Introduction: Rotator cuff (RC) tear is an inflammatory and degenerative shoulder disease. Nicotine is a potent vasoconstrictor that decreases oxygen support in the Codman's critical zone.Methods: Nonrandomized clinical trial of 24 patients with R/CT divided into nonsmoking (n=12) and smoking (n=12) groups, which received physical therapy three times a week for four weeks. The following were evaluated: pain level, range of motion (ROM), muscle strength, and functionality. Results: Pain was reduced in the long term only in the nonsmoking group. Functionality was improved in the nonsmoking group. Smokers started the treatment with a lower ROM of forward flexion, abduction, and external rotation of the left shoulder. After the intervention, they remained with less forward flexion and abduction of the left shoulder (p<0.05). The nonsmoking group increased the ROM of bilateral forward flexion, abduction, extension, and external rotation of the right upper limb (p<0.05). In the smoking group, muscle strength was lower for forward flexion, abduction, bilateral external rotation of the shoulder, and internal rotation of the left shoulder after the interventions (p<0.05). Conclusion: Cigarette smoking worsens functional outcomes following a physical therapy program for shoulder RCT. Level of evidence: IIb.