Background:
Health related behaviour specially smoking and tobacco in any form are major determinants of health and lead to health inequities. Tobacco leads to various health problems including ear, nose and throat diseases.

Objective:
To determine the influence of smoking or tobacco use on ear diseases we performed a retrospective study among men.

Method:
Of 11454 subjects of different age-groups there were 4143 men aged 20-60 years who were evaluated for demographic variables, smoking/tobacco use and middle and internal ear diseases. Descriptive statistics and age adjusted logistic regression analyses were performed.

Results:
Among the 4143 men, 1739 (42.0%) were smokers or used tobacco. In smokers/tobacco users compared to non-users the age adjusted odds ratios and 95% confidence intervals (CI) for chronic suppurative otitis media were 1.13 (CI 0.96-1.34), acute otitis media 1.16 (CI 0.82-1.64), suppurative otitis media 1.21 (CI 0.79-1.84), otosclerosis 0.97 (CI 0.52-1.33) (p > 0.05) and for overall middle ear diseases was 1.15 (CI 0.99-1.33, p = 0.05). For internal ear diseases the age adjusted odds ratios were for sensorineural hearing loss 1.12 (CI 0.92-1.58), 0.12 (CI 0.42-0.93) for vertigo and tinnitus and overall internal ear diseases were 0.97 (CI 0.77-1.22, p = 0.81). Among men 40-60 years there was a significantly greater risk for both middle ear (OR 1.73, CI 1.29-2.30) and internal ear diseases (OR 1.94, CI 1.24-3.04) (p < 0.001).

Conclusion:
Smoking/tobacco use is significantly associated with greater prevalence of middle and internal ear diseases among middle-aged men in India.