I like the OOB thinking here. You're probably gonna get hit with the anti-smoking vote and the anti-sepia vote and the "I can't see her face" vote. BUT, I do think the shot has a lot of artistic merit. :-)
Composition is a little unbalanced due to the cut off elbow and the dark shape behind the hand. The hand is pointing away from the camera which does not help in the emotion of the image to the viewer. I can see from a photographers point of view how this image would be emotionally attached in the heat of the moment...but from a neutral point of view...not as good.