........it had a much more literal meaning.
I find this particular illustration hysterical! I'm sorry, but the guy on the left looks more like he's taking a hit off the reclining woman than blowing smoke into her.
The practice came about as a way to revive drowning victims. (click for link with more detail). It some cases it even worked! Not so much in others. It seemed to depend on just how 'drowned' you were. (Think Miracle Max in "Princess Bride")
Miracle Max: Hoo hoo hoo! Look who knows so much, heh? Well, it
just so happens that your friend here is only mostly
dead. There's a big difference between mostly dead
and all dead. Please, open his mouth. Now, mostly
dead is slightly alive. Now, all dead...well, with
all dead, there's usually only one thing you can do.
Miracle Max: Go through his clothes and look for loose change.
Coincidentally, fans of the movie may recall that Max uses a bellows on Wesley, only he stuck it in Wesley's mouth. The items below were used elsewhere:
Tools of the 'smoke-blowing' trade.
Now it has been a while since those halcyon days of rectal puffing, but the idea has not gone away completely. It turns out that some crack smokers will engage in the same practice. ( Imagine smoking crack then blowing the smoke INTO a crack? That's like double-crack! ) It's called "booty-bumping" and can usually mean a more traditional enema injection, or blowing cocaine powder, or in the case presented here, as crack smoke.
So the next time you hear someone say, "don't blow smoke up my ass" you can now know that at other times, folks have said, "oh, by all means......please do."