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The earliest available usage of the photograph was published on The Cut on August 25th, 2016, with the caption: "Ben Affleck loves to smoke and hates the thought of existing in his own body for the rest of his time on earth." That sentence alone is a masterpiece of internet writing and it instantly framed how the world would interpret the image forever

The first study examined dogs affected by myxomatous mitral valve disease and found that individuals living in households with smokers exhibited statistically significantly lower plasma concentrations of tetrahydrobiopterin (p=0.01) [a cofactor for endothelial-derived vasodilator nitric oxide, whose depletion is associated with oxidative stress], suggesting that passive smoke exposure may contribute to oxidative imbalance 37

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