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COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS

Epidemiological Profile on Alcohol, Tobacco

and Other Illicit Drug Use 2010 Addendum

DEPARTMENT OF PUBLIC HEALTH COMMUNITY GUIDANCE CENTER

Prepared by the CNMI State Epidemiological Outcomes Workgroup (SEOW) Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) CNMI Strategic Prevention Framework – State Incentive Grant (SPF-SIG)

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS

Epidemiological Profile on Alcohol, Tobacco

and Other Illicit Drug Use 2010 Addendum

DEPARTMENT OF PUBLIC HEALTH COMMUNITY GUIDANCE CENTER

Prepared by the CNMI State Epidemiological Outcomes Workgroup (SEOW) Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) CNMI Strategic Prevention Framework – State Incentive Grant (SPF-SIG)

CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW

2

Contents

Acknowledgements…………………………………………………………3 New Data Sources…………………………………………………………..4 Method of Work and Background Information…………………………….4 About DPH-CGC…………………………………………………………...5 Project Brabu ……………………………………………………………….6 CNMI State Epidemiological Outcomes Workgroup Charter……………...7 Acronym Key…………………………………………………………….....9 Index of Tables and Figures………………………………………………...10 Alcohol……………………………………………………………………..12 Tobacco…………………………………………………………………….20 Illicit Drug Use……………………………………………………………..25 Alcohol, Tobacco and Illicit Drugs Comparative Data…………………….30 Additional Statistics………………………………………………………..34 References………………………………………………………………….38


3

Acknowledgements

The Department of Public Health (DPH) would like to thank the members and partners of the Commonwealth of the Northern Mariana Islands-State Epidemiological Outcomes Workgroup (CNMI SEOW) for their dedication and assistance in identifying, collecting, and compiling data sources; selecting indicators and in updating the 2010 CNMI Epidemiological Profile Addendum on Alcohol, Tobacco and Other Illicit Drug Use. The members of the CNMI-SEOW and the technical support group include the following: Josephine T. Sablan Eulalia Villagomez Director/CNMI-SEOW Project Director Statistics Analyst Department of Public Health Criminal Justice Planning Agency Community Guidance Center David Maratita Elizabeth D. Rechebei, Ed.D. Director Researcher/Writer Department of Commerce CNMI SPF-SIG Evaluator Alcohol Beverage & Tobacco Control Division Reyna M. Saures James H. Arriola Prevention Services Manager Statistics Specialist Project Brabu Manager EPI. Chair (SEOW) Department of Public Health Department of Public Health Community Guidance Center Community Guidance Center Matilde Rosario Vivian Nogis Administrative Officer II Warrant Officer CNMI-SEOW Finance Manager Department of Finance Department of Public Health Customs Division Community Guidance Center Jesse R. Aguon Galvin Guerrero Computer Specialist II Director Project Brabu Data Manager Northern Marianas College Department of Public Health Office of Institutional Effectiveness Community Guidance Center Edward P. Diaz, Jr. Sergeant James Guerrero Epidemiologist Officer in Charge (OIC) Department of Public Health Department of Public Safety Division of Public Health Communication and Technology Section George Cruz Rita A. Sablan, Ed.D Chairperson Commissioner of Education CNMI Substance Abuse Prevention Coalition Public School System CNMI


4

New Data Sources

New Data Sources Num. Data Source Year Agency Data Type

1 Youth Risk

Behavior Survey 2009

Public School System

Youth alcohol, tobacco and illicit drugs

2 Health & Vital Statistics Office

Data 2009

CNMI Department of Public Health

Mortality alcohol, tobacco and illicit drugs

3 Alcohol and Tobacco Data

Registry 2009

Department of Commerce -

ABTC

Alcohol and tobacco licenses, citations, minor sales, hearing

and suspensions

4 Birth and Death Health Registry

2009 CNMI

Department of Public Health

Births, Deaths and Fetal Death Data

5 Health & Vital Statistics Office

Data 2009

CNMI Department of Public Health

Pregnancy and alcohol and tobacco

6 CGC's Integrated Client Database

System 2009

DPH – Community

Guidance Center

Number of persons aged 12 and older meeting DSM-IV criteria for alcohol and illicit

drug abuse or dependence

7 Department of Public Safety

2008-2009

Department of Public Safety

Juvenile Criminal Offences, alcohol, traffic, criminal offenses and controlled

substances

8 Army & Air force Exchange Service

2007-2008

Office of the General Council

– Exchange Division

Tobacco, Wine, Spirits and Beer Purchases

Method of Work and Background Information

For a detailed description of the methods utilized and the background information of the CNMI which include history, demographics, population and a cultural summary, please refer to the CNMI Epidemiological Profile on Alcohol, Tobacco and other Illicit Drug Use 20081. The information contained in the 2010 Epidemiological Profile is updated information in regards to the areas of alcohol, tobacco and illicit drug use in the CNMI. Some information contained in this 2010 update may be new in these three areas or an update of previously reported data in which previous editions may be used for further referencing.

