I quit smoking 31 yrs ago and my dr says he can see that i used to smoke becuz of clubbing. i also have a heart murmur. can smoking cause this defect ?

Not Reliable & Yes: Clubbing occurs both as a genetic variant & is ↑ed by chronic lung disease & ↓o2; however no way to know the basis just by its presence. Heart murmur just means sound, typically due to turbulence in blood flow, believed to be originating from the heart. Mitral leak most common basis for murmur, aortic sclerosis/stenosis 2nd most frequent. Both can be promoted by smoking>artery ds, mi & aortic ds.