I, too, smoked for over 40 years. Between that and severe acid reflux, I had built up excess tissue on my vocal cords, to the point that I could hardly talk. I'd gotten to the point that it was so painful to even make sound that I tried not to talk as much as possible. I was sent to an ENT, who said he could remove that tissue (it wasn't cancer, but he was sure it would be soon), but he wouldn't touch me until I had quit smoking for 2 months.