Smoking a single cigarette can reduce digital blood flow. Sarin (1974) showed a 42% reduction in digital blood flow in his series, and other investigators have shown similar findings (Ludbrook 1974, Rottenstein 1960). The focus of this paper is on the pharmacological effects of the various components of cigarette smoke and their potentials effects on wound healing in the hand. A case is described to illustrate the effect of stopping smoking upon a non-healing fingertip ulcer.