Can e-cigarette (electronic cigarette) use contribute to otitis media (middle ear infection)?

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Last updated: March 8, 2025View editorial policy

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From the Research

Yes, e-cigarette use can contribute to otitis media (middle ear infection). The most recent and highest quality study, published in 2023 1, found that exposure to e-cigarette emissions (EE) may confer a greater risk of pediatric otitis media than previously identified factors, with an odds ratio of 1.61 for having three or more ear infections. This suggests that e-cigarette use can increase the risk of developing otitis media, particularly in children.

Key Findings

  • The study found a significant association between EE and the risk of having three or more ear infections, with an odds ratio of 1.61 (95% CI 1.01-2.58, P = .047) 1.
  • Although the association fell below significance after adjustment for covariates, the study highlights the potential risk of e-cigarette use on otitis media, particularly in children.
  • Other studies have also suggested that tobacco smoke exposure, including secondhand smoke, is associated with an increased risk of otitis media and other respiratory infections 2, 3, 4.

Clinical Implications

  • Reducing or eliminating e-cigarette use may help decrease the frequency and severity of ear infections in individuals experiencing recurrent otitis media.
  • Healthcare providers should consider the potential risks of e-cigarette use when evaluating patients with otitis media symptoms, such as ear pain, hearing loss, or drainage.
  • Antibiotics, such as amoxicillin, may be prescribed if a bacterial infection is present, typically at a dose of 500mg three times daily for 5-7 days in adults.

Recommendations

  • Avoid e-cigarette use to reduce the risk of otitis media and other respiratory infections.
  • Consult a healthcare provider if experiencing otitis media symptoms, as they can provide guidance on treatment and management.
  • Further research is needed to fully understand the effects of e-cigarette use on otitis media and other respiratory infections.

References

Research

Association of e-Cigarette Exposure with Pediatric Otitis Media Recurrence.

The Annals of otology, rhinology, and laryngology, 2023

Research

Otitis Media and Tympanostomy Tubes.

Pediatric clinics of North America, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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