A device combining a variable sound attenuator with a hearing device, (such as a hearing aid or tinnitus device) that allows a user to adjust the amount of attenuation of environmental sound in a variable, continuous fashion or in a discrete controlled fashion from zero attenuation to maximum attenuation without removing the device from the ear. The attenuator includes a housing having a passageway, the passageway allowing for sound to pass through the housing and a variable control, the variable control able to control the size of the passageway through the housing and the device including a second passageway for transmitting amplified sound from the hearing device into the ear of the wearer.