Tinnitus is a perceptual condition that involves “hearing” an internal sound within your ears or head. Smoking and chemicals like nicotine may contribute to tinnitus in various ways.

Cigarette smoking can affect almost every organ of your body, including those responsible for hearing and auditory processing.

Subjective tinnitus occurs when you perceive, or “hear,” a sound within your ears or head that doesn’t have an external source and can’t be heard by other people. People often describe it as a ringing, whistling, or buzzing, and its intensity and disruptiveness can vary for each person.

Smoking is considered a risk factor for tinnitus, and chemicals like nicotine may play an important role in why.

Researchers have linked smoking to an increased rate of tinnitus through multiple studies across multiple populations. There are more than 7,000 harmful chemicals in cigarette smoke that can contribute to body-wide inflammatory conditions. One of these chemicals is nicotine, and it may affect tinnitus in a variety of ways.

A 2018 systematic review and meta-analysis from Germany, for example, found that smoking at any time in life, even if you weren’t a current smoker, was associated with an increased risk of tinnitus.

A systematic review published in 2022 found that, out of modifiable risk factors, tinnitus risk was highest among people who currently smoked or had a history of smoking.

However, the link between smoking and tinnitus does not mean smoking directly causes tinnitus. Experts believe smoking may contribute to hearing challenges in many different ways.

Several toxins in cigarettes have been linked to hearing loss, and nicotine is a well-known chemical in cigarettes that can also potentially affect hearing function.

How nicotine may affect hearing

When it comes to the link between smoking and tinnitus, no evidence suggests that nicotine is solely to blame. Many chemicals in cigarette smoke can affect processes in the body related to hearing.

Nicotine is recognized as the primary addictive substance in cigarettes, which is why it is the focus of abundant research.

When it comes to your hearing, nicotine may contribute to tinnitus through a variety of effects in the body, such as:

  • narrowing blood vessels and reducing blood flow to the inner ear
  • disrupting neurotransmitters necessary for auditory perception and processing
  • contributing to oxidative stress that can damage tissues involved in hearing and hearing perception
  • promoting inflammation of the auditory brainstem, a hearing-specific network in the brain

Can vaping cause or affect tinnitus?

Vaping tobacco products can still expose you to chemicals that affect hearing and potentially contribute to tinnitus.

Electronic cigarettes, for example, are a type of vaping device that typically contains nicotine and cancer-causing chemicals found in traditional cigarettes, like acetaldehyde and formaldehyde.

A scientific paper from 2024 notes that vaping, or the inhalation of vapor rather than smoke, still produces inflammation, oxidative stress, and disruption of neurotransmitters that can affect your hearing.

Nicotine withdrawal may change your auditory perception, which can include experiences of tinnitus.

As an addictive substance, nicotine acts on your brain’s reward system. Your body gets used to its presence and adjusts your baseline functions, like neurotransmitter production, to accommodate. When you stop providing nicotine, your system becomes unbalanced without it, and withdrawal symptoms develop as your brain tries to regulate.

Imbalances in neurotransmitters from nicotine withdrawal could contribute to auditory experiences like tinnitus. You may also be more stressed during the withdrawal period, which could cause heightened tinnitus symptoms.

Because nicotine’s effects on the body are not limited to exposure through smoking or vaping, it may be possible for nicotine replacement products to also affect tinnitus — in a positive way or negative way.

Nicotine gum, patches, and other forms of replacement products provide controlled doses of nicotine to help people overcome dependency. When you use them correctly, they may help relieve auditory issues related to nicotine withdrawal by providing a therapeutic dose during your body’s adjustment period.

If you use them incorrectly and in excess, however, high amounts of nicotine may contribute to tinnitus in a way similar to smoking or vaping.

Support for quitting or reducing nicotine habits

It’s never too late to consider support for reducing nicotine habits. Whether you want help with smoking cessation or wish to eliminate the use of other tobacco products, help is available.

You can start your journey by calling the SAMHSA National Helpline at 800-662-4357. Your call is always confidential, and representatives are available 24/7 to talk with you about nicotine use and local programs.

Other resources include:

Tinnitus is a perceptual auditory condition that may be affected by cigarette smoking and vaping.

Nicotine and other harmful chemicals in tobacco can affect the networks and structures of your body involved in sound perception and processing.