Personal Listening Devices and Hearing Health: The Psychological and Social Factors Influencing Undergraduate Students’ Safe Listening Behaviors

Abstract Background Recreational noise-induced hearing loss (NIHL) is a growing public health concern, particularly among young adults who frequently use personal listening devices (PLDs) at high volumes. While previous research has examined the prevalence of unsafe listening and low NIHL awareness, less attention has been paid to the behavioral and psychological mechanisms that sustain risky listening habits. Objective This study explored the psychological, cognitive, and social factors influencing unsafe PLD use among undergraduate students, with a particular focus on optimism bias, cognitive dissonance, peer norms, environmental constraints, and limited awareness of protective strategies. Methods A secondary thematic analysis was conducted using open-ended responses from a cross-sectional survey of 154 undergraduate students at a large urban university in South Africa. Unlike previous analyses that emphasized descriptive statistics, this study applied a behavioral science lens to examine the psychosocial determinants underlying persistent high-volume listening. Results Five interrelated themes emerged: (1) Optimism bias and perceived invincibility—students underestimated their risk of NIHL or viewed it as a distant concern; (2) Social reinforcement—peer norms normalized high-volume listening; (3) Cognitive dissonance—students rationalized their behaviors to reduce internal conflict; (4) Environmental barriers—noisy academic and transport settings encouraged volume increases; and (5) Limited awareness of safer listening alternatives—many students lacked knowledge of device-based protections such as volume limiters. These findings suggest that knowledge alone is insufficient in changing listening behaviors, as students’ decisions are shaped by psychological rationalizations, peer influence, and situational constraints. Conclusions NIHL prevention strategies should extend beyond conventional awareness campaigns to include behaviorally informed interventions. Universities and public health stakeholders should implement practical technology-based nudges, peer-driven social norm-shifting campaigns, and personalized risk-feedback tools to reduce NIHL risk among young adults across global settings.