Why do some smokers have a hole in their throat?

Head and neck cancer: Cancer of the larynx or pharynx may require removal of the voicebox (larynx) which requires having a tracheotomy, the medical term for the "hole" in the mid-neck. In some cases, even more extensive surgery may need to be done, like removal of part or all of the tongue, and the tissues surrounding the lower jaw, sometimes even including the jawbone (mandible). All this can be avoided by not smoking