The relationship between passive smoking and middle ear disease was reviewed. The hypothesis that acute otitis media, serous otitis media, and related diseases in children are caused by inhalation of second-hand smoke has been accepted by many. We reviewed the literature on this topic. There are many studies that do not support the hypothesis. There is no indication that the smokers themselves have a higher incidence of middle ear disease. Considering the difficulty of publishing negative studies, the need for academics to publish significant findings, and the poor foundation for some authors' conclusions in the literature, we find that the literature does not offer sufficient support for the hypothesis that second-hand smoke causes middle ear disease to accept the hypothesis.

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