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They determined: Smoking lowers the pitch of the voice (fundamental frequency Smoking lowers the maximum phonation time (the length of time you can make sound before needing to breathe again) Smoking may cause voice disorders, such as cancer, although functional disorders (i.e., injury) were not clearly proven Smoking can dry the vocal cord mucosa and irritate the vocal cords Smoking causes vocal cord inflammation Pulmonary function is weakened (breath supply and vocal power) Of note, it is not the tobacco that is the culprit

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[48] [49] Despite it being illegal at the time, tobacco marketers gave out free cigarette samples to children in black neighbourhoods in the U.S