Smoking can alter the voice. The chemicals in cigarette smoke directly affect the delicate structures within the throat and voice box. These changes involve the physical impact on the vocal cords and resulting audible characteristics.
How Smoking Physically Affects the Voice
Smoking exposes the throat and vocal cords to numerous irritants, including tar, nicotine, and carbon monoxide. These substances lead to inflammation and irritation of the vocal cords. Chronic irritation makes the vocal cords unable to vibrate normally.
Over time, smoking contributes to the thickening and stiffening of the vocal cords. Thickened vocal cords impede the clear, strong sounds typically produced during speech.
A specific condition associated with long-term smoking is Reinke’s edema, also known as smoker’s polyps. This involves a buildup of fluid within the superficial layer of the vocal cords, causing them to swell. The increased mass of the vocal cords causes them to vibrate at a slower rate, leading to a deeper pitch.
Smoking also reduces saliva production, leading to dryness in the throat and vocal cords. Additionally, smoking can increase mucus production, which interferes with vocal cord function and can lead to a persistent cough, causing more irritation.
Common Voice Changes
One of the most recognized voice changes caused by smoking is hoarseness. This hoarseness often presents as a raspy, weak, or harsh sound. The irritation and swelling of the vocal cords prevent them from closing and vibrating effectively, leading to this altered vocal quality.
Smoking frequently leads to a lowering of vocal pitch, particularly in women. The increased mass of the vocal cords due to inflammation and conditions like Reinke’s edema causes them to vibrate more slowly, resulting in a deeper voice.
Beyond pitch changes, a smoker’s voice can develop a breathy quality. This occurs when the vocal cords cannot fully close due to swelling or growths, allowing air to escape. The voice may also sound strained, and individuals might experience a reduced vocal range, especially difficulty reaching higher pitches.
The changes in vocal quality often develop gradually over many years of smoking. Individuals may also experience a persistent “smoker’s cough,” which stresses the vocal cords and exacerbates hoarseness. This involves the vocal cords repeatedly slamming together, increasing irritation and swelling.
Can Voice Damage Be Reversed?
Some voice changes from smoking can improve after quitting, particularly those related to inflammation. However, it may take several months for vocal cord and larynx irritation to fully resolve.
Long-standing structural changes, such as severe Reinke’s edema or vocal cord polyps, may not fully reverse with quitting alone. While quitting can prevent these conditions from worsening, surgical intervention is often necessary to reduce the mass of the vocal cords and improve voice quality. Surgical reduction can lead to vocal improvement, although complete restoration to a pre-smoking voice may not always be possible.
Beyond benign changes, chronic smoking increases the risk of developing serious conditions, including laryngeal cancer. Laryngeal cancer (cancer of the voice box) can cause persistent hoarseness or other voice changes that do not improve. If cancer develops, treatment may involve surgery to remove part or all of the larynx, which can permanently impair voice function.
Early detection of laryngeal cancer is important for effective treatment and can help preserve voice and swallowing abilities. Any persistent voice changes, such as hoarseness lasting more than a few weeks, warrant medical evaluation.