Marlboro is a major producer of cigarettes. Cigarettes, and tobacco products as a whole, are expensive, smelly and are proven to increase cancer risks due to the inhalation of carcinogens as the cigarette is lit and then inhaled. The burning of cigarettes also creates tar that is then inhaled, so there is literally black sludge that slowly accumulates in ones lungs as one inhale the smoke.

Reading all that, you might wonder how one could "love" it. Thing is, Tobacco products are incredibly addictive, once you start smoking cigarettes it is incredibly hard to stop. People start by only doing it with friends once a month or so, many people say it has a relaxing effect, especially when taken in a social circle, but then their brain craves it twice a month, and suddenly they want to do it every day or more often. It's as we grown ups say, "a hooker who takes all your money but wont love you back".

Cigarettes also make hrt less effective.

This is then revealed to be a breaking point for the portrayed smoker, evidently a hormone replacement therapy user. See, hrt is helping a lot of people growing into a body they feel comfortable in. It's like puberty, but a more controlled process some people really want to do to feel comfortable in their body. This meme is showing that this desire is so great they even give up something that is incredibly hard to quit, because this step in their life is so important to them. The same way some people love to stay fit to feel good about their bodies, hrt users expend real effort to get to a body they don't hate when necessary.