May refer to a female that has an unusually small bust size. See flatchested.
The opposite of tig ol' bitties which refer to a woman's large breasts.
A woman with tall ol' smitties may be subject to ridicule and humiliation by others, and may not be considered a suitable mate by some men. This, however, is not recommended because all titties should be seen as a gift from God. Some men enjoy tall ol' smitties because they tend to be more perky than tig ol' bitties.
Guy A: Man, look at the tig ol' bitties on that girl over there! DAMN!!
Guy B: Yeah, but her friend's tall ol' smitties are just fine.
Her boyfriend had smitties with hairy moles on them. She preferred that he kept his shirt on while they engaged insexual intercourse because his smitties made her tiny titties look like pimples.