Tobacco products and sensory health: An assessment of taste and smell disorders using 2021 NHIS data

Abstract

Introduction: This study aims to assess the relationship between use of tobacco products and taste and smell disorders.

Methods: A secondary dataset analysis of cross-sectional data from the National Health Interview Survey (NHIS) 2021 survey cycle, a nationally representative annual cross-sectional interview of non-institutionalized US civilians, was used. Participants' senses of smell and taste are assessed using self-reported questions. Participants were categorized into five groups based on their tobacco use: non-tobacco users; cigarettes only; e-cigarettes only; cigar, pipe, or smokeless tobacco; and poly-tobacco product users. Disorders were defined as any self-reported difficulty in smelling, tasting, or reporting unpleasant odors or persistent tastes. Weighting procedures were used to estimate the national prevalence of taste, smell, and other disorders, stratified by tobacco products used. Adjusted logistic regression models were used to determine the association between tobacco products used and taste or smell compared to non-tobacco users.

Results: A total of 40.2 million US adults reported experiencing smell or taste disorders. Nearly one in 10 adults reported a taste disorder (9.8%), and 13.4% indicated a smell disorder. The prevalence of taste or smell disorder was higher among females (17.5%), Hispanics (19.5%), individuals identified as 'other' racial minorities (21.1%), and lower income groups (21%). Compared to non-tobacco users, the highest odds of experiencing smell or taste disorders were among poly-tobacco product users (adjusted odds ratio, AOR=1.44; 95% CI: 1.31-1.58), followed by e-cigarette-only users (AOR=1.38; 95% CI: 1.02-1.87), cigarette-only smokers (AOR=1.17; 95% CI: 1.04-1.32), and users of cigars, pipes, or smokeless tobacco (AOR=1.15; 1.00; and 1.33; respectively).

Conclusions: Tobacco product use was associated with an increased risk of smell and taste disorders. The rising use of e-cigarettes among adolescents and young adults is particularly concerning given the limited understanding of the sensory effects of e-cigarettes and their growing popularity among younger populations. The study findings highlight the need for interventions aimed at reducing tobacco use of all kinds.

Keywords: NHIS; e-cigarettes; smell disorder; taste disorder; tobacco.

Figure 1

Prevalence of smell, taste, and smell or taste disorders, by tobacco use groups among US adults, aged ≥18 years, who reported their smoking status and responded to taste and smell questions in the 2021 National Health Interview Survey (NHIS)

Figure 2

Adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) of experiencing taste and smell disorders compared to non-tobacco users among US adults, aged ≥18 years, who reported their smoking status and responded to taste and smell questions in the 2021 National Health Interview Survey (NHIS), adjusting for gender, age, race, and income level