My brother is dying. He lives in a small town in the West, a village really, and he moves from room to room with an air hose in his nostrils constantly filling his lungs with a steady stream of oxygen. The sun warms the south side of the house and tulips bloom in the flowerbeds, but he can’t see them. It’s too hard to leave the house. In a Western world of wide-open spaces, he’s confined to three or four rooms.

In the late 19th and early 20th century in the American West, it was miner’s consumption that cut short male lives. In San Juan County, Colo., with a population of 589 in the 2000 census, the only town is Silverton. Over 3,000 people lie buried in the town’s cemetery, and the average age of males is only 42. They died young in the mines from cave-ins and accidents, from hard living and hard working, and inhaling rock dust that perforated their lungs.

In other parts of the West, fatal respiratory ailments came from working in coal mines, breathing black dust and deadly gases that put many a miner into an early grave. The West was a land of dangerous workplaces before unions and health and safety laws forced an improvement in working conditions. Near Grants, N.M., it was uranium mining, the dust from digging yellowcake, that forced Navajo men back into their homes to wheeze their last breaths beneath a turquoise sky.

For many a decade, it was routine to die after short careers digging gold, silver, coal or uranium. At one time in Colorado, a widow’s compensation for her husband’s accidental death in a gold mine was $75, a coffin, and a notice to vacate company housing by the end of the week. Why in the West, with all our clean air, have we sacrificed so many men in so many industries to live their last days struggling to breathe? In Libby, Mont., we know now, it was vermiculite asbestos that slowly eliminated lung capacity for miners and unwittingly harmed their families as well.

But for my brother, it wasn’t the mines but the myth that nailed him, that Marlboro Man myth of the rugged cowboy, his horse silhouetted against a Western sunset, his Stetson tipped back at the end of the day, and always, a cigarette dangling from his lower lip.

For how many years did we Westerners permit our spectacular landscapes and a ranching way of life to become enmeshed in popular culture with smoking? My brother began to smoke in a decade when large-format photo magazines like Life and Look featured full-page ads for cigarettes. Smoking was good for you, and your doctor was kind enough to recommend his brand. Smoking calmed your nerves and aided digestion. And there were those cowboys on horseback in a stunning landscape, pausing from he-man work, cigarette in hand. The message: This is the way to live to be a real man.

Western scenery sold cigarettes, and it still does, and now my brother’s dying of end-stage emphysema, although he quit smoking a few years ago. He has maybe six months left to live. He’ll never enjoy retirement and traveling around the West. He’ll never make it to the North Rim of the Grand Canyon or once again drive Trail Ridge Road high above Denver. His wide-open spaces have become closed-in places.

How many other men, around the world, have died before their time because of the glorification of Western sunsets, cowboys riding the range and cigarettes sold as a seductive symbol of manhood? We know what happened to two actors who portrayed Marlboro Men in commercials: Wayne McLaren and David McLean both died of lung cancer.

The harsh beauty of Monument Valley, Utah, on the Navajo Reservation, has been a backdrop for selling countless products ever since the movie-making days of director John Ford and actor John Wayne. The mythology of the West endures, and every summer, European tourists drive slowly through Monument Valley, entranced by the landscape, cigarettes dangling out the windows of their rental SUVs.

I hope that the next generation “gets” the anti-smoking message, but I’m not so sure. Macho myths die hard, and plenty of young men think nothing about lighting up a smoke. I wish they could meet my brother. Before it’s too late for him, before it’s too late for them.

Andrew Gulliford is a contributor to Writers on the Range, a service of High Country News (hcn.org). He is a writer, photographer and professor of Southwest Studies and History at Fort Lewis College in Durango, Colorado.