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Pre-cancerous growths often present in this way

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Similar to other noxious effects of tobacco, the association of thyroid multinodularity also seems to exist predominantly in areas with more pronounced iodine deficiency suggesting that tobacco smoke may be more toxic for a compromised thyroid gland.[] The best evidence for the role of iodine intake comes from an interesting study from Denmark, which followed 8,219 individuals before and after the mandatory salt iodization program in year 2000.[] The authors found a reduction in the overall difference in thyroid volume between heavy smokers and nonsmokers across the age groups after iodization of salt was introduced