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Background Smoking is a major global health issue that is linked to various health conditions, including hearing loss and reduced salivary flow. This study aims to explore the relationship between smoking, hearing loss, and salivary flow rate. Methods This cross-sectional study was conducted over two months at a tertiary healthcare institute in Central India, involving 100 participants (50 smokers and 50 non-smokers) aged 18-55 years. Hearing status was assessed using audiometry, and the salivary flow rate was measured. Statistical analyses were performed using SPSS version 21 (IBM Corp., Armonk, NY, US). Results Smokers had a significantly higher prevalence of hearing loss (40%) compared to non-smokers (10%). The salivary flow rate was significantly lower in smokers (mean 0.5540 ml/min) than in non-smokers (mean 0.9240 ml/min). However, no significant correlation was found between the duration and frequency of smoking with hearing loss or salivary flow rate. Conclusion Smoking significantly impacts both hearing and salivary flow rate, hence smokers show a higher risk of hearing loss and reduced salivary flow rate. Early hearing screenings and preventive measures are recommended for smokers. Further research with larger sample sizes is needed to explore the long-term effects of smoking on these health parameters., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. IHEC AIIMS Bhopal issued approval AIIMS/BPL/IECSR/JAN/23/STS/03. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Meghani et al.)