An analysis of data from 1,533 persons aged 12 to 19 years participating in the National Health and Nutrition Examination Survey 2005-2006 (NHANES) has uncovered an association between secondhand smoke and an increased risk of hearing loss in members of this age group, with most of them being unaware of the problem. © Secondhand smoke is a known risk factor for otitis media (OM), with recurrent acute OM being more common in the nearly 60% of U.S. children exposed. Secondhand smoke also may have the potential to affect auditory development, leading to sensorineural hearing loss. © The NHANES adolescents had been interviewed about their health status, family medical history, exposure to secondhand smoke, and self-recognition of hearing impairment. They also underwent physical examination, including hearing tests and blood testing for cotinine, a by-product of nicotine exposure. © Compared with teens that had no secondhand-smoke exposure, those who were exposed exhibited notably higher rates of low- and high-frequency hearing loss. The rate of hearing loss appeared to be cumulative, increasing with the level of serum cotinine. Nearly 82% of the afflicted parties did not recognize hearing difficulties. © "Adolescents exposed to [secondhand smoke] may need to be closely monitored for early hearing loss with periodic audiologic testing," cautioned the researchers.