LOS ANGELES – Debi Austin looked into the camera, swallowed — the hole in her throat as big as a half-dollar coin and as black as nothingness — and said she had her first cigarette when she was 13, that she had tried to quit but couldn’t. And that “they” say nicotine is not addictive.

Then she picked up a half-burned, still-lit cigarette from an ashtray, tilted back her head and took a drag from the hole in her neck. She winced, and as the smoke wafted out of the hole she said: “How can they say that?”

The public-awareness television ad, which began airing in the mid-1990s, turned the San Fernando Valley woman into a powerful symbol of the anti-smoking movement.

Austin, who became an anti-smoking advocate and educator, died Feb. 22 at Valley Presbyterian Hospital in Van Nuys after a 20-year battle with cancer, her family said. She was 62.

Diagnosed with cancer of the larynx, she had a laryngectomy, which removed the tumor and her vocal cords. She learned to talk using esophageal speech, or “burp talk.”

She agreed to make the startling “Voicebox” ad only after a 4-year-old niece drew a black dot on her own neck to mimic her aunt’s scar from the surgery and said: “I want to be like you.”

In recent years, Austin often traveled around the state to spread her anti-smoking message to young people. She also made two more anti-smoking ads that began airing in 2011.

People remembered her, Austin said, because she was scary. She hoped that they would see her and think twice about lighting up, according to a 2010 Los Angeles Times interview.

Deborah Austin was born April 13, 1950, in Illinois and moved to Los Angeles the year she turned 4.

While walking home from junior high school in Canoga Park she took her first puff on a cigarette, an unfiltered Camel. By high school, she was smoking a pack of unfiltered Camels a day.