Preventing Adolescent and Young Adult Tobacco and Nicotine Use

December 31, 2019

New Hampshire and the entire country received a timely holiday gift on Friday, December 20. Congress passed, and the President signed, a 1.4 trillion dollar spending package that included a provision to raise the age to legally purchase tobacco and tobacco products from 18 up to 21.

This is a significant public health achievement. We know that the vast majority of smokers start as adolescents and young adults, and studies have shown that raising the age for purchase of tobacco products to 21 will significantly decrease the number of people who ever smoke, which in the long term will decrease the substantial morbidity and mortality related to smoking.

Our Role in Combating the ‘Deaths of Despair’

December 11, 2019

Over the past couple of years, many of us have heard and read about so-called ‘deaths of despair’—the increasing mortality rates of middle aged white Americans (age 45-54) due to drugs, alcohol, and suicide.  One of the root causes of this trend, as proposed by the authors of a recent study featured by NPR, is a lack of steady, well-paying jobs for whites without college degrees, which in turn has caused pain, distress, and social dysfunction to build up over time, leading ultimately to people killing themselves “either quickly with a gun or slowly with drugs and alcohol.”

Final Presidential Week

November 12, 2019

I hope to see many of you at the NH Medical Society Annual Scientific Conference this coming weekend at the Mt. Washington Hotel in Bretton Woods. It is great to see so many of you signed up to attend and I am looking forward to the President’s Inaugural Dinner, since I will be less nervous and able to enjoy the meal!

As I enter my last week as NH Medical Society president, I thank you all for allowing me to represent you for the past year. I am thrilled to have had this opportunity and I enjoyed bringing the topic of vaccinations back to the forefront of public health.

MMA and CNESMS meetings

October 2, 2019

Over the past month, I have had the opportunity of attending the Maine Medical Association (MMA) annual session and the Council of New England State Medical Societies meeting.

The MMA meeting featured Maine Governor Janet Mills and her senior health care leadership team (including former MMA EVP Gordon Smith) presenting issues about Maine’s health care system, including the opioid crisis, rural medicine concerns and Maine’s ACA marketplace exchange. There was also a panel discussion with physicians, residents and medical students discussing leadership roles, advocacy and how they incorporated it into their busy lives. I enjoyed hearing how these leaders are dealing with similar challenges to our state in differing ways.

Surgeon General Advisory on Marijuana Use and the Developing Brain

September 4, 2019

A few days ago, the U.S. Surgeon General, Vice Admiral Jerome Adams, held a press conference with the U.S. Secretary of Health and Human Services, Dr. Alex Azar, to present the Surgeon General’s Advisory in regards to Marijuana Use and the Developing Brain.

The Surgeon General and Secretary both emphasized that science and federal laws have not changed. No amount of marijuana during pregnancy or adolescence is safe.

The concerns they express are regarding the increased risk that the higher potency of THC in marijuana and the changing methods of use pose on pregnant women and the effect on the infant brain and on the adolescent brain. They also recognize that women and adolescents are less likely to recognize the risk due to the rapid “normalization” of marijuana use due to changing state laws across the United States.

Tick Bite Prevention

July 16, 2019

TickAs it is summer time in New Hampshire and ticks are all around us, I thought it was important to have a discussion about tick bite prevention.  I hope you noticed I said tick bite prevention and not Lyme disease prevention.  This is intentional.  I think we are at a time in NH that we need to step back and rethink our approach to ticks and Lyme disease.  Lyme disease is not the only disease spread by the blacklegged (deer) tick, so focusing on Lyme disease should be secondary to focusing on preventing tick bites. 


July 2, 2019

Albee Budnitz MD, FACP, FCCP, did a lunch time presentation for my department last week regarding vaping or “Juuling.” It was an eye-opening presentation for many of us. From a discussion of what vaping is, the products available and “accessories” and the health implications, it was a whirlwind of frightening information. 

Here are a few of the highlights that I found most interesting, disturbing and concerning:

  • In the past year vaping among high schoolers has increased 78%.

  • Most e-cigarettes contain nicotine and most adolescents do not know this and nicotine is a very highly addictive drug.

  • Some e-cigarettes/pods contain as much nicotine as a pack of 20 regular cigarettes – and some teens will “vape” up to 4 pods per day – that is the equivalent of a 4 pack per day smoker!! This has led to nicotine toxicity.

AMA in Chicago

June 19, 2019

Tessa Lafortune-Greenberg with Surgeon General Jerome Adams, MDLast week I attended the annual meeting of the American Medical Association in Chicago for the first time. This included four days of taking part in business of the House of Delegates (HOD).  Due to circumstances of my colleagues not being available I was promoted (battlefield promotions I was told) to alternate delegate then delegate. This allowed me voting rights on HOD business and was quite an experience. 

There were 2500 physicians, residents and medical students from all 50 states and over 115 specialties, including our delegate Dr. Bill Kassler, Dr. Stuart Glassman representing the AAPMR as a delegate, our EVP Jim Potter  and Dr. Georgia Tuttle. 

New England Medical Societies & AMA Delegation Meeting

May 29,2019

I recently spent a Saturday morning at meetings of the Council of New England State Medical Societies and New England Delegation to the American Medical Association at the Massachusetts Medical Society Headquarters in Waltham, MA. Along with the other New England State Medical Society presidents, I presented our New Hampshire report to the group and discussed resolutions to bring to the AMA meeting in June.

It was great to see that our neighboring states are dealing with similar issues that we are working on in the Granite State. Vermont is working on leadership trainings, opioid prescribing and paid family leave.  Maine and Massachusetts are working on immunization requirements. Vermont and Connecticut are also advocating against marijuana commercialization legislation.