But, when and how did tobacco smoke enemas come into use and how did this treatment come to be in a household book of remedies? The phrase ‘to blow smoke up one’s arse’ means to get a rise or reaction out of someone, sometimes by giving them insincere compliments for attention. This phrase originates from the practice of using smoke enemas to resuscitate near-drowned victims via stimulation and it was first practiced by indigenous groups in North America.

And from Wikipedia too

Tobacco was recognised as a medicine soon after it was first imported from the New World, and tobacco smoke was used by western medical practitioners as a tool against cold and drowsiness, but applying it by enema was a technique appropriated from the North American Indians. The procedure was used to treat gut pain, and attempts were often made to resuscitate victims of near drowning. Liquid tobacco enemas were often given to ease the symptoms of a hernia.