Histologic changes in the larynx in relation to smoking habits

Histologic changes in the larynx were microscopically studied in 942 men who died and came to autopsy at the Veterans Administration Hospital, East Orange, N. J., between 1964-1967. Atypical changes in cells in the epithelium of the larynx were most often observed in the true vocal cord and, to a lesser degree, in the false vocal cord and the area of the larynx above the vocal cord. The least changes were observed in the area below the vocal cord. The histologic changes (including cells with atypical nuclei, carcinoma in situ, and early invasive carcinoma) were highly related to smoking habits. They were much higher in cigarette smokers than in men who never smoked; they increased in proportion to the number of cigarettes smoked per day before death and were seen to a greater degree in cigarette smokers than in cigar and pipe smokers. Ex-cigarette smokers had fewer such changes than men who continued to smoke cigarettes up to the time of death. Cells with disintegrating nuclei were found mainly in ex-cigarette smokers.