Smith started performing professionally in her mid thirties. Under her married name, Bette Smith, she began singing at PTA meetings and on local radio broadcasts. Her performances developed a local following and she eventually recorded a demo record. Under the same name she released her debut album in 1971 titled I'm a Lady. The record was issued on Nashville North Records and contained a total of 12 tracks. Eight of the album's songs were composed by Smith herself and also featured covers of gospel recordings, including "In the Garden." Smith also released four singles on the Chart and Sugar Hill labels during this period. At the same time, Smith maintained her full-time teaching career, working at Westlake Elementary School in New Carlisle, Ohio. She also took several graduate courses and painted landscapes during her free time.
In 1978, Warner Bros. released two singles by Smith that became number one singles on the Billboard country songs survey. Both "Don't Break the Heart That Loves You" and "It Only Hurts for a Little While" reached the top spot and had previously been pop hits a decade prior to Smith's cover. Her next single release was also a pop cover: "Little Things Mean a Lot." The song reached number three on the country songs chart. All three tracks also reached top ten positions on the RPM chart in Canada. The songs were issued on Smith's fifth studio album, Don't Break the Heart That Loves You. The album included a mixture of cover tunes and original recordings, including a self-penned track by Smith. The album was her highest-charting record in the United States, reaching number 27 on the Billboard country albums survey in 1978. Allmusic gave the project a three-star rating. Others took notice of Smith's singing style with the album's release. Writers Mary A. Bufwack and Robert K. Oermann remarked of her musical image during this period as being "housewifey," while also highlighting the "Jean Arthur purr in her voice."
In 1979, Smith felt her music lacked an identity of its own. Together, with songwriter Mack David and producer Norro Wilson, she wrote a song that would alter her artistic image. Titled "Still a Woman," the song focused on the marital needs facing middle-aged women, according to an excerpt from Billboard magazine. Smith also spoke of the song in the same interview: "I wanted to write a song that said 'hey, even though I may have a few children and a few gray hairs, I'm just as good as I ever was'." Released as a single, it reached number seven on the Billboard country list and the top 20 of the RPM chart in 1979. The song was released on a similarly themed album called A Woman. The project peaked at number 36 on the country albums chart. Writer Greg Adams described A Woman as having "a mildly adventurous spirit." Kurt Wolff commented that A Woman made Smith into "a middle-aged sexpot." The album would also produce a second single in 1979. Smith's cover of "If I Give My Heart to You" would reach the top ten of the Billboard country chart in 1979.
Smith's new musical style brought further career changes. She began incorporating a new concert style that included "increasingly flashy" stage shows, according to Kurt Wolff. She also included stage choreography and spoke openly about sex in interviews. "Sex is a part of every woman and if she says it ain't, she's a liar. That's the way I feel," she explained in 1980. Her career persona helped increase her fan club, which began to include a larger female audience. She also received more concert work, opening for larger country acts with her band Night Flight. She continued the same image with her next album release titled Just Margo (1979). The album's cover featured Smith wearing just a satin robe. Sales in Canada brought the album to the number 14 spot on the RPM Country Albums survey in 1979. It also produced the top 20 country hit, "The Shuffle Song," which Smith co-wrote. She transitioned into 1980 with the album Diamonds and Chills, whose album cover displayed Smith with a "plunging neckline," according to Wolff. The album received three stars from Allmusic and Billboard praised its country pop musical styles. The album's two singles, which included a cover of Mary Wells' "My Guy" peaked outside the top 40 of the North American country charts. In 1981, she collaborated with country artist Rex Allen Jr. on the duet, "Cup of Tea." Released as a single, the track reached number 12 on the country songs chart.
Smith returned to a more traditional musical image and went on to call her former "sexy" musical persona a mistake. "I had an image for singing sweet ballads and I should'a stuck with it," she recalled in 2003. Smith was released from her contract with Warner Bros. in 1982 and began recording with Cammeron Records, an independent label founded by her second husband. Through the label, Smith issued her next studio release in 1981 titled Ridin' High. The project featured ten tracks, six of which were self-penned and included co-writing credits from her husband. Four singles were released from the album that peaked outside the top 40 of the Billboard country chart, including a cover of Hank Williams' "Wedding Bells". In 1983, she released The Best of the Tennessee Yodeler, a studio record dedicated to her childhood idol, Bonnie Lou. The album featured Smith's yodeling vocal technique and was sold on television via direct-response marketing advertisements. In 1985, Dot Records revived its Nashville division and announced it would release music from veteran country performers. Among the artists chosen was Smith, who released her second eponymous studio album with Dot (along with MCA Records) in 1986. It featured re-recordings of her major hits from the 1970s.
In later years, Smith continued performing while also venturing into other projects. She started selling a tape on her official website that taught singers how to yodel. She also mentored performers who wanted to learn the skill, including Taylor Ware, who appeared on a season of America's Got Talent. Smith also continued releasing music of her own. In 2005 she issued her most recent studio effort to date, titled Nothing to Lose. The album was released on Lamon Records. She also continued to perform in The Villages, Florida, where Smith lived year-round. In 2015, she helped raise $11,000 for The Ukulele Kids Club, a Florida organization that provides musical instruments to children in hospitals.
Smith's musical style embeds the genres of Country, Christian and Country pop. Many of her Warner Bros. albums embedded country pop arrangements. Jim Worbois found that Smith's 1977 album, Happiness included songs that "would have sounded equally at home at pop radio" while finding a place with "pure country". Author Kurt Wolff noted a similar theme in her Warner Bros. albums, finding that their production often incorporated heavy elements country pop.
Smith's yodeling vocal style has also been observed by journalists and writers. Writers Mary A. Bufwack and Robert K. Oermann found that she often incorporated "quasi-yodel vocal breaks" into her singing performances. Tony Violanti of The Villages-News also found Smith's yodeling to display emotion: "Smith may have tiny physical stature but her voice can crackle with emotion." In a 2006 interview, Smith explained that her yodeling style is created from a vocal break in her voice known as a "glottal catch". "Not just anybody can yodel. You have to have the ability to have that flip in your voice," she commented.
Smith's image has also been a subject of discussion among writers. Authors of music publications have pointed out that Smith's music helped provide an outlet for middle-aged women attempting to rekindle romantic relationships. Kurt Wolff of Country Music: The Rough Guide explained that "few singers spoke so unabashedly of attempting to reinvigorate love's fading fires, especially from a woman's perspective." Wolff further commented that Smith's songwriting contained "lyrical boldness" that helped provide voice to "middle-aged couples who'd been together for years." Mary A. Bufwack and Robert K. Oermann remarked that her concerts of the late 1970s were among "the era's flashiest show queen stage routines."
In 1985, the Cammeron's Nashville home was destroyed in a house fire where they lost many material possessions. A fundraiser was later created to help the couple rebuild.
In August 2014, Smith was involved in a near fatal head-on car collision near her home in The Villages, Florida. She suffered a shattered wrist, broken ankle, and multiple bruises. She spent three months at a local rehabilitation center and made a full recovery and was expected to return to performing in December 2014. Law enforcement officials later stated that Smith would not have survived the accident if she had not been wearing a seat belt or left her car's convertible top down. In June 2016, Smith was hospitalized with double pneumonia, among other health concerns. She was sent to the intensive care unit where she remained until her health improved. Smith later made a full-recovery and began performing in the fall of 2016. "I feel as well as I can be and I feel great singing in front of all these people," she commented.
Smith died on January 23, 2024, in Franklin, Tennessee, at the age of 84, from complications of a stroke she suffered two days earlier.
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