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

The takeaway

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.

Singers, voice professionals, ENT specialists, and cannabis smokers experiencing voice changes.

Dark vocal folds in smokers

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Moderate: systematic review methodology, but very limited primary evidence on vocal effects specifically.

When this study was published

Published in 2019.

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.

Questions still open

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

Common 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 the original research

Cannabis Inhalation and Voice Disorders: A Systematic Review.

JAMA otolaryngology-- head & neck surgery, 145(10), 956-964

View on PubMed ↗Publisher’s paper ↗

Citation

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