It seems unfair of the US public health organisation Truth Initiative to single out Netflix for special censure in a new report on depictions of on-screen smoking. The study found that “79% of the shows most popular with young people aged 15-24 depict smoking prominently”.

It isn’t that there is no cause for concern here. The US surgeon general has said: “Youths who are heavily exposed to onscreen smoking imagery are approximately two to three times more likely to begin smoking than youths who are less exposed”. But what does Truth Initiative expect in the case of a period piece such as Netflix’s Stranger Things, which was the worst offender? The programme makers might just as easily be reprimanded for featuring too many shaggy hairdos and crimes of fashion. It’s the 1980s. It comes with the territory.

‘Films such as Basic Instinct have made smoking synonymous with sexual charisma.’ Photograph: Allstar/TRISTAR/Sportsphoto Ltd./Allstar

Back then, smoking was permitted in cinemas as well as on screen. Look at the opening scene of the nostalgic comedy Son of Rambow if you don’t believe me, as the camera pans across a darkened cinema and on to a young audience member puffing away in the stalls, or that moment in Cape Fear when a cigar-puffing Robert De Niro ruins a trip to the movies.

British cinemas in the 1980s made a negligible concession to any non-smokers in attendance by imposing an imaginary divide down the middle of the auditorium: you could smoke on the left side, but not the right. A fat lot of good that did – everyone ended up with lungfuls of secondhand smoke anyway. The mystery is that even as you choked and spluttered and peered through the fog at the movie, the smoking on screen still looked pretty cool. That’s the idealising power of cinema for you. The moving image is well-equipped to make pursuits that are bad for your health look good.

No roll-call of the most memorable stars in cinema could ever be entirely tar-free. James Dean, Bette Davis, Lauren Bacall, Humphrey Bogart, Rita Hayworth and Marlon Brando wouldn’t have had the same allure slapping on a nicotine patch. Films as different as Basic Instinct, To Have and Have Not and The Graduate have made smoking synonymous with sexual charisma. Even as the habit has plummeted (Britain has the second-lowest rates in Europe, while in the US smoking has fallen to 15.5% of the population), the on-screen cigarette has had trouble shedding its connotations of stylishness.

Some studios have done their bit to stub it out. In the 1980s, anti-smoking campaigners persuaded Hollywood to slash the on-screen smoking rate to less than half of what it had been in the 1950s, when stars had sparked up at an average of almost five times an hour. But it had shot back up again by the early 21st century. Disney, which announced in 2015 that it would ban all depictions of smoking from its movies, is one of the few to stand in opposition to that trend.

One alternative for those filmmakers who want to kick the habit without relinquishing the aura of coolness might be found in the vitality of the vape, seen recently to striking effect in Beach Rats. That gay indie movie showcased some atmospheric vaping, even featuring the lesser-spotted smoke ring. But even when it’s meant to signify despair, there’s something uniquely eloquent about a cigarette. Think of Alec Baldwin in the afterlife’s waiting room in Beetlejuice, where he refuses a smoke offered to him by a charred skeleton. (“I’m trying to cut down myself,” sighs the bag of burned bones.) And Bill Murray has rarely been more adorable than the moment in Rushmore when he lights a second cigarette while the first one is still dangling from his lips.

Dustin Hoffman and Anne Bancroft in The Graduate. Photograph: Allstar/Cinetext/EMBASSY

How to explain the enduring popularity in cinema of something we know to be rotten in real life? Perhaps it’s analogous to the situation shown in Café Flesh, a scuzzy 1980s exploitation movie set in a post-apocalyptic future where the majority of the population can no longer have sex because it makes them sick. These bereft souls gather in an old theatre to watch live sex shows; they get their kicks, as far as they can, from gawping at what they are no longer able to do. A bit like ex-smokers going to the cinema today. Even the woebegone patrons of Café Flesh have one thing in their favour: at least they can enjoy a post-coital smoke.

• Ryan Gilbey is film critic for the New Statesman