I think it's the other way around. I think he or she, whomever he is singing to, was in denial about the singer (abusing drugs, making bad decisions, etc.) and they initially ignored all the warning signs. ("Smoke" is just a metaphor) After it all came out in the wash, they were committed to him and stuck around, regardless of his refusal to change. "Til I'm blue in the face" is a saying referring to exhausting all efforts and he is sarcastically acknowledging it.
I think it's the other way around. I think he or she, whomever he is singing to, was in denial about the singer (abusing drugs, making bad decisions, etc.) and they initially ignored all the warning signs. ("Smoke" is just a metaphor) After it all came out in the wash, they were committed to him and stuck around, regardless of his refusal to change. "Til I'm blue in the face" is a saying referring to exhausting all efforts and he is sarcastically acknowledging it.