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Chronic irritation may lead to inflammation and swelling of the vocal folds, resulting in: Hoarseness Raspy voice Voice fatigue Reduced vocal range Long-term smoking is also linked to Reinkes edema, a condition in which fluid accumulates within the vocal cords, causing a deepened or rough-sounding voice
The phrenic nerve responds well when breathing patterns stabilize
They reflect genuinely lower historical tobacco use across much of the region
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