If a patient smokes, will this hurt their chances for a heart transplant?

Yes: Smoking accelerates vascular disease.

Yes: A heart transplant isn't an easy procedure, and doesn't end with the surgery. Many lifestyle changes need to be made to live with a donor heart. There are anti-rejection drugs, risk of infections, and other complications of treatment. If someone isn't willing to give up smoking, there isn't much hope he will be able to modify his life to accommodate the other necessary modifications.