One of the things that the show “Mad Men” has gained notoriety for is its depiction of the hedonistic culture of the establishment of the 1960s — from three martini lunches to infidelity and most obviously, smoking.

Main character Don Draper smokes heavily and has been in charge of advertising campaigns for cigarette brands. In fact, most of the characters on the show are seen every episode smoking. I’m old enough to remember that that’s what it was like back in those days. Virtually everyone smoked … and in my experience, virtually all of those smokers eventually died or was seriously sickened by their smoking. Smoking was glamorous in the 1960s, it was a horror in the 1970s and 1980s when all that “glamour” started killing everyone off through heart and lung disease.

One of the main characters, Don Draper’s ex-wife Betty Draper has been diagnosed with lung cancer and is dying. The show takes place in 1970 and it’s very true that a lung cancer diagnosis in 1970 was pretty much a death sentence. So “Mad Men” is not only showing the Devil-may-care culture of the 1960s, but one of the consequences of that culture — which is a hell of a lot of people back then died of lung cancer (In fact, I’ve called it the “slow-motion tobacco holocaust of the 20th century.”).

HuffPost wrote about how cancer diagnoses worked in the early 1970s and suggested “Mad Men” was spot-in about the stigma around a cancer diagnosis in those days.

Smoking seemed cool and glamorous well through the 1960s. It was cool and glamorous not only in billboards and magazine ads, but in countless movies of the time. James Bond smoked cigarettes. Matt Helm smoked cigarettes (and Dean Martin died of lung cancer and emphysema), etc.

From a Daily Beast column on Betty Draper’s lung cancer. This column by Lizzie Crocker about smoking on the show is absolute awesome. I’m quoting several paragraphs here because she is explaining this much better than I can (Since I’ve never really watched the much of the show):

As with many of the series’ final episodes, the decision to kill off Betty with lung cancer was rather on-the-nose. For a show in which so little actually happens, it’s clear Matthew Weiner, the show’s creator, is rushing to tie up loose ends, like Betty and Sally’s fraught relationship, which has led to some soap-operatic plot twists.

We knew someone was going to die in these final episodes, and the fraught, discontented, ill-fated Betty, still in her 30s, had to suffer the health consequences of chain-smoking that everyone else on Mad Men has managed to avoid. Roger had a heart attack earlier in the series and he still puffs away with impunity.

But not Betty, whose diagnosis is confirmed not by the doctor but by her husband Henry, having just received ‘the news.’ When she reaches for a pack of cigarettes in the car, he angrily snatches them and tosses them in the back.

We see her disease-clogged lungs on an X-ray; a desperate Henry breaking down when he visits Sally at school; Sally devastated and covering her ears when Henry tells her about the diagnosis.

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The link between smoking and cancer has always lurked in the background of the show. In the pilot, “Smoke Gets in Their Eyes,” Don has to think of a clever way to sell Lucky Strikes after the 1960 Reader’s Digest report linking cigarettes and cancer. The client isn’t pleased when Pete suggests they work society’s “death wish” into a new campaign slogan.

But Don saves the day with a pitch emphasizing how Lucky Strikes are made: “Everyone else’s tobacco is poisonous. Lucky Strikes are toasted.” All cigarettes are toasted, of course, but consumers don’t know that. “Advertising is based on one thing: happiness,” Don tells the client.

Happiness is “the smell of a new car. It’s freedom from fear.” And all Lucky Strike smokers need is “a billboard on the side of the road that screams with reassurance that whatever you’re doing, it’s ok.”

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And as we close in on the series finale, Betty’s diagnosis seems to be the apogee of the show’s relationship with smoking.

That slow-motion shot of the sauntering Peggy from two Sundays ago, one of the most memorable moments this season, will likely be the last time that we see a cigarette as emblematic of anything other than anxiety and death.

Cigarettes, and their celebration, were one of the vital accessories of Mad Men, the show’s perverse fuel. Now, stripped of their allure like those stripped of their status in the move from SCDP to McCann, they’ve come to signify the very literal death of the show.