Post History
Another difference between the two forms is that the first makes it clear where the patronising smile is directed, i.e. whom it's patronising. In the second, the smile could have been there before...
Answer
#3: Attribution notice added
Source: https://writers.stackexchange.com/a/47817 License name: CC BY-SA 3.0 License URL: https://creativecommons.org/licenses/by-sa/3.0/
#2: Initial revision
Another difference between the two forms is that the first makes it clear where the patronising smile is _directed_, i.e. _whom_ it's patronising. In the second, the smile could have been there before; it could be a reaction to someone or something else (present or remembered). If you want to avoid an adverb (and other answers have shown why that's not necessarily a useful goal), you could mention the patronising smile _in relation to_ the people involved, e.g.: > “Don't worry your pretty little heads about it,” he told them with a patronising smile. (Though in that example, it's probably clear from the speech alone…)