Ask the Throat Doctor: May 1997

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La Scena Musicale's Discovery Box

How Does Smoking Affect the
Voice?


Smoking kills both smokers and their voices. Countless scientific
reports have established the causal connection between tobacco
smoking and cancer of the mouth, throat, lungs, and esophagus. The
relative risk of developing cancer of the larynx is doubled in those
who smoke more than 20 cigarettes a day. Alcohol and tobacco appear
to act synergistically to elevate this risk still further.


It is not the nicotine in tobacco which causes cancer. Tobacco
smoke is dark with tar — a mixture of polycyclic aromatic
hydrocarbons that is markedly carcinogenic. The heat of the smoke in
the throat is dangerous as well. Pipes and cigar smoking are not
harmless substitutes for cigarettes, since they too cause cancer of
the mouth and throat.


In the tissues of the respiratory tract, cigarette smoke provokes
effects similar to those of inflammation: redness, swelling,
increased mucus production, and thickening of the surface lining or
mucosa. Both the smoke particles and the heat of the inhaled fumes
appear to damage the mucosa. Interestingly, unfiltered marijuana
smoke causes even greater irritation to the throat and trachea than
does tobacco smoke.


A laryngologist can recognize smokers just by the typical
appearance of their nose and throat: nicotine staining of the nasal
hairs, dry throat, dry swollen vocal cords, and tenacious
secretions. Singers who smoke have a harsh breathy voice and a loss
of clarity in their upper range. Women who smoke may suffer from
polyps on their vocal cords and severe degeneration, polyps which
have the appearance of big balloon blisters. Persons with chronic
smoking-related inflammation often develop leukoplakia, or white
patches on the lining of the throat, a known precursor of
cancer.


Smoking also reduces normal breathing capacity. The decrease in
air flow due to bronchial constriction impairs vocal performance,
and such organic changes to the respiratory tract cannot be overcome
by heroic singing technique alone! Smokers cannot expect to produce
a clear ringing pianissimo that will reach the far corners of a
hall. Obviously, very few singers of the classical repertoire choose
to smoke. Some rock and pop singers do use smoking to create a
characteristic vocal quality that fits this repertoire. Some women
find that deepening their normal vocal range is well suited to a
blues or soul sound. The cost of this choice is high, however.
Emphysema, bronchitis, recurrent throat infection, and sometimes
cancer have brought numerous singing careers to an early and
disquieting end.


The damage to vocal cords may not completely heal even after the
smoking has ceased. Mild swelling may take six to nine months to
resolve and the more significant inflammatory lesions may require
surgery. Smoking is a major cause of refractory vocal nodules, since
constant irritation in the throat prevents them from healing. Even
with surgery there is no guarantee of recovering a desirable singing
voice.


Singers who
perform in smoke-filled clubs may also suffer some of the same
effects. When it is not possible to avoid such situations,
non-smoking performers should compensate for them by increasing
their water intake and going out for fresh air between
sets.



Finally, all
serious singers learn how to give meticulous care to their complete
vocal instrument, i.e. to both vocal cords and throat. Such
attention is usually rewarded many times over. With appropriate
care, the gift of voice and song may indeed endure the whole life
long.

Françoise P.
Chagnon is the Director of the Voice Lab at the Montreal General
Hospital

Advice on Quitting Smoking


Smoking is more an addiction than a bad habit, and quitting often
requires more than a strong will. Smoking cessation programs today
include a variety of medical treatments, from anxiolytics that
control withdrawal anxiety and reduce insomnia to transdermal
nicotine patches that smooth out metabolic readjustments.
Fortunately smokers who successfully quit but later relapse will
find it easier to quit the second time.


The advice here is: smokers, study your options! Cut down now on
the number of cigarettes you smoke each day. Identify the times when
you smoke to calm your nerves, to satisfy peer pressure, or just for
no apparent reason. Choose a program to cure you of your addiction.
Treat tobacco as you would cholesterol-rich food or hard liquor: use
it very occasionally if at all, and certainly not every day.


Dr.
Chagnon

La Scena Musicale - Coffret Découverte
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