Am J Public Health. 2003 July; 93(7): 1045.

PMCID: PMC1447901

Courage and Dignity

Lyndon Haviland, DrPH, Cheryl G. Healton, DrPH, Elizabeth Fee, PhD, Theodore M. Brown, PhD, Bernadette A. Toomey, and
Beverly Kastens
Lyndon Haviland, Cheryl G. Healton, Bernadette A. Toomey, and Beverly Kastens are with The Legacy Foundation, Washington, DC. Elizabeth Fee is
with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md. Theodore M. Brown is with the
Departments of History and of Community and Preventive Medicine at the University of Rochester, Rochester, NY.
Requests for reprints should be sent to Elizabeth Fee, PhD, Building 38, Room 1E21, 8600 Rockville Pike, Bethesda, MD 20894 (e-mail:
elizabeth_fee@nlm.nih.gov).

Copyright © American Journal of Public Health 2003

LINDA COSTIGAN STRUGGLED to quit smoking. She was finally successful—but only after she had been
diagnosed with lung cancer. By then she had been smoking for 42 years. Although she could do little to save
herself, Linda tried to do what she could to educate others about the hazards of smoking. She allowed the
American Legacy Foundation to use her image and her brief but heartfelt letters to her daughter, J. C., her friend,
Pat, and her granddaughter, Ally, in its 2002– 2003 national advertising campaign against smoking. She was one
of 4 women to allow their personal stories to be used in trying to reach the 46 million Americans who are still
smoking.1

This haunting photograph was taken by Richard Avedon in March 2002. Linda felt that this advertising campaign
gave her life meaning in her final months. This ad and her “voice” is her legacy to the world. Linda Costigan
died in January 2003.

In remembering Linda Costigan, we should also remember that, each year, 178 000 women die of tobacco-related
illnesses.2 Tobacco use is the largest preventable cause of death among women in the United States, responsible
for the premature deaths of approximately 3 million women since 1985.3

Linda’s daughter, like many other American women, has herself struggled to quit smoking.

Figure 1
Source. Courtesy of The Legacy Foundation.

References
1. Centers for Disease Control and Prevention. Cigarette smoking among adults–United States, 2000. MMWR
Morb Mortal Wkly Rep. 2002;51:642– 645. [PubMed]

2. Centers for Disease Control and Prevention. Annual smoking-attributable mortality. Years of potential life lost
and economic costs—United States, 1995– 1999. MMWR Morb Mortal Wkly Rep. 2002;51:300–303. [PubMed]

3. Women and Smoking. A Report of the Surgeon General. Rockville, Md: Center for Chronic Disease Prevention
and Health Promotion, Office on Smoking and Health; 2001:190.

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association