Is smoking a risk factor for tinnitus? A systematic review, meta-analysis and estimation of the population attributable risk in Germany

TY - JOUR

T1 - Is smoking a risk factor for tinnitus? A systematic review, meta-analysis and estimation of the population attributable risk in Germany

AU - Veile, Annette

AU - Zimmermann, Heiko

AU - Lorenz, Eva

AU - Becher, Heiko

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/2/22

Y1 - 2018/2/22

N2 - OBJECTIVE: To assess the epidemiological association of smoking status and tinnitus with a systematic review and meta-analysis and to estimate the population attributable risk in Germany.DATA SOURCES: A systematic literature search in PubMed and ISI-Web of Science Core Collection resulted in 1026 articles that were indexed until 15 September 2015. Additionally, proceedings of the international tinnitus seminars and reference lists of relevant articles were screened.STUDY SELECTION: Two reviewers searched independently for epidemiological studies. Tinnitus as a manifestation of tumours, vascular malformations, specific syndromes or as a consequence of surgical and medical treatment was not considered. Moreover, studies conducted among patients of ear, nose and throat clinics were excluded.DATA EXTRACTION: If only raw data were provided, effect sizes were calculated. Further unpublished data were received by corresponding authors.DATA SYNTHESIS: Data of 20 studies were pooled. Current smoking (OR 1.21, 95% CI 1.09 to 1.35), former smoking (OR 1.13, 95% CI 1.01 to 1.26) and ever smoking (OR 1.20, 95% CI 1.11 to 1.30) were significantly associated with tinnitus. Moreover, sensitivity analyses for severe tinnitus (OR 1.32, 95% CI 1.10 to 1.58) and for studies of superior quality (OR 1.15, 95% CI 1.03 to 1.29) showed increased risks. According to this, the population attributable risk estimate in Germany is 3.5%.CONCLUSION: There is sufficient evidence that smoking is associated with tinnitus. As the review mainly consists of cross-sectional studies, the observed correlation does not give evidence of a causal relationship. Due to the impact of various confounders, further research is needed to provide more evidence on the strength of association and causal relationships.

AB - OBJECTIVE: To assess the epidemiological association of smoking status and tinnitus with a systematic review and meta-analysis and to estimate the population attributable risk in Germany.DATA SOURCES: A systematic literature search in PubMed and ISI-Web of Science Core Collection resulted in 1026 articles that were indexed until 15 September 2015. Additionally, proceedings of the international tinnitus seminars and reference lists of relevant articles were screened.STUDY SELECTION: Two reviewers searched independently for epidemiological studies. Tinnitus as a manifestation of tumours, vascular malformations, specific syndromes or as a consequence of surgical and medical treatment was not considered. Moreover, studies conducted among patients of ear, nose and throat clinics were excluded.DATA EXTRACTION: If only raw data were provided, effect sizes were calculated. Further unpublished data were received by corresponding authors.DATA SYNTHESIS: Data of 20 studies were pooled. Current smoking (OR 1.21, 95% CI 1.09 to 1.35), former smoking (OR 1.13, 95% CI 1.01 to 1.26) and ever smoking (OR 1.20, 95% CI 1.11 to 1.30) were significantly associated with tinnitus. Moreover, sensitivity analyses for severe tinnitus (OR 1.32, 95% CI 1.10 to 1.58) and for studies of superior quality (OR 1.15, 95% CI 1.03 to 1.29) showed increased risks. According to this, the population attributable risk estimate in Germany is 3.5%.CONCLUSION: There is sufficient evidence that smoking is associated with tinnitus. As the review mainly consists of cross-sectional studies, the observed correlation does not give evidence of a causal relationship. Due to the impact of various confounders, further research is needed to provide more evidence on the strength of association and causal relationships.

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

KW - Tinnitus/epidemiology

KW - Humans

KW - Risk Factors

KW - Germany/epidemiology

KW - Smoking/adverse effects

U2 - 10.1136/bmjopen-2017-016589

DO - 10.1136/bmjopen-2017-016589

M3 - SCORING: Review article

C2 - 29472253

VL - 8

SP - e016589

JO - BMJ OPEN

JF - BMJ OPEN

SN - 2044-6055

IS - 2

ER -