Abdominal Aortic Aneurysms (AAA) are one of the leading causes of death in America. AAA’s occur when the primary artery in the body grows in diameter and is at risk for spilling blood outside of the artery. One of the major risk factors is smoking tobacco. Tobacco weakens the wall as well as raises blood pressure. Surgery is typically recommended for repairing all large AAA’s but due to the risk factors for tobacco it may be too risky. The hypothesis of this study is that if patients who smoke tobacco do not have surgery for a large AAA, then their average life expectancy will be higher than if they do have surgery. This study will collect data from hospitals in NYC so that the study can be done quickly rather than a multiyear study. Patients will have a large aneurysm in order to ensure that surgery would be recommended if tobacco was not smoked. If the Aneurysm was smaller than 3.5cm, then doctors would recommend an endovascular approach and Tobacco would have less of an impact on the procedure. Patients will make a decision to ensure whether or not they want surgery knowing the risks of both getting the surgery and not getting the surgery. Many patients are expected to pass away during surgery. This is why I expect that participants who do not get surgery will live for a longer time on average. Even if my hypothesis is not supported then results can be used to better advise patients who smoke and have AAA’s.