Jonahtan Wright, MD reviews the effect of smoking on functional outcomes and implant survival of anatomical total shoulder arthroplasty. He and his team sought to compare functional outcomes and survival between non-smokers, former smokers, and current smokers who underwent anatomical total shoulder arthroplasty (aTSA) in a large cohort of patients. Our study suggests that smoking has a negative effect on aTSA functional outcomes that may persist even after quitting.