You were nominated for a “4 Under 40” award for your advocacy and education efforts around tobacco prevention and cessation. What motivated you to become so involved in this work?
When I was a resident training at Hasbro Children’s Hospital Primary Care, we were coming up with different ideas for projects and, in the back of my mind, I was thinking about how difficult it had been for my dad to quit smoking. He tried a lot of different medications – nicotine patch, nicotine gum, Chantix – but had a really hard time quitting. So when we were coming up with ideas for projects there was an article that had just come out from Dr. Jonathan Winickoff (he researches strategies to address tobacco use) about how pediatricians could prescribe nicotine replacement for parents to help them quit smoking. That really resonated with me because while pediatricians are focused on kids, we get to know their families through our work and, in doing so, earn the trust of parents. We often actually see the parent more than they might see their own doctor. This gives pediatricians a very unique opportunity to provide parents with tobacco cessation support and, in turn, create a healthier environment for our patients.
Once you were motivated to get involved with tobacco cessation, then what?
The article came out in my third year of residency, so I did a small project at Hasbro on screening for tobacco use in parents and I took off from there. Through the American Academy of Pediatrics (AAP), I received training on how to address and treat tobacco use in parents and teens. Then I started applying what I leaned and the parents are just so grateful. I see it when I ask them, “Can I help you quit? Do you want to talk about quitting?” And they’re just like “Yes, thank you, no one has ever asked me.” Some of them had tears in their eyes when I asked them. And, so I prescribe nicotine replacement therapy for parents in my clinic and now, I train the residents and the pediatricians in the state to do the same. It’s been so rewarding. I have parents come back and tell me they were able to quit. They tell me how proud they are and how proud their kids are.
It’s a really joyous moment in the office when they’re so incredibly happy and thankful. It’s been so rewarding. You’re helping the parent with their own health but you’re really helping the kids as well. They become less exposed to smoke and they’re not seeing tobacco use in the home so they’re less likely to initiate use. It’s a huge family win!
In 2020, I became the AAP E-Cigarette Chapter Champion for Rhode Island and received additional training from the AAP. I learned how to better address vaping, advocate in the community, and work with schools. Working with community partners like Tobacco Free Rhode Island has been incredibly rewarding and allowed me to have a greater impact in my community and state.
Can you share a story that validated to you the importance of your work as a “tobacco prevention champion”?
I have so many patient stories. One mom said she started smoking at 13, but she was finally ready to quit for her child who had asthma. We walked through the patch and gum and she was able to quit. Today, she remains tobacco free. Another example is a dad who was in the office with me when I was helping a resident. After discovering through the screening that he smoked, we asked him if he was interested in quitting and he said “Yes, I would really like that.” He was literally in tears as we were helping him – he was so ready and so excited. The entire family was really proud of him and thrilled for him to quit. It’s these individual “wins” that really make this work so worthwhile.
What is the greatest challenge in doing this work?
The greatest challenge is advocating for change in the laws around tobacco. For example, we tried to pass a comprehensive flavor ban two years ago for all tobacco products – including e-cigarettes, regular cigarettes, and cigars – and that didn’t go through. So that was frustrating and disappointing. But every year we come back at it and try something different. Over time, we’re hopeful we’ll be able to make this change. I have so many teens come to the clinic who say they tried an e-cigarette because it tasted good, like candy. One middle schooler said he tried it because he had a sweet tooth. I think that says it all. These dessert and candy flavors are appealing to teens. We have to get these off the market and unavailable to kids.
What would you want your legacy to be?
I hope to lower our rate of tobacco use in teens and in adults. And, to prevent that next generation from using through teaching and educating pediatricians and residents so they, in turn, can educate patients.
What key guidance or “words of wisdom” do you share with medical students interested in impacting tobacco use?
It’s about the patient in front of you. Every visit, every patient, every family – you want to ask about tobacco use and see if there’s an opportunity to teach them a little bit because everything relates. If a child comes in with asthma or an ear infection, that could easily have been caused by second hand smoke so it’s important to ask about. Also, get involved with community organizations that are working on this issue. By working together as a team, we can really make a positive change in our community.
At what point in your life did you know you wanted to be a physician?
Honestly, I have always known that I wanted to be a pediatrician. In looking back, I can remember thinking about it in middle school and high school. There was no real “aha” moment. I think it was just something I always wanted to do. I have always loved working with kids – even as a babysitter, camp counselor and captain of my sports teams.
Outside of your demanding job, what do you like to do in your spare time?
I have two boys, ages 4 and 7, so they take up a lot of my time. We’re a really active family. A lot of outside play! We do a lot of biking, hiking and swimming.