Regular Cannabis Use Nearly Doubles Risk of Eustachian Tube Dysfunction | Research

The takeaway

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.

ENT physicians, audiologists, cannabis users experiencing ear problems, and primary care providers counseling patients on cannabis health effects.

What the researchers 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).

Why it 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 numbers in context

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 the study worked

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).

What this study cannot 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%).

How to read the evidence

Large nationally representative sample with objective tympanometry measurement, but cross-sectional design and high cannabis use threshold limit conclusions.

When this study was published

Published 2026; uses 2015-2018 NHANES data.

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.

Questions still open

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?

Common 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 the original research

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

View on PubMed ↗Publisher’s paper ↗

Citation

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