Smokers’ disease is a cerebrovascular disease that was first discovered by a Japanese medical expert in the 1960s. Since then, the disease has been identified around the world. Smoky disease is named after the patient’s cerebrovascular imaging pattern, due to the narrowing or occlusion of the main cerebral arteries, followed by the formation of an abnormal vascular network at the base of the skull, which resembles the smoke exhaled during smoking on cerebral angiography. The main danger of smoky disease comes from two aspects, one is cerebral infarction and the other is cerebral hemorrhage, which are both very dangerous and may even be life-threatening in severe cases, with high rates of disability and death. In addition, smog often triggers chronic ischemia of the brain, transient ischemic attacks, and seizures. Therefore, once suffering from smog disease should be promptly treated with surgery. Some patients ask whether it is suitable to have Tower Bridge surgery for smog in winter. In fact, this is not a problem to consider at all. The surgical treatment of smog has nothing to do with weather, climate or season. In hospitals where smog surgery is performed, both the operating room and the ward are very well equipped with warming facilities and other items, so it is not a problem at all to perform smog bypass surgery in winter. Once the disease is diagnosed, surgery should be performed as soon as possible, otherwise it may lead to cerebral infarction, cerebral hemorrhage, and other serious consequences. The combined vascular bypass surgery is a relatively advanced and effective surgical procedure, which can establish a good and sufficient blood supply channel for the brain from both the main artery and the skull base vascular network, and the treatment effect is very ideal.