At the time of the recording of Small Change Waits was drinking more and more heavily, and life on the road was starting to take its toll on him. Waits, looking back at the period said:
I was sick through that whole period […] It was starting to wear on me, all the touring. I’d been travelling quite a bit, living in hotels, eating bad food, drinking a lot - too much. There’s a lifestyle that’s there before you arrive and you’re introduced to it. It’s unavoidable.