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/Sounds like the letters "S" + "M" + "H" (spelled out)/

Meaning

Short for "shaking my head," used to express disappointment, disbelief, or second-hand embarrassment. The digital equivalent of silently shaking your head at something.

Examples

He showed up late again, smh.

Smh, I can't believe he actually said that seriously.

Regional synonyms

In El Salvador and Honduras, a pig or hog. Also used colloquially to call someone dirty or messy, like "pig" in English.