WITHDRAWN: Association between Hearing Loss and Substance Use: Evidence from a National Survey

Background and Purpose:  

Hearing loss is one of the most prevalent health conditions and is an important contributor to health disparities for Americans. Hearing loss is greatly associated with chronic diseases, poorer mental health, and a high level of social withdrawal, isolation, and exclusion. Although substance use is a leading determinant of health disparities, little attention has been paid to the relationship between hearing loss and substance use. A few studies have found that the prevalence of substance use among people with hearing loss is higher, compared to their hearing counterparts, since they have a lower level of health literacy and difficulties in accessing mental health services. However, previous studies were mostly based on small samples with non-standardized measures. Thus, this study aims to rigorously examine the association between hearing loss and substance use, using a nationally representative data.

Methods:

This study used secondary data analysis of the 2016 National Survey on Drug Use and Health (NSDUH), which is the annual survey to explore civilians’ drug use and mental illness. The outcome variables for substance use were: habitual smoking (smoked six or more cigarettes per day in the last month), binge drinking (drank four/five or more alcoholic beverages in one day at least once during the past month), and marijuana use (used marijuana or hashish during the past month). The independent variable for hearing loss was measured by using a single item asking whether respondents were deaf or had serious difficulty hearing. Age, gender, race, marital status, educational attainment, income, insurance status, urbanization, and employment status were identified as covariates. Survey data analysis procedures were employed because of the complex survey design of NSDUH.

Results:

Multivariable logistic regression analyses revealed that hearing loss was a significant predictor of substance use in terms of habitual smoking, indicating people with hearing loss were more likely to habitually smoke cigarettes, compared to their counterparts (OR=1.89, p<0.05). However, hearing loss was not significantly associated with binge drinking or marijuana use. Among covariates, gender, race, age, employment status, insurance status were significant predictors of habitual cigarette use, while marital status, income, and educational attainment had no effect on habitual smoking.

Conclusions and Implications:

The study found positive associations between hearing loss and habitual smoking, but not for binge drinking and marijuana use. These different outcomes may be attributable to several factors. First, buying cigarettes is easy for people regardless of communication difficulties. Second, hearing loss has an adverse effect on communicating with others, making it difficult to access and purchase alcohol and illegal substances. Third, the real voices of those with hearing loss may not be comprehensively captured by the NSDUH study data collection. More evidence is needed regarding differential substance use among people with hearing loss. Providing effective interventions and treatments to reduce substance use which are tailored to the needs of people with hearing loss should be considered.