The American Lung Association and Christmas Seals

American Lung Association logo

Edward Livingston Trudeau
Edward Livingston Trudeau M.D., one of the founders and first president.
Edward Livingston Trudeau M.D., one of the
founders and first president.

For more than 110 years, the American Lung Association has been America's leading force for lung health—successfully tapping into America's spirit of community that inspires us to work together for better health and longer life for all.

Targeting Tuberculosis

In 1904 it was a revolutionary concept—a nationwide organization to fight a single disease – tuberculosis. Tuberculosis (TB) was the most feared disease in the world, striking down the young and old, the rich and poor.

Determined to battle TB, a group of doctors and concerned citizens formed the first voluntary health agency in America, the National Association for the Study and Prevention of Tuberculosis (NASPT), later to become the American Lung Association. One of these founders was Edward Livingston Trudeau M.D. As a young doctor, Trudeau himself had suffered from TB. He became the new association’s first president and dedicated his life to fighting the disease.

Over a difficult 50-year fight, the Association played a critical role in developing and funding increasingly effective weapons to prevent, detect and treat the disease. Along the way, the Christmas Seals® campaign was launched, the first "direct mail" fundraiser that has become an enduring symbol of the power of volunteers to battle disease.

Health education and public awareness campaign sign
Health education and public awareness campaigns help in the fight against TB.
Health education and public awareness
campaigns help in the fight against TB.

The Birth of Christmas Seals

The story of Christmas Seals dates back to 1907, when physicians were experiencing the first signs of success treating tuberculosis in special hospitals called sanatoriums. One of those facilities had fallen on tough times, and the tiny Delaware sanitorium would have to close its doors if $300 could not be raised to save it. One of its doctors explained the plight to his cousin, a volunteer named Emily Bissell. Bissell was a veteran fundraiser, and she soon came up with a plan based on one that had worked in Denmark: She would design and print special holiday seals and sell them at the post office for a penny each.

The campaign got off to a slow start, but a feature in the Philadelphia North American newspaper and a surprise endorsement by President Theodore Roosevelt, helped Bissell and a large group of committed volunteers raise ten times their goal. The American Lung Association Christmas Seals® were born.

The following year, Christmas Seals became a national campaign, with millions of seals printed and $135,000 raised – enough to support more sanitoriums and advance the fight against TB.

Soon the Christmas Seals became a widespread holiday tradition and outgrew its humble beginnings of direct sales from neighborhood stands.  In 1920, the NASPT - now known as the National Tuberculosis Association (NTA) – took over all aspects of the campaign and transitioned into a nationwide direct-to-public mail campaign.  With Emily Bissell and an army of NTA volunteers promoting the campaign, Christmas Seals were the first, and soon became the largest nonprofit direct mail campaign in the country.

Emily Bissell
Emily Bissell
Emily Bissell

Emily Bissell kicks off first Christmas Seal campaign by buying the first seal from the stand in the Wilmington DE. Post office – 1907.
Emily Bissell kicks off first Christmas Seal campaign by buying the first seal from the stand in the Wilmington DE. Post office – 1907.
Emily Bissell kicks off first Christmas Seal campaign by
buying the first seal from the stand in the Wilmington DE.
Post office – 1907.

U.S. postage stamp honors Emily Bissell – 1980
U.S. postage stamp honors Emily Bissell – 1980
U.S. postage stamp honors
Emily Bissell – 1980

First Christmas Seal, designed by Emily Bissell
First Christmas Seal, designed by Emily Bissell
First Christmas Seal, designed
by Emily Bissell

1920 Christmas Seal
1920 Christmas Seal
1920 Christmas Seal

Collage of Christmas Seals over the years.
Christmas Seals over the years.
Christmas Seals over the years.

Bob Hope and Christmas Seal artists from Maryland.
Bob Hope and Christmas Seal artists from Maryland.
Bob Hope and Christmas
Seal artists from Maryland.

Shirley Temple (left) and volunteers – 1940
Shirley Temple (left) and volunteers – 1940
Shirley Temple (left) and volunteers – 1940

Frank Sinatra promotes Christmas Seals – 1963
Frank Sinatra promotes Christmas Seals – 1963
Frank Sinatra promotes
Christmas Seals – 1963

Carol Burnette promotes Christmas Seals – 1968.
Carol Burnette promotes Christmas Seals – 1968.
Carol Burnette promotes
Christmas Seals – 1968.

Cybil Shephard supports Christmas Seals – 1986.
Cybil Shephard supports Christmas Seals – 1986.
Cybil Shephard supports
Christmas Seals – 1986.

