In addition to health issues, there’s also more risk to one’s instruments/equipment when performing than in recording.
Musicians do what they do for different reasons. I’ve performed with a taiko drumming group, but I’ve done a lot more recording.
For me, performing was a complex emotional rush (excitement and sometimes euphoria, combined with intense anxiety) and it is also exhausting (moving the gear, travel, unfamiliar locations, body under stress while performing, exerting oneself often in heat and humidity while trying not to look tired, generally not eating/drinking as healthy as one should). (In my case I didn’t have to worry about secondhand smoke or crazy drunks very much.) But aside from a few seconds of structured solo time, there’s not a lot of creative reward in it. I was working hard to bring other peoples’ music to life, and between rehearsals and performances and still working full-time, it didn’t leave me with the time and energy to do much else.
(Note, I was never paid for performing. The group charged for performances except for certain non-profits, but the money simply went into expenses… and in fact performers had to pay monthly dues as well to help cover those.)
Actually writing music, doing sound design, recording/producing it etc. are much more creatively rewarding to me and it’s much more personally sustainable.
Besides which, not all types of music are suited to live performance. I make music for headphone listening, mostly ambient or abstract electronica; not the sort of thing that works in bars and clubs. I’ve seen only a little bit of electronic music done live, and the entire process is very different from creating music in a studio setting.
I’ve self-released a couple of albums and charged for them – back when nobody was really selling digital downloads and streaming hadn’t taken over. They basically paid for the costs of having the CDs, cases and inserts printed, but didn’t actually compensate me or pay for any gear. I probably could have sold more copies if I’d put more time and energy into promotion (which I don’t enjoy) but I’m not sure it would have been enough to compensate for that time and energy. And if I’d gone looking for a record label, I might have been worse off financially even if more copies were sold.
Since then I’ve just given away my work and considered it a labor of love (though for next year I’m considering going back to an album format and giving Bandcamp a shot… and definitely not quitting my day job).