The vast majority of cases of smoker’s disease in clinical practice are congenital, and in the case of children, they are definitely congenital, so it must be judged on a case-by-case basis. However, in clinical practice, it is important to note the difference between smog and laparoscopic smog, although the two are very similar in clinical presentation. However, the treatment factors are different, and some of them are of an acquired nature, so they should not be confused. Smog is often bilateral with simultaneous smog-like changes, and smog-like disease is often unilateral with smog-like changes in the blood vessels, so these are different. Smoky disease is born, while smoke-like disease is formed later in life, including the possibility of narrowing and occlusion of the blood vessels. Other cases are caused by inflammation of the blood vessels, which can lead to smog-like reactions. Therefore, these cases are different, and it is important to clarify what kind of changes are involved in order to determine whether they are congenital or acquired.