can affect the cochlea’s hair cells and auditory nerves. This type of hearing loss is often irreversible and can worsen with continued smoking.
According to a 2020 research study led by researcher Dr Brian M Lin and team and published in the American Journal of Medicine, smoking is associated with a higher risk of hearing loss. The risk tends to be higher when the number of cigarettes smoked increases. It was found that the risk of hearing loss diminished when the individuals gave up smoking.
Smoking may trigger or worsen tinnitus, a condition characterised by persistent ringing or buzzing in the ears. The toxins in cigarette smoke can disturb the auditory nerves, contributing to the onset or intensification of tinnitus.
Effect on the nose and sinuses
Smoking causes chronic irritation and inflammation and adversely affects the nasal passages and sinuses. The toxic chemicals in cigarette smoke can damage the lining of the nasal cavity and sinus passages, impairing their ability to filter and humidify the inhaled air.
Dr Ghanashyam Talukdar, consultant ENT, Dibrugarh, Assam, lists a few conditions of the nose that smoking can cause or aggravate.
Constant exposure to smoke can lead to chronic rhinitis, a condition characterised by persistent nasal congestion, runny nose and postnasal drip. Smoke-induced irritation of the nasal lining can cause inflammation and exacerbate these symptoms.
Smoking can contribute to chronic sinusitis by causing inflammation the sinus passages and impairing their natural defence mechanisms. “Individuals who smoke are more likely to experience recurrent sinus infections and prolonged episodes of sinusitis,” Dr Talukdar says.
Effects on the throat and larynx
The detrimental effects of smoking on the throat and larynx are well-documented. They significantly increase one’s risk of developing various ENT conditions, including throat cancers and laryngeal disorders.
Dr Talukdar and Dr Dutt list a few of them:
Smoking is a major risk factor for throat cancers, including cancers of the larynx, pharynx, and oesophagus. Carcinogens present in cigarette smoke can cause mutations in the cells of the throat and lead to the development of malignant tumours.
Smoking can irritate and damage the larynx, resulting in chronic hoarseness, vocal cord polyps and other vocal cord disorders. Continued smoking can lead to severe complications in the laryngeal region.
Effects on voice and vocal cords
Smoking can have a serious effect on the voice and vocal cords, affecting vocal quality and potentially leading to long-term consequences for individuals who smoke heavily.
Chronic irritation and inflammation of the vocal cords can be caused, resulting in hoarseness and a rough or strained voice.
Vocal cord disorders
Prolonged smoking can cause structural changes in the vocal cords, leading to conditions such as vocal nodules, polyps or even precancerous lesions.
Certain demographics within the population exhibit varying degrees of susceptibility to the detrimental effects of smoking on their ear, nose, and throat (ENT) health. “Younger individuals with developing ENT structures, particularly children and adolescents, are highly susceptible to the adverse consequences of smoking,” says Dr Dutt. According to him, their ENT systems are still in the crucial stages of growth and development, making them more vulnerable to the harmful chemicals found in tobacco. “Exposure to these toxic substances during this critical phase can lead to lasting damage to their respiratory and sensory systems, affecting their hearing, taste, and overall respiratory health.”
On the other end of the spectrum, older individuals with reduced healing capacity face an increased susceptibility to the harmful effects of smoking on ENT health, according to Dr Dutt. The natural ageing process diminishes the body’s ability to repair and regenerate damaged tissues, making it more difficult for them to recover from the damage caused by smoking.
“This reduced healing capacity makes them prone to chronic conditions such as chronic obstructive pulmonary disease (COPD), chronic bronchitis, and various types of cancers affecting the ENT region,” says Dr Talukdar. Moreover, smoking exacerbates existing ENT issues commonly associated with ageing, such as hearing loss and voice disorders, adds Dr Dutt.
Benefits of quitting smoking
Giving up smoking can mitigate these risks and improve ENT health. “The benefits of quitting [smoking] can be observed relatively quickly, with improvements in breathing, reduced inflammation and a decreased risk of developing further ENT complications,” says Dr Talukdar.
A few steps to quitting
Shreya Gupta, counselling psychologist, Gurugram, suggests a few steps to stop smoking:
- Set a date to quit: Choose a specific date to quit smoking, providing yourself a target to work towards. This will mentally prepare you for your commitment.
- Understand triggers: Identify situations, places or activities that trigger your urge to smoke. This awareness will help you devise strategies to avoid, or cope with, the triggers.
- Explore nicotine replacement therapies: Consider using nicotine replacement therapies such as nicotine gum, patches, lozenges or inhalers to manage cravings and withdrawal symptoms.
- Develop coping strategies: Learn and practise stress reduction techniques, such as deep breathing, meditation or yoga, to manage stress without resorting to smoking.
- Reward yourself: Celebrate milestones and achievements in your journey to quitting smoking. Treat yourself to something enjoyable as a reward for reaching specific goals.
It is essential to recognise that ENT health is an integral part of our overall well-being, affecting our communication, sensory perception and quality of life. The imperative to quit smoking extends beyond the desire for cleaner lungs. It also encompasses the preservation of our senses, our ability to enjoy the world around us and our overall health and well-being.