I don’t condone smoking. And I’ll always encourage my patients to quit. But I also live in the real world. Not everyone can stop overnight—and some won’t stop at all. That doesn’t mean they don’t deserve care or honesty. Here’s the truth: • Smoking reduces blood flow • It slows bone, tendon, and wound healing • It increases infection and complication rates • It can directly affect surgical outcomes My job isn’t to judge. My job is to educate, treat, and optimize your outcome as best as possible.