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. 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.