With two cancelled tours in as many months, there was a lot of speculation about Adele’s voice. Could this really be something as simple as laryngitis as was claimed? Or was something more sinister going on?
It is common knowledge that Adele smokes. That said, I believe her claims of laryngitis and vocal hemorrhage. She is a young artist with a difficult, unhealthy habit. Smoking can cause both laryngitis and increase the risk of vocal hemorrhage. In reality, smoking one cigarette a day is enough to cause these problems.
Laryngitis means “inflammation of the throat.” The toxins and chemicals in cigarettes, when they are inhaled past the vocal folds, cause instant inflammation. A vocal hemorrhage or bruise happens with vocal trauma, such as excessive or loud voice use; underlying inflammation, such as that caused by smoking, makes bruising even more likely.
When cigarettes are added to excessive voice use, you are at high risk of hemorrhage.
In medicine, we have a saying “when you hear hoofbeats, think of horses, not zebras.” This means that when you see a patient, think of things that are more likely to affect that patient. Don’t worry about the rare things initially. Factor in:
- History (family history, smoking history, etc)
Young patients (Adele is 23 years old) rarely develop smoking-related cancer. Of course, other cancers do occur in this age group, but not those in which smoking played a major role. That said, smoking has a multitude of effects that may develop at any age:
- chronic laryngitis (hoarseness is often permanent)
- gingivitis and bad breath
- hearing loss
- and anxiety, among others
Singers who smoke are at high risk for smoking-related damage because the vocal cords are being irritated by smoking but also used at a high level through singing. Essentially, the singer is working an injured body part. Findings in singers who smoke include:
- polypoid corditis (also called Reinke’s edema or “smoker’s voice”)
- pre-cancerous lesions
A proper laryngeal exam utilizing videostroboscopy can determine if there are any issues related to smoking. If you have one of these complications, there are options.