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Patients with ARHL were selected based on their pure-tone audiometry results. Previously reported risk factors for ARHL were analyzed using logistic regression and propensity score-matching, and synergistic effects between risk factors were analyzed using propensity score-matching. Of the 12,570 individuals aged 40\u201379\u00a0years, 2002 (15.9%) met the criteria for ARHL. Male sex, exposure to occupational noise, and diabetes showed a significant relationship with ARHL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) in both the logistic regression and propensity score-matching analyses. Smoking and diabetes showed the strongest significant synergistic effect on ARHL (odds ratio [OR] 1.963, 95% confidence interval [CI] 1.285\u20122.998; <jats:italic>p<\/jats:italic>\u2009=\u20090.002). In the subgroup analysis based on smoking status, current smokers with diabetes had a significant relationship with ARHL (OR 1.883, CI 1.191\u20122.975; <jats:italic>p<\/jats:italic>\u2009=\u20090.009), whereas ex-smokers with diabetes did not (OR 1.250; CI 0.880\u20121.775; <jats:italic>p<\/jats:italic>\u2009=\u20090.246). This implies that current smokers with diabetes may benefit from the cessation of smoking. In conclusion, patients with diabetes should strictly avoid or cease smoking to prevent the progression of ARHL.<\/jats:p>","DOI":"10.1038\/s41598-020-75880-2","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T11:02:41Z","timestamp":1604401361000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Synergistic effect of smoking on age-related hearing loss in patients with diabetes"],"prefix":"10.1038","volume":"10","author":[{"given":"Seong Hoon","family":"Bae","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Hyun","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinsei","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"key":"75880_CR1","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1159\/000338588","volume":"58","author":"AR Kidd Iii","year":"2012","unstructured":"Kidd Iii, A. 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