Systematic review links cannabis smoking to voice changes, respiratory symptoms, and darkened vocal folds

Cannabis smoking was associated with dark vocal folds, respiratory symptoms, and negative lung function changes, especially in heavy smokers, though switching to vaporizing reduced symptoms.

Meehan-Atrash, Jiries et al.·JAMA otolaryngology-- head & neck surgery·2019·Moderate EvidenceSystematic Review
RTHC-02172Systematic ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Systematic Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

The only laryngeal study found dark vocal folds in cannabis smokers. Six clinical studies showed association between cannabis inhalation and respiratory problems that improved with cessation or switching to vaporizing. Light cannabis smoking maintained lung function long-term, while heavy use was associated with negative changes.

Key Numbers

19 studies included (6 clinical, 13 basic science/animal). Only 1 study assessed laryngeal symptoms directly. Light use maintained lung function; heavy use showed negative changes. Switching to vaporizing reduced respiratory symptoms.

How They Did This

Systematic review per PRISMA guidelines, searching PubMed, CINAHL, Scopus, and Cochrane (2007-2018). Identified 6 clinical science and 13 basic science/animal studies on inhaled cannabis and vocal/respiratory function.

Why This Research Matters

Voice professionals, singers, and public speakers who use cannabis need to know about vocal fold risks. This is the first systematic review specifically addressing cannabis and voice disorders.

The Bigger Picture

Voice disorders from cannabis smoking may be underrecognized because patients do not connect their smoking to voice changes, and clinicians may not ask about cannabis use. The finding that vaporizing reduces symptoms offers a harm reduction pathway.

What This Study Doesn't Tell Us

Very limited direct evidence on vocal effects (one study). Most evidence extrapolated from respiratory studies. Cannot separate cannabis combustion effects from cannabinoid effects. No controlled trials.

Questions This Raises

  • ?Are vocal fold changes reversible with cessation?
  • ?Do edible cannabis products avoid all vocal/respiratory effects?

Trust & Context

Key Stat:
Dark vocal folds in smokers
Evidence Grade:
Moderate: systematic review methodology, but very limited primary evidence on vocal effects specifically.
Study Age:
Published in 2019.
Original Title:
Cannabis Inhalation and Voice Disorders: A Systematic Review.
Published In:
JAMA otolaryngology-- head & neck surgery, 145(10), 956-964 (2019)
Database ID:
RTHC-02172

Evidence Hierarchy

Meta-Analysis / Systematic ReviewCombines many studies into one answer
This study
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Analyzes all available research on a topic using a structured method.

What do these levels mean? →

Frequently Asked Questions

Can smoking cannabis damage your voice?

The limited evidence suggests cannabis smoking is associated with darkened vocal folds and respiratory symptoms. Heavy smokers show more negative effects than light users.

Does vaporizing cannabis protect the voice?

Studies found switching from smoking to vaporizing reduced respiratory symptoms, though specific vocal effects of vaporizing have not been directly studied.

Read More on RethinkTHC

Cite This Study

RTHC-02172·https://rethinkthc.com/research/RTHC-02172

APA

Meehan-Atrash, Jiries; Korzun, Tetiana; Ziegler, Aaron. (2019). Cannabis Inhalation and Voice Disorders: A Systematic Review.. JAMA otolaryngology-- head & neck surgery, 145(10), 956-964. https://doi.org/10.1001/jamaoto.2019.1986

MLA

Meehan-Atrash, Jiries, et al. "Cannabis Inhalation and Voice Disorders: A Systematic Review.." JAMA otolaryngology-- head & neck surgery, 2019. https://doi.org/10.1001/jamaoto.2019.1986

RethinkTHC

RethinkTHC Research Database. "Cannabis Inhalation and Voice Disorders: A Systematic Review..." RTHC-02172. Retrieved from https://rethinkthc.com/research/meehan-atrash-2019-cannabis-inhalation-and-voice

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.