Smoking is not only bad for the lungs and heart, it can also damage your hearing, research suggests.
A study of more than 50,000 participants showed an increased risk of hearing loss among current smokers compared with people who had never smoked.
Smoking led to an increased risk of hearing loss that ranged from 20% to 60%.
Researchers analysed data from annual health check ups which included hearing testing and a life-style questionnaire.
The impact of smoking remained even after adjusting for factors that may have affected the results, such as exposure to occupational noise.
Lead scientist Dr Huanhuan Hu, from the National Centre for Global Health and Medicine in Japan, said: “With a large sample size, long follow-up period, and objective assessment of hearing loss, our study provides strong evidence that smoking is an independent risk factor of hearing loss.
“These results provide strong evidence to support that smoking is a causal factor for hearing loss and emphasise the need for tobacco control to prevent or delay the development of hearing loss.”
Smoking appeared to affect the ability to hear both high and low frequency sounds, but the association with high frequency loss was greater, said the scientists.
The findings appear in the journal Nicotine and Tobacco Research.