'Mad Men' got the smoking issue right after all

Story highlights

  • Robin Koval: "Mad Men" liberally showed people smoking, harking back to the 1960s
  • Koval: The show didn't stint on showing the negative consequences of smoking

Robin Koval is the CEO and president of Legacy, the public health foundation dedicated to ending the tobacco epidemic in the United States. The opinions expressed in this commentary are hers.

(CNN)As a veteran of the advertising business I have been a "Mad Man" fan since the beginning. But when I left the agency world to run a public health foundation dedicated to ending tobacco-related illness and death, the show became a truly "guilty pleasure."

Each week I winced as Don, Betty, Roger, Joan and lately even a teen, Sally, picked up a cigarette and began to puff away on screen.
I knew it was all make-believe, but I also knew that there's real science linking smoking on screen to youth behavior. The U.S. Surgeon General has concluded that youth who are exposed to images of smoking in movies are more likely to smoke. In fact, those who get the most exposure to onscreen smoking are about twice as likely to begin smoking as those who get the least exposure.
    Robin Koval
    And so as "Mad Men" entered its final season, I found myself wondering if there was a way to bring attention to damage that seven seasons of smoking on a program that had shaped the way we dressed and decorated our offices and homes might also be doing on the impressions and behaviors of young watchers?
    Then, with the penultimate episode came Betty's diagnosis: aggressive lung cancer. And suddenly the fictional world of "Mad Men" collided with the facts about women's lung and heart health and the array of deadly illnesses linked to women smoking.
    Betty's diagnosis was revealed on Mother's Day, which was also the start of National Women's Health Week. This year, the Centers for Disease Control has been working to draw attention to the dangers that tobacco still holds for women and girls in the U.S. In fact, smoking is more deadly for women today than it was in Betty Draper Francis' day -- three times more deadly. And smoking in 2015 remains the leading preventable cause of death in the United States.
    This bears noting, in great part, because too often people think that as rates of smoking have gone down -- particularly among youth -- smoking-related illness is more of a 1970 problem than a 2015 problem. They are wrong. More women die from lung cancer in the U.S. each year than any other cancer. Add in heart disease, the leading cause of death among women, stroke and respiratory diseases -- all of which are linked to smoking - and the magnitude of the problem becomes clearer.
    More than 200,000 women will die of smoking-related illnesses in the United States this year alone. And more than 20 million women and girls in the U.S. still smoke. They are the reason we should all feel guilty about smoking imagery in entertainment: images influence behavior and smoking remains a deadly behavior.
    I am truly grateful to the creators of the fictional world of "Mad Men" that they have allowed the consequences of real world choices to touch one of their iconic characters. The show has been full of cultural and political milestones, but at long last they have given us a small window of opportunity to appreciate the results of the tobacco addiction that flourished on screen.
    With youth smoking rates down at 8%, we have a chance to help today's youth be the generation that ends tobacco use. If Betty can help us drive home that message in 2015, that would be a far greater contribution than their newfound appreciation for Eames chairs, Ray Bans and shirt-waist dresses.