Will Smith supports Christmas Seals – 1991.
Will Smith supports Christmas Seals – 1991.
Will Smith supports
Christmas Seals – 1991.

1930s TB/Christmas seals promotional poster.
1930s TB/Christmas seals promotional poster.
1930s TB/Christmas seals
promotional poster.

Every year, celebrities and public officials endorsed and embraced the Christmas Seals campaign. Endorsements by Presidents Calvin Coolidge, Woodrow Wilson, Franklin Roosevelt and movie stars like Bob Hope, John Wayne, Abbott & Costello and many others enabled the NTA to fund medical research, create a massive public health education campaign, and provide TB screening services, including mobile X-Ray units.

By the mid-1950s, the decades of work paid off. The combination of new drugs and improved public health and education resulted in tuberculosis being largely controlled in the United States. Death rates in 1954 were one-fiftieth of what they had been in 1904 when the organization was founded.

The American Lung Association expands its mission to include air pollution, smoking and other risks to lung health.
The American Lung Association expands its mission to include air pollution, smoking and other risks to lung health.
The American Lung Association expands its mission to
include air pollution, smoking and other risks to lung health.

A Broader Mission – The American Lung Association

Over the years, the NTA continued the fight, targeting other threats to lung health, and changing its name to the American Lung Association, guardians of everyone's right to breathe.

Still revolutionary, the Lung Association was among the first to tackle smoking as the nation's greatest preventable health risk, and to make the connection between air pollution and lung health.

Landmark victories include:

  • Discovering an effective new treatment for children with TB
  • Discovering the cause of infant respiratory stress syndrome
  • Eliminating smoking on domestic air flights
  • Strengthening the Clean Air Act
  • Discovering the gene that causes cystic fibrosis
  • Passing the Tobacco Control act to regulate the manufacture, sale, marketing and promotion of tobacco products
  • Discovering a cancer causing oncogene, as well as treatment that inhibits the growth of lung cancer tumor cells
  • Launching LUNG FORCE a nationwide movement to unite women against lung cancer and for lung health

Early research advances led to breakthroughs in the treatment of tuberculosis, infant respiratory distress syndrome and cystic fibrosis.
Early research advances led to breakthroughs in the treatment of tuberculosis, infant respiratory distress syndrome and cystic fibrosis.
Early research advances led to breakthroughs
in the treatment of tuberculosis, infant respiratory
distress syndrome and cystic fibrosis.

The Legacy of the Mail

Over the decades, Christmas Seals and other direct mail outreach played an important role in funding the Lung Associations lifesaving mission.

Emily Bissell, who created and led the Christmas Seals campaign into the 1940s was honored with a commemorative U.S. postage stamp in 1980.

Direct mail activity peaked for the Lung Association around 1990, with approximately 80 million pieces sent, raising $60 million that year.

Although online, special events and other outreach methods have become more prominent, direct mail still provides significant support to the Lung Association. In 2015, they mailed 27 million pieces and generated just over $23 million.

Girl wearing oxygen mask
The Lung Association’s Healthy Air Campaign works to make the air we breathe clean and healthy.
The Lung Association’s Healthy Air Campaign works to make
the air we breathe clean and healthy.

Doctor in a lab
Recent research is unlocking the secrets of lung cancer.
Recent research is unlocking the secrets of lung cancer.

Collage of health education materials
American Lung Association health education materials help patients and caregivers learn about and manage lung diseases.
American Lung Association health education materials help patients and caregivers learn about and manage lung diseases.

Signing of the Tobacco Control Act – 2009.
Signing of the Tobacco Control Act – 2009.
Signing of the Tobacco Control Act – 2009.

LUNG FORCE standing in front of the White House with Lung Force sign.
LUNG FORCE initiative targets lung cancer in women.
LUNG FORCE initiative targets lung cancer in women.

Woman with a baby looking at a power plant
The Lung Association played a major role in strengthening the Clean Air Act in 1990.
The Lung Association played a major role in strengthening the
Clean Air Act in 1990.

Looking to the Future

Today the American Lung Association’s mission is more important than ever. The Lung Association, never takes breathing for granted, because millions of Americans fight for each and every breath.

And after more than 110 years, the American Lung Association’s crucial mission is still supported by Christmas Seals®. Each year, millions observe the tradition of sealing holiday cards and packages with that year’s special seal. And each year, their Christmas Seals® donation support the important fight against lung disease being waged every day by the American Lung Association.

Today, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on five strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; eliminate tobacco use and tobacco-related diseases; and monitor and enhance organizational effectiveness.

Children playing outside
The American Lung Association is looking to the future.
The American Lung Association is looking to the future.