In two studies, each with 5 test series, physiological costs of the hearing due to legally tolerable noise exposures of 94 dB(A) for 1 h have been measured audiometrically. The temporary threshold shifts (TTS) and their restitution time, as well as cardiovascular responses in work-related heart rate increases, of 10 and 8 subjects (Ss), respectively, could be shown to be modulated by additional physical stress and combined exposure to alcohol (Study 1) and cigarette smoke (Study 2). Moderate dynamic muscle work (50 W) administered via a bicycle ergometer either immediately after noise, or simultaneous to the noise exposure, significantly reduced restitution time as well as the integrated restitution temporary threshold shift (IRTTS). A physical stress to 100 W – which exceeded the endurance level when demanded simultaneously to the noise exposure – did not show any favorable effects. However, if the same physical stress succeeded the noise exposure, and when it was interrupted several times for the audiometric measurements, it also brought about significant accelerations of the restitution processes. Some reductions in physiological costs of the hearing were found due to an intervening alcohol consumption (BAC ~ 0.08 %) prior to the noise exposure and a simultaneous physical load of 50 W. Smoking 10 cigarettes instead of the consumption of alcohol was associated with a reduced TTS, but a prolonged restitution time. IRTTS as total physiological costs of the most unfavorable combination of noise, simultaneous high physical workload, and preceding smoke exposure was increased. The results of the test series with cigarette smoke – probably due to the small group of just 8 Ss and the counteracting effects of the agents carbon monoxide (CO) and nicotine – were not statistically significant, but these exposures were associated with a substantial activation of the cardiovascular system. Significant heart rate increases are evidence that CO and nicotine must not be neglected as influential factors in the context of physiological costs which the organism, and especially the hearing, has to pay for noise exposures.