1 Commonwealth of the Northern Mariana Islands State Epidemiological Workgroup. CNMI Epidemiological Profile on Alcohol, Tobacco and other Illicit Drug Use 2008. DPH-Community Guidance Center, Navy Hill, Saipan, 2010.


5

About The Department of Public Health’s

Community Guidance Center

The Community Guidance Center (CGC), a division under the Department of Public Health (DPH), continues to be the primary provider of mental health and substance abuse services for all individuals residing in the CNMI. The CGC incorporates all outpatient mental health services and administers all Federal health programs in the CNMI related to mental health and substance abuse, as well as all other publicly funded mental health services. All services and programs administered by the CGC are supervised by substance abuse and mental health program managers under the management of the Director of CGC, who is overseen by the Secretary of Health in turn reports all activities directly to the Governor. It is the Director of CGC who continues to facilitate the integration of mental health and substance abuse services, as well as steering policy direction. Through collaboration and establishing interdependent relationships with other system providers, the CGC is committed to providing high quality mental health and substance abuse treatment and other therapeutic services to the multi-diverse population of the CNMI, as well support services to families and friends, community outreach, prevention and education services, and referral assistance to other community resources. CGC’s vision is to ensure that every individual who has made the CNMI their home may be able to live and interact with each other in a community that is not only nurturing to its spiritual growth, psychological balance, emotional stability, and physical well-being, but at the same time fostering the development and maintenance of a cooperative and harmonious society.


6

CNMI DPH-COMMUNITY GUIDANCE CENTER

PROJECT BRABU

In response to a submitted Strategic Prevention Framework State Incentive Grant proposal in November 2008, the Substance Abuse and mental Health Services Administration (SAMHSA) announced the five-year grant award to the Commonwealth of the Northern Mariana Islands (CNMI) Department of Public Health, Community Guidance Center in the amount of $974,674 per year for five years. This planning and implementation of this grant award will focus on four primary goals:

1.) Build Prevention Capacity and Infrastructure in the CNMI 2.) Prevent the Initiation of and Reduce Substance Abuse, Including Childhood and

Underage Drinking

3.) Reduce Substance Abuse-related Problems

4.) Evaluate All Project Activities

The Strategic Prevention Framework (SPF) is built on a community-based risk and protective factors approach to prevention and a series of guiding principles that can be utilized at the federal, state/tribal/territory, and community levels. The SPF requires states and communities to systematically access their prevention needs based on epidemiological data, build their prevention capacity, strategically plan for and implement effective community prevention programs, policies and practices, and evaluate their efforts for outcomes.

Enhanced data collection and management, capacity building, strategic planning,

implementation, and evaluation will serve as a positive effect of this grant that will only increase efforts to prevent and address substance abuse in our CNMI communities. Community Prevention Programs will be strengthened and equipped in developing, implementing, and evaluating successful, evidence based programs, practices, and services. A significant part of this grant award involves ensuring that the program(s) and decision-making and are data-driven, data reporting becomes systematic and routine, and assistance, program funding opportunities, education and awareness, and media development are just a few of the strategic components that will be offered to our community and partners to improve the quality of life and promote a drug-free CNMI!


7

Charter

of the Commonwealth of the Northern Mariana Islands

State Epidemiological Outcomes Workgroup (CNMI-SEOW)

Article I: Name

Section 1. The name of the entity is the “CNMI State Epidemiological Outcomes Workgroup” or “SEOW.”

Article II: Mission Statement and Purposes

Section 1. Mission: To help strengthen the quality of data available for the CNMI Substance Abuse Prevention programs and activities.

Section 2. Purpose:

A. To create and implement a systematic collection, analysis, reporting, and dissemination of accurate and comprehensive data related to substance abuse in the CNMI.

B. To generate a broader awareness, among stakeholders in the community, of the physical, mental, economic, and social impacts caused by substance abuse.

