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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

This is particularly concerning for patients with asthma and COPD as their already compromised lung function is further weakened by vaping, potentially reducing the effectiveness of their inhaled treatments (Labiris and Dolovich 2003)

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