Preheat the smoker to 180°F for 15 minutes
Combine half and half, butter, cream cheese, Worcestershire sauce, minced garlic, and black pepper in a large bowl. Mix, then pour into a 12-inch castiron skillet. Place on the grill grate in the smoker and close the lid. Smoke for 45 minutes.
While the cream is smoking, bring a pot of water to a boil. Add the macaroni and cook for 3 minutes less than the package recommends. Drain pasta and rinse with cold water. Add to a large mixing bowl.
Shred the cheese then add it to the bowl with the pasta and stir.
Remove the cream sauce from the smoker.
Increase the smoker temp to 325°F and preheat for 15 minutes.
Whisk the cream sauce well, and pour into the bowl with the noodles. Stir until well combined.
Add pasta to a 9x13-inch foil grill pan.
Cook bacon on the stovetop until crisp. Set aside fat drippings. Crumble the bacon and add to a small bowl.
Mix bacon drippings with panko crumbs. Stir in the crumbled bacon. Spread mixture over the top of the macaroni.
Place into the smoker and close the lid. Smoke for 1 hour.
Remove from the smoker and let sit for 5 minutes. Top with smoked paprika and chives. Enjoy!