C. To strengthen information sharing among all stakeholders for the purposes of planning, implementation, monitoring, and evaluation of prevention and intervention strategies and activities.

Article III: Creation And Status Section 1. Established on July 2007, the SEW currently (SEOW) consisting of key

stakeholders/agencies and organizations officially met on February 2008. Section 2. The SEOW shall exist and comply with appropriate rules and regulations.

Article IV: Principal Office and Main Point of Contact

Section 1. The Principal Office shall be located at the CNMI’s Department of Public Health’s (DPH) Community Guidance Center (CGC).

Section 2. The main Point of Contact (POC) for the Program Director of CGC. The address

and contact information of the POC is: Community Guidance Center / Department


8

of Public Health / PO Box 500409 CK / Saipan, MP 96950 / Phone: 670-323-4066 or 6560 / Fax: 670-323-6580.

Article V: Functions

Section 1. A. Secure sustainable funding to support SEOW work through grants and

leveraging of resources among stakeholders. B. Recruit qualified staff and obtain professional services. C. Train staff, SEOW members, advisory council members, policy makers and

stakeholders on the purpose and operational aspects of the SEOW. D. Develop indicators on consequences, consumption and prevalence for alcohol,

tobacco and other drugs (ATOD). E. Identify sources and reliability of data for each indicator. F. Address logistical needs to conduct the routine collection, input, and analysis,

of data. G. Update and improve, as needed, the CNMI’s Epidemiological Profile based

upon data collected on the use and abuse of substances identified by the SEOW. H. Distribute the Epidemiological Profile to stakeholders to use in developing

effective prevention and intervention strategies. I. Monitor and continue to improve data collection strategies in coordination with

stakeholders on a regular basis.

Article VI: Organizational Structure

Section 1.

A. The SEOW works as a subcommittee under the advisory council. Membership shall include the Epi. Lead, the Strategic Prevention Framework – State Incentive Grant (SPF_SIG) Project Manager and stakeholders. The Epi. Lead functions under the directive of the SPF-SIG project manager. Members shall include the Department of Public Health (DPH), the Department of Public Safety (DPS), the Department of Commerce Alcoholic Beverage and Tobacco Control Division (ABTC), etc. Membership will be updated as needed, refer to appendix for list of current members.

Article XI: Meetings

Section 1. Meetings will be held monthly or as needed. And will be conducted through via the

web, conference calls and/or face-to-face.


9

Acronym Key: CGC (Community Guidance Center)

CNMI (Commonwealth of the Northern Mariana Islands) DPH (Department of Public Health) DPS (Department of Public Safety)

PSS (Public School System) SEOW (State Epidemiological Outcomes Workgroup)

YRBS (Youth Risk Behavior Survey)


10

INDEX OF TABLES & FIGURES In Order of Publication

Alcohol Table 1.1: Drinking and Driving, Age at First Use, Current Use and Binge Drinking 2003-2009 Table 1.2: Drinking and Driving 2003-2009 Figure 1.1: Drinking and Driving 2003-2009 Table 1.3: Binge Drinking 2003-2009 Figure 1.2: Binge Drinking 2003-2009 Table 1.4: Alcohol Licensing, Citation, Hearings and Suspensions 2008-2009 Figure 1.3: Alcohol Licensing, Citation, Hearings and Suspensions 2008-2009 Table 1.5: CNMI Department of Public Health - Alcohol Use During Pregnancy 2006-2009 Figure 1.4: CNMI Department of Public Health - Alcohol Use During Pregnancy 2006-2009 Table 1.6: CNMI Department of Public Health - Alcohol-Related Mortality 2006-2009 Figure 1.5: CNMI Department of Public Health - Alcohol-Related Mortality 2006-2009 Table 1.7: DSM-IV criteria for ALCOHOL 2009 Figure 1.6: DSM-IV criteria for ALCOHOL 2009 Table 1.8: Juvenile Criminal Offenses, Alcohol Involved, Calendar 2008 Table 1.9: Juvenile Traffic Offenses per Ethnic Group/Sex Calendar 2008 Table 1.10: Traffic Offense Class/Sex (DUI) 2008 Tobacco Table 2.1: Tobacco Age at First Use, Current, Daily Use, Current Use Smokeless 2003-2009 Figure 2.1: Percentage of students who smoked cigarettes on 20 or more of the past 30 days 2003-2009 Table 2.2: Tobacco Licensing, Citation, Hearings and Suspensions 2008-2009 Figure 2.2: Tobacco Licensing, Citation, Hearings and Suspensions 2008-2009 Table 2.3: CNMI Department of Public Health - Tobacco Use During Pregnancy 2006-2009 Figure 2.3: CNMI Department of Public Health - Tobacco Use During Pregnancy 2006-2009 Table 2.4: CNMI Department of Public Health – Tobacco-Related Mortality 2006-2009 Figure 2.4: CNMI Department of Public Health – Tobacco-Related Mortality 2006-2009


