A 1776 textbook drawing of a tobacco smoke enema device, consisting of a nozzle, a fumigator and a bellows. If a doctor, nurse or anyone else recommends that you or your child get vaccinated, they are – to use a slang expression – “blowing smoke up your arse.” SOURCE. The expression “blowing smoke up your arse” originates from a bizarre medical practice which started in the 18th century.