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Due to the changes caused by tobacco smoke in the oral cavity and pharynx, secondary bacterial infections of the tonsils ensue through biofilm formation in the tonsils

Cleveland Clinic, 2024) When symptoms might not be tonsil stones - Strep throat or other infections/tonsillitis - Allergies and post-nasal drip - Acid reflux (laryngopharyngeal reflux) - Dental or gum disease (Harvard Health Publishing, 2024