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Building on previous discoveries, recent research has revealed that exogenous factorsparticularly cigarette smoke exposurecan fundamentally remodel this dynamically balanced architecture via nicotine-mediated epigenetic pathways (Table 3)

To present a more realistic picture, in the following sections we will also consider the lifetime risks of oral, throat, and lung cancer, cardiovascular disease, stroke, and COPD among adults who never use tobacco

Also, it becomes more difficult to work with, making the singer or voice use need to push harder for sound production

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