The last game I worked on was Heavenly Sword on the PS3 and that was written in C++, even the cell code. Before that, I did some PS2 games and PC games and they were C++ as well. Non of the projects used smart pointers. Not because of any efficiency issues but because they were generally not needed. Games, especially console games, do not do dynamic memory allocation using the standard memory managers during normal play. If there are dynamic objects (missiles, enemies, etc) then they are usually pre-allocated and re-used as required. Each type of object would have an upper limit on the number of instances the game can cope with. These upper limits would be defined by the amount of processing required (too many and the game slows to a crawl) or the amount of RAM present (too much and you could start frequently paging to disk which would seriously degrade performance).
Games generally don't use exceptions because, well, games shouldn't have bugs and therefore not be capable of generating exceptions. This is especially true of console games where games are tested by the console manufacturer, although recent platforms like 360 and PS3 do appear to have a few games that can crash. To be honest, I've not read anything online about what the actual cost of having exceptions enabled is. If the cost is incurred only when an exception is thrown then there is no reason not to use them in games, but I don't know for sure and it's probably dependant on the compiler used. Generally, game programmers know when problems can occur that would be handled using an exception in a business application (things like IO and initialisation) and handle them without the use of exceptions (it is possible!).
But then, in the global scale, C++ is slowly decreasing as a language for game development. Flash and Java probably have a much bigger slice of market and they do have exceptions and smart pointers (in the form of managed objects).
As for the Cell pointer access, the problems arise when the code is being DMA'd into the Cell at an arbitrary base addresses. In this instance, any pointers in the code need to be 'fixed up' with the new base address, this includes v-tables, and you don't really want to do this for every object you load into the Cell. If the code is always loaded at a fixed address, then there is never a need to fix-up the pointers. You lose a bit of flexibility though as you're limiting where code can be stored. On a PC, the code never moves during execution so pointer fix-up at runtime is never needed.
I really don't think anyone 'distrusts' C++ features - not trusting the compiler is something else entirely and quite often new, esoteric architectures like the Cell tend to get robust C compilers before C++ ones because a C compiler is much easier to make than a C++ one.
