11.Acid Reflux
Gastroesophageal reflux disease (GERD), makes stomach acid rise up into your throat or even onto your vocal cords. Over time, this laryngopharyngeal reflux (LPR) irritates your throat tissues. Usually your hoarseness will be worse in the morning, if GERD is the cause. You may not have any heartburn at all when you have LPR.
12.Smoking
Breathing in smoke, either by smoking yourself or by taking it in secondhand, can cause permanent changes to your vocal cords over time. When they swell, the pitch of your voice could get deeper. Smoking also raises your risk of throat cancer.
