Hello, The cold, painful and swollen feet in elderly is matter of great concern with history of chronic smoking as: - Peripheral blood circulation compromise by effects over medium sized arterioles provoking low blood supply to legs and distal lower limb via effects of micro thrombi formation - Possible diabetes - Hypercholesterolemia - Lack of exercises - Sedentary life style - Continuous current status of smoking are the contributing factors in the first reason. In my clinic, I do recommend a detailed physical examination including pulsations of both lower limbs, Doppler ultrasound of the lower limbs and further guidelines of cure accordingly. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon