IMHO repair the quilt this time and if it happens again repair them again if you want too. It shouldn't matter if it is holes from smoking or stains or anything else as to whether you repair them. Just do it because you Love her if you have the time. Not every one can sew or knows where to get stuff repaired. Try to use fabric that matches and patch the front bad back. Apparently these are quilts that are used a lot not just to look at.