This study compared the amplitude of transient evoked otoacoustic emissions (TEOAEs) and latencies of vestibular evoked myogenic potentials (VEMPs) among non-smokers, cigarette smokers, water pipe smokers, mixed smokers and ex-smokers. A total of 50 non-smokers, 28 water pipe smokers, 34 pure cigarette smokers, 28 mixed cigarette-water pipe smokers, and 21 ex-smokers were evaluated in this study. Their age ranged from 20 to 40 years. All had normal hearing sensitivity and normal middle ear functions. TEOAEs amplitude and VEMPs were measured for all participants. Results of this study showed that smoking had deleterious effects on the hair cells in the labyrinth. Damage to the outer hair cells was evidenced by the reduced amplitude of the TEOAEs in smokers and ex-smokers when compared with control group. Harm to the saccular hair cells is detected by the increased latency of the VEMPs. Results also suggested that cessation of smoking could not change the profile of TEOAEs or VEMPs. Our results suggested that smoking could have irreversible hazardous effects on the labyrinthine hair cell functions. These effects could be attributed to the impact of nicotine on the microvascular dynamics.