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.
Quick Facts
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)
- Authors:
- Hori, Kaitlin, Cobian, Alexander, Gallagher, Tyler, Choi, Janet S
- Database ID:
- RTHC-08340
Evidence Hierarchy
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.
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Cite This Study
https://rethinkthc.com/research/RTHC-08340APA
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.