11

Illicit Drugs Table 3.1: Current Use Cocaine, Lifetime Use Cocaine, Heroin, Methamphetamines, Ecstasy 2003-2009 Table 3.2: Marijuana Age at First Use, Current Use, Lifetime Use 2003-2009 Table 3.3: Lifetime Use Illicit Drugs 2003-2009 Figure 3.1: Lifetime Use Illicit Drugs 2003-2009 Table 3.4: CNMI Department of Public Health - Illicit Drug-Related Mortality 2006-2009 Figure 3.2: CNMI Department of Public Health - Illicit Drug-Related Mortality 2006-2009 Table 3.5: DSM-IV criteria for ILLICIT DRUGS 2009 Figure 3.3: DSM-IV criteria for ILLICIT DRUGS 2009 Table 3.6: Juvenile Criminal Offenses per Ethnic Group/Sex Calendar (Controlled Substance) 2008

Alcohol, Tobacco and Illicit Drug Comparative Data Table 4.1: Age of First Use Marijuana, Alcohol and Tobacco 2003-2009 Figure 4.1: Age of First Use Marijuana, Alcohol and Tobacco 2003-2009 Table 4.2: Current Use Alcohol, Tobacco and Marijuana 2003-2009 Figure 4.2: Current Use Alcohol, Tobacco and Marijuana 2003-2009 Additional Statistics Table 5.1: CNMI Department of Public Safety - Violent Crime and Property Crime Data 2007-2008 Figure 5.1: CNMI Department of Public Safety - Violent Crime and Property Crime Data 2007-2008 Table 5.2: CNMI Department of Public Health - Births, Deaths and Fetal Death Data 2006-2009 Figure 5.2: CNMI Department of Public Health - Births, Deaths and Fetal Death Data 2006-2009 Table 5.3: Juvenile Criminal Offenses per Age/Sex Calendar 2008 Table 5.4: Army and Air Force Exchange Service Alcohol and Tobacco Sales FY 2007-2008


12

ALCOHOL

OHL


13

ALCOHOL

Alcohol abuse has both direct and indirect consequences on the people of the CNMI. Health, social, and economic consequences brought on by alcohol abuse impact the unborn as well as the youth, adults, and the elderly. Alcohol abuse is also associated with cancer, psychiatric problems, liver and cardiovascular diseases, and infant morbidity and mortality (CDC, 2008). Further the manner in which alcohol use is embodied in the CNMI population stems not only from relatable U.S. trends such as accessibility and socio-economic factors, but larger and less researched historical factors which include occupational trauma, long lasting affects of WWII and massive social factors that have impacted these small islands in such a short span of time. Among the youth, alcohol abuse could also be a factor in the use of other illicit drugs that may lead to academic problems and other risky behavior.

Table 1.1 YEAR

SEOW Construct PSS CATEGORY & YEAR 2003 2005 2007 2009

Alcohol

Drinking & Driving

Percentage of students who drove a car or other vehicle one or more times during the past 30 days when they had been drinking alcohol 19.4 14.1 15.0 13.7

Percentage of students who rode one or more times during the past 30 days in a car or other vehicle driven by someone who had been drinking alcohol. 53.8 49.0 48.1 43.3

Age at First Use

Percentage of students who had their first drink of alcohol other than a few sips before age 13 years 29.8 26.1 27.4 24.6

Current Use

Percentage of students who had at least one drink of alcohol on one or more of the past 30 days 49.0 43.6 41.1 38.8

Current Binge Drinking

Percentage of students who had five or more drinks of alcohol in a row, that is, within a couple of hours, on one or more of the past 30 days 31.0 27.0 25.5 24.0

Source: PSS, CNMI Youth Risk Behavior Survey (YRBS), 2009.

Drinking

Drinkhas bhigh problwhich

Source

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king and dribeen an effor

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20

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14

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Figure 1.1

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15

Table 1.3

Binge Drinking

Percentage of students who…..

