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.