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The vocal folds react to smoking, from irritate the mucous to the tissue changes or dysplasia that degradation of voice performance in daily living. This study determine the influence of smoking habits to the voice handicap score by Voice Handicap Index score (VHI). The design was a retrospective cohort study from 96 adults that identified level of voice fatigue through VHI. From the history there were divided into 3 groups: a group of active smokers, passive smokers and nonsmokers. The statistical test used was Chi-square test and regression nominal test. Voice fatigue (VHI score > 20) in both active smokers (13.54%) and passive smokers (15.62%) compared with nonsmokers (6.25%), by Chi-square test results was p = 0047 (p <0.05). Nominal regression test between 3 groups of samples were (RR = 3.0, CI 95% = 0.95 to 9.21) between the group of active smokers and passive smokers (RR = 3.8, CI 95% = 1,23-11.80 ). Smoking habits influence the voice handicap score in both active smokers and passive smokers compared with nonsmokers. Active smokers have a risk of fatigue voice 3 times more often than nonsmokers and passive smokers have a risk 3.8 times more often than non-smokers.