What do the cigarettes at the end of chapter 23 symbolize ?

Having treated these men with such great disrespect and taking away something of value to McMurphy, she triggers his anger. He responds with impudence. When he breaks the glass, this is the first physically aggressive action he takes against Nurse Ratched. This brings the confrontation between the two characters back to the fore, for McMurphy is aggressively acting out on behalf of the privileges of the patients. He is taking a risk in that the act will mean a longer stay in the institution, but at this moment his anger or rebellion is stronger than such a fear.