Regular Cannabis Use Nearly Doubles Risk of Eustachian Tube Dysfunction

Regular cannabis use (>15 days/month) was associated with nearly double the odds of obstructive eustachian tube dysfunction, independent of cigarette and e-cigarette use, with combined substance use further increasing risk.

Hori, Kaitlin et al.·Otology & neurotology : official publication of the American Otological Society·2026·Moderate EvidenceCross-Sectional
RTHC-08340Cross SectionalModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=2,777

What This Study Found

Regular cannabis use was independently associated with OETD (OR=1.95, 95% CI=1.02-3.72) after adjusting for cigarette and e-cigarette use, while current cigarette smoking showed even stronger association (OR=2.18, 95% CI=1.27-3.74), and combined use of all three substances increased odds further (OR=2.10, 95% CI=1.23-3.58).

Key Numbers

N=2,777; 4.9% had OETD; regular cannabis use OR=1.95; current cigarette OR=2.18; ever cigarette OR=1.62; combined use (all 3) OR=2.10; e-cigarette use not independently significant

How They Did This

Cross-sectional analysis of 2,777 NHANES participants (2015-2018) with complete tympanometry data, using multivariable logistic regression to examine cannabis, e-cigarette, and cigarette use associations with OETD (defined as middle ear pressure <-100 Decapascals).

Why This Research Matters

Eustachian tube dysfunction can cause ear pain, hearing problems, and recurrent ear infections — this study provides the first evidence that regular cannabis use independently increases this common condition's risk.

The Bigger Picture

Cannabis smoke, like tobacco smoke, appears to damage upper airway tissues including the eustachian tube — an underappreciated health consequence that may affect the millions of regular cannabis smokers.

What This Study Doesn't Tell Us

Cross-sectional design; NHANES tympanometry at single timepoint may not reflect chronic OETD; self-reported substance use; cannabis use definition (>15 days) is a high threshold; cannot determine mechanism; relatively small OETD prevalence (4.9%).

Questions This Raises

  • ?Would non-smoked cannabis (edibles, tinctures) avoid this risk?
  • ?Is the effect reversible with cessation?
  • ?Does cannabis-related OETD lead to hearing loss over time?

Trust & Context

Key Stat:
Evidence Grade:
Large nationally representative sample with objective tympanometry measurement, but cross-sectional design and high cannabis use threshold limit conclusions.
Study Age:
Published 2026; uses 2015-2018 NHANES data.
Original Title:
Association of Cannabis and Cigarette Use With Eustachian Tube Dysfunction.
Published In:
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 47(2), 304-311 (2026)
Database ID:
RTHC-08340

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Can smoking cannabis cause ear problems?

This study found that regular cannabis use (more than 15 days per month) nearly doubled the risk of eustachian tube dysfunction, which can cause ear pressure, pain, and hearing problems — likely from smoke irritating the upper airway.

Is cannabis or cigarettes worse for ear health?

Both are problematic — current cigarette smoking had slightly higher odds (2.18x) of eustachian tube dysfunction than regular cannabis use (1.95x), and using both together further increased the risk.

Read More on RethinkTHC

Cite This Study

RTHC-08340·https://rethinkthc.com/research/RTHC-08340

APA

Hori, Kaitlin; Cobian, Alexander; Gallagher, Tyler; Choi, Janet S. (2026). Association of Cannabis and Cigarette Use With Eustachian Tube Dysfunction.. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 47(2), 304-311. https://doi.org/10.1097/MAO.0000000000004756

MLA

Hori, Kaitlin, et al. "Association of Cannabis and Cigarette Use With Eustachian Tube Dysfunction.." Otology & neurotology : official publication of the American Otological Society, 2026. https://doi.org/10.1097/MAO.0000000000004756

RethinkTHC

RethinkTHC Research Database. "Association of Cannabis and Cigarette Use With Eustachian Tu..." RTHC-08340. Retrieved from https://rethinkthc.com/research/hori-2026-association-of-cannabis-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.