Year

2003 2005 2007 2009

Percentage of students who had five or more drinks of alcohol in a row, that is, within a couple of hours, on one or more of the past 30 days 31.0 27.0 25.5 24.0

Source: 2009 PSS YRBS Survey Results for the Northern Mariana Islands High School

Figure 1.2


Table 1.4

Alcohol License

Issued Alcohol Citations

Issued Hearings License Suspension

2008 656 15 15 14 2009 615 7 7 7

2008 0 Sold to minors 2009 2 Sold to minors

Source: CNMI Department of Commerce, ABTC Division.

Percentage of students who had five or more drinks

of alcohol in a row, that is, within a couple of hours,

on one or more of the past 30 days

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

2003 2005 2007 2009


16

Figure 1.3

Source: CNMI Department of Commerce, ABTC

Table 1.5

Source: CNMI Department of Public Health, Division of Public Health.

Figure 1.4


0200400600800

Department of Commerce ‐ Alcohol & Tobacco Data

2008 2009

CNMI Department of Public Health ‐ Alcohol Use

During Pregnancy

‐ 500 1,000 1,500 2,000

2006

2007

2008

2009

Unknown

Alcohol Use DuringPregnancy

Total Birth

CNMI Department of Public Health ‐ Alcohol Use During Pregnancy.

Year

2006 2007 2008 2009

Total Birth 1,440 1,441 1,428 1,432

Alcohol Use During Pregnancy 3 4 2 1

Unknown 0 114 3 0

Source: RPMS, Health & Vital Statistics Office, Dept. of Public Health

Note: Births Tobacco and Alcohol are not measured, but asked in general usage during pregnancy.


17

Table 1.6

CNMI Department of Public Health ‐ Alcohol‐Related Mortality

Year

2006 2007 2008 2009

Total Mortality 174 141 178 195

Liver disease 3 3 1 5

Suicide 4 3 3 2

Homicide 4 0 1 4


Note: Mortality deaths are not necessarily tobacco and alcohol related.


Figure 1.5

Table 1.7

Number of persons aged 12 and older meeting DSM-IV criteria for ALCOHOL abuse or dependence

Year 2009

Age Group Female Male

12-17 Year 0 2

18-20 Year 1 3

21-34 Year 0 21

35-64 Year 1 28

65 and Over 0 0

Grand Total 2 54

Source: CGC's Integrated Client Database System

174

141

178195

3 3 1 5 4 3 3 2 4 0 1 4

Total Mortality Liver disease Suicide Homicide

CNMI Department of Public Health ‐ Alcohol‐Related

Mortality

Year 2006 Year 2007 Year 2008 Year 2009

Source

Source

e: CGC's Integ

T

T

T

e: CNMI Depa

1

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18

Figure 1.6

m

Table 1.8 es, Alcohol Invo

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21

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emale Male

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32 1

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48 5

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231 6

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3 8

5 3

3 26

3 13

5 51

7 6

7 27

3 134

No Yes

3 2

24

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6 49

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48 89

111 223

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12

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104

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19

Table 1.9

Juvenile Traffic Offenses per Ethnic Group/Sex Calendar 2008

Ethnic Group and

Sex

Carolinian Chamorro

Traffic Offense Class F M F M

Traffic Offense Accident/Rpt 2

Traffic Offense DUI 3 2

Traffic Offense Equipment 1

Traffic Offense Lic/reg 2

Traffic Offense Moving 1 9 1 4

Traffic Offense Vehicle Theft 1

Grand Total 4 15 1 6

Source: CNMI Department of Public Safety, 2008.

Table 1.10 Traffic Offense Class/Sex < 10 10 ‐ 12 13 ‐ 15 16 ‐ 18 19 ‐ 20 Total

Traffic Offense Accident/Rpt

Female 1 2 3 6

Male 3 1 4

Traffic Offense DUI

Female 1 2 3

Male 9 12 21

Traffic Offense Equipment

Female 1 1

Male 1 1

Traffic Offense Lic/reg

Female 1 3 2 6

Male 4 4 6 14

Total 0 2 9 67 81 159

Grant Total: 8 26 106 281 166 587



20

TOBACCO


21

TOBACCO

According to the WHO’s Western Pacific Region, which covers East Asia and the Pacific including the CNMI, this area has the highest smoking rate in the world, with nearly two-thirds of men smoking. About one in three cigarettes are consumed in the Western Pacific Region alone. (WHO WPRO, 2002) Although we can see in many of the figures below that there has been a decrease in smoking trends, significantly in some instances, there is a large concern in how tobacco is being used demographically and how the larger community based numbers are not representative of the many different ways tobacco is used by population. Although the total percentages of tobacco statistics are promising, we now need to move towards more specific disaggregated data in order to take a more detailed focus on the communities more specific needs in the area of tobacco and prevention.

Tobacco usage in the CNMI is one that has many implications from various perspectives. The social and economic impacts on families, communities, and the entity as a whole are not easily measured. Furthermore, most of the research conducted on social impacts done elsewhere may be difficult to generalize to island conditions particularly in the context of unstable demographic and economic conditions. Regardless, growing concerns about tobacco and its direct and indirect impacts on health and welfare of the CNMI are reflected in various community and school anti-smoking campaigns, media ads, and efforts to enforce smoking prohibition in public facilities. As of 2009 PL 16-46 has been a triumph in the move towards better tobacco measures by banning smoking in all public locations. Although there are several areas that we are only now discovering need to be improved in regards to loop holes, the overall impact has been a great accomplishment and is strongly felt in the community.

Table 2.1 YEAR


Tobacco

Age at First Use

Percentage of students who smoked a whole cigarette for the first time before age 13 years 40.1 34.0 28.6 23.6

Current Use Percentage of students who smoked cigarettes on one or more of the past 30 days 48.8 35.8 31.1 26.8

Daily Use Percentage of students who smoked cigarettes on 20 or more of the past 30 days 16.8 11.1 8.2 7.5

Current Use (Smokeless Tobacco)

Percentage of students who used chewing tobacco snuff, or dip on one or more of the past 30 days 42.5 36.9 36.3 31.9

Source: PSS, CNMI Youth Risk Behavior Survey, 2009.


22

Figure 2.1


Table 2.2

Tobacco License

Issued Tobacco Citations

Issued Hearings License Suspension

2008 318 23 15 14

2009 284 11 7 7 2008 14 Sold to minors 2009 9 Sold to minors

Source: CNMI Department of Commerce, ABTC Division.

Figure 2.2

Source: CNMI Department of Commerce, ABTC

Percentage of students who smoked cigarettes on 20 or more of the past 30 days

16.8

11.18.2 7.5

2003 2005 2007 2009

Year

0200400600800

Department of Commerce ‐ Alcohol & Tobacco Data

2008 2009


23

Table 2.3

CNMI Department of Public Health ‐ Tobacco Use During Pregnancy.

Year

2006 2007 2008 2009

Total Birth 1,440 1,441 1,428 1,432

Tobacco Use During Pregnancy 84 81 76 57

Unknown 0 0 2 0


Note: Births Tobacco and Alcohol are not measured, but asked in general usage during pregnancy.


Figure 2.3


Table 2.4

CNMI Department of Public Health – Tobacco‐Related Mortality

Year

2006 2007 2008 2009


Lung cancer 9 7 6 2

COPD 2 4 4 6

Cardiovascular disease 5 10 6 5



1,44084

0

1,44181

0

1,42876

2

1,43257

0

2006

2007

2008

2009

CNMI Department of Public Health ‐ Tobacco Use

During Pregnancy

Total Birth Tobacco Use During Pregnancy Unknown


24

Figure 2.4


174

9 2 5

141

7 4 10

178

6 4 6

195

2 6 5

2006 2007 2008 2009

CNMI Department of Public Health ‐ Tobacco‐Related

Mortality

Total Mortality Lung cancer COPD Cardiovascular disease


25

ILLICIT DRUGS


26

ILLICIT DRUGS

Although we have seen some promising trends in the area of alcohol and tobacco, the area of illicit drugs has a mixed review in view of the statistical trends reported. The growing problem of many new and different types of drugs being introduced and accessibility compounded with current international and social impacts of both the U.S. and near by Asian countries has brought a rising new trend in illicit drugs particularly with marijuana.

Marijuana is illegal in the CNMI and is associated with long and short term physical, mental, emotional and behavioral consequences, and is generally considered a gateway drug to stronger drugs. Methamphetamine-related crimes and abuse have figured in the news on numerous occasions in the CNMI. Drug trafficking, violent crimes, and damages to property are frequently attributed to the use or dealing in illicit drugs.

Although there has been a concerted effort by enforcement in cracking down on the trafficking and solicitation of drugs, particularly ice, this has only made clearer the increase of the growing problem.

Table 3.1

Source: PSS, CNMI Youth Risk Behavior Survey, 2009.

YEAR


Illicit Drugs

