Tobacco induced diseases · 2026
Associations of combined smoking and drinking with subjective and objective olfactory dysfunction: A secondary dataset analysis of NHANES 2013-2014.
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He Lu, Wang Jianhong, Rao Yuansheng, Yang Fan
Аннотация
INTRODUCTION: The association between smoking, alcohol consumption, and olfactory dysfunction (OD) remains inconclusive, and few studies have simultaneously examined their relationships with both subjective and objective OD in large population-based samples. This study aimed to investigate the associations of different smoking and drinking statuses with subjective and objective OD among US adults aged ≥40 years.
METHODS: This secondary dataset analysis of NHANES 2013-2014 included 3376 adults aged ≥40 years who completed the chemosensory questionnaire, smoking and alcohol use questionnaires, and the odor identification test. Subjective OD was based on self-reported olfactory impairments from the NHANES chemosensory questionnaire, and objective OD was assessed using an 8-item odor identification test (score 0-5 indicating impairment). Smoking status was classified based on smoking index, serum cotinine, and time to first cigarette; heavy drinking was defined based on daily drinking habits during any period in life. Multivariable logistic regression models adjusted for demographic factors and OD-related risk factors.
RESULTS: The prevalence of subjective and objective OD was 20.3% and 18.3%, respectively. For subjective OD, significantly elevated adjusted odds were observed for chronic smoker (AOR=1.47; 95% CI: 1.12-1.93), chronic active smoker (AOR=1.55; 95% CI: 1.16-2.08), high dependent active smoker (AOR=1.69; 95% CI: 1.19-2.40), chronic smoker-heavy drinker (AOR=1.72; 95%CI: 1.14-2.60), and active smoker-heavy drinker (AOR=1.90; 95% CI: 1.25-2.88). For objective OD, significantly higher adjusted odds were found for chronic smoker (AOR=1.64; 95% CI: 1.26-2.12), chronic active smoker (AOR=1.59; 95% CI: 1.10-2.32), high dependent smoker-heavy drinker (AOR=2.69; 95% CI: 1.36-5.34), and chronic smoker-heavy drinker (AOR=1.67; 95% CI: 1.12-2.50).
CONCLUSIONS: Chronic smoking and heavy drinking, particularly in combination, are significantly associated with both subjective and objective OD in US adults aged ≥40 years. These findings suggest that smoking and heavy alcohol use may represent modifiable risk factors for olfactory impairment. Further longitudinal studies are warranted to confirm these associations and explore underlying mechanisms.
METHODS: This secondary dataset analysis of NHANES 2013-2014 included 3376 adults aged ≥40 years who completed the chemosensory questionnaire, smoking and alcohol use questionnaires, and the odor identification test. Subjective OD was based on self-reported olfactory impairments from the NHANES chemosensory questionnaire, and objective OD was assessed using an 8-item odor identification test (score 0-5 indicating impairment). Smoking status was classified based on smoking index, serum cotinine, and time to first cigarette; heavy drinking was defined based on daily drinking habits during any period in life. Multivariable logistic regression models adjusted for demographic factors and OD-related risk factors.
RESULTS: The prevalence of subjective and objective OD was 20.3% and 18.3%, respectively. For subjective OD, significantly elevated adjusted odds were observed for chronic smoker (AOR=1.47; 95% CI: 1.12-1.93), chronic active smoker (AOR=1.55; 95% CI: 1.16-2.08), high dependent active smoker (AOR=1.69; 95% CI: 1.19-2.40), chronic smoker-heavy drinker (AOR=1.72; 95%CI: 1.14-2.60), and active smoker-heavy drinker (AOR=1.90; 95% CI: 1.25-2.88). For objective OD, significantly higher adjusted odds were found for chronic smoker (AOR=1.64; 95% CI: 1.26-2.12), chronic active smoker (AOR=1.59; 95% CI: 1.10-2.32), high dependent smoker-heavy drinker (AOR=2.69; 95% CI: 1.36-5.34), and chronic smoker-heavy drinker (AOR=1.67; 95% CI: 1.12-2.50).
CONCLUSIONS: Chronic smoking and heavy drinking, particularly in combination, are significantly associated with both subjective and objective OD in US adults aged ≥40 years. These findings suggest that smoking and heavy alcohol use may represent modifiable risk factors for olfactory impairment. Further longitudinal studies are warranted to confirm these associations and explore underlying mechanisms.