Smoker’s disease is a rare anomalous disease of the cerebral vasculature, mainly due to chronic progressive stenosis or occlusion of the major bilateral branches of the cerebral arterial ring (the siphon segment of the internal carotid artery, the anterior cerebral artery, the middle cerebral artery, and sometimes the beginning of the posterior cerebral artery), followed by abnormal changes in the vascular network at the base of the skull, resulting in the formation of abnormally fragile and small smoke-like vessels, hence the name smoker’s disease. Some patients ask if there is a difference between smog and smog syndrome. In typical smoldering disease, the lesions are bilateral, with narrowing or occlusion of the major arteries on both sides of the brain and abnormalities in the vascular network at the base of the skull; however, some patients have unilateral lesions, with only the left or right hemisphere having the corresponding lesions, or with a combination of other diseases, which is generally called smoldering syndrome. Therefore, there is certainly a difference between smog and smog syndrome, except that sometimes the term is less strict, and sometimes smog syndrome is referred to generically as smog disease. However, regardless of whether it is a typical smog disease or a smog syndrome, both require prompt medical treatment. At present, some large hospitals in China perform combined vascular bypass surgery, which is a dual procedure combining direct bypass and patching, to better improve the blood supply to the brain tissue and achieve a more desirable treatment effect. Of course, for smog syndrome combined with other diseases, in addition to combined vascular bypass surgery for smog lesions, other combined diseases need to be treated symptomatically.