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On September 12, 1906, what would later become known as the American Lung Association of Washington was organized at a meeting of the State Medical Society in Spokane. The purpose of the Washington Association for the Prevention and Relief of Tuberculosis was to raise awareness about the causes and treatment of tuberculosis, construct institutions in which cases of tuberculosis and other respiratory diseases could be treated, and promote the formation of local associations at the county level. Responsibility for developing the role of the Washington Association for the Prevention and Relief of Tuberculosis in the promotion of community health was given to Dr. William R.M. Kellogg. He was named secretary of the organization at its founding.

In the next two years, despite having contracted tuberculosis, Dr. Kellogg focused on extending the organization from Seattle north to Everett, where anti-tuberculosis programs were directed primarily towards children. The result of these efforts is the organization’s continuing emphasis on education. In order to educate a larger number of people on a regular basis, Dr. Kellogg began publication of The Pacific Coast Journal of Tuberculosis in 1908. In addition to calling attention to the need to educate people about the disease, Dr. Kellogg led the effort to establish an institution in Seattle for the treatment of tuberculosis patients. The first sanatorium in the state, the Pulmonary Hospital of the City of Seattle, was completed in 1908.

On October 14, 1908, Dr. Kellogg passed away after his struggle with tuberculosis. His death was a significant obstacle to the further development of the organization; as a result of his passing, little was done by the association until 1910.

In 1909 the initial steps toward a reinvigoration of the anti-tuberculosis movement in the state were taken. Members of the state association founded the Anti-Tuberculosis League of King County, on February 25, and soon thereafter a statewide traveling clinic raised broader interest in the issue. The following year Bethesda Beals Buchanan accepted the position of the first Executive Secretary of the Washington Association for the Prevention and Relief of Tuberculosis.

Mrs. Buchanan, held the position for for thirty-five years. During this time she oversaw the organization and publicity work of the association. During the early part of her tenure, the association focused on expanding the number of county leagues in the state. In 1911, in addition to the King County league, there were newly formed leagues in Clark, Pierce, Snohomish-Island, and Spokane counties, with the Skagit County league coming into existence within the year.

The efforts of both the state association and the county leagues at this time were concentrated in a limited number of areas related to the treatment of the disease. These areas of involvement remained close to the original purpose of the organization and included the continued use of traveling clinics, the development of nursing and public health programs, the sale of Christmas Seals, the placement of exhibits and booths at county and state fairs, and the construction of sanatoria. In 1913 the association succeeded in creating and passing the “Tuberculosis Law of 1913,” which provided county commissioners with the opportunity for increased autonomy from the state association by allowing counties to employ nurses and construct hospitals on their own. The most prominent and regionally oriented of these hospitals were Fairland (1911) in Seattle; Mountain View (1914 – the first county sanatorium in the state) in Lakeview, Pierce County; Edgecliff (1915) in Spokane; and Aldercrest (1918) in Snohomish, the latter three resulting from the 1913 legislation.

In 1915 the Washington Association for the Prevention and Relief of Tuberculosis was incorporated. In the next four years leagues were established in fifteen counties, including Walla Walla (1916), Yakima (1918), Chelan (1918), and Grays Harbor (1919). The following year, on February 6, 1920, the Washington Association for the Prevention and Relief of Tuberculosis ‘following the example of many similar organizations,’ changed its name to the Washington Tuberculosis Association.

The organization, while maintaining its emphasis in the previously mentioned areas of education and care, expanded its role. The Health Pilot , a monthly newsletter edited by Mrs. Buchanan, Dr. Clarence A. Smith, and John Weinzirl, was first published in January 1919 and continued through 1944. Correspondence between Mrs. Buchanan and the secretaries of the individual county associations, most notably Honoria Hughes of the Anti-Tuberculosis League of King County and Minnie M. Sheldon of the Tuberculosis League of Pierce County, increased as the leagues developed. The growth of the separate leagues also allowed for a certain degree of specialization, with various counties leading the progression in certain areas of the anti-tuberculosis movement. This organizational structure, in which the county leagues remained predominantly independent of one another and from the state association, remained essentially the same for fifty years.

In 1971 the Washington Tuberculosis Association changed its name to the Washington Tuberculosis and Respiratory Disease Association. Two years later, in addition to undertaking another change in name, this time to the Washington Lung Association, the association absorbed each of the county corporations and associations.

In the 1970s the association focused more intensely on advocacy and activism in addressing community issues related to respiratory health. The two most significant cases in which the association was involved were related to the American Smelting and Refining Company’s (ASARCO) Tacoma copper smelter and the incidence of asbestos in Seattle schools. In both cases the Washington Lung Association worked with community and environmental organizations to raise awareness about health risks.

In the instance of ASARCO, the association assisted a number of organizations in their efforts to enforce the company's compliance with sulfur dioxide emissions standards variances granted by the Puget Sound Air Pollution Control Agency . These groups included Clean Air for Washington, the Washington Environmental Council, Friends of the Earth, and the Air Quality Coalition. The extent to which the Washington Lung Association played a role in the legal battles that ensued is unclear, but the association did, at various times, correspond with the National Clean Air Coalition, the Environmental Protection Agency and the Puget Sound Air Pollution Control Agency on the issue. In the early 1980s, evidence of elevated levels of lead and arsenic were documented in the soil and vegetation in areas located downwind from the smelter. In 1985 the Tacoma plant was closed after approximately fifteen years of legal challenges.

The late 1970s and early 1980s also saw the Washington Lung Association address the issue of asbestos in Seattle-area schools. Janet Chalupnik, the Director of Environmental Health Programs at the W.L.A., headed efforts to call attention to the deteriorating condition of ceilings in certain schools within the district. In June of 1979 Mrs. Chalupnik addressed the Seattle School Board on the risk posed to children in the affected schools. Those schools that were found to be in the poorest condition included Roosevelt and Garfield high schools, Madison Junior High, Hamilton Middle School and Bryant Elementary School. In 1983, as a result of the efforts of the association and parents of students who were attending the schools, the Seattle School District met a 1982 Environmental Protection Agency regulation that required school administrators to inspect for friable asbestos.

On July 17, 1981, the Washington Lung Association changed its name once again, this time to the American Lung Association of Washington (ALAW). In the next two decades the ALAW remained active in educating the public about potential health risks, as well as maintaining an influential advocacy presence in Olympia. Today the ALAW, through awards and grants, supports research at institutions such as the University of Washington, the Fred Hutchinson Cancer Research Center, and Children’s Hospital and Regional Medical Center. The association also organizes activities such as the Trek Tri-Island cycling trip and the Climb for Clean Air ascent of Mt. Rainier, as fundraisers and also in order to raise awareness about issues related to air pollution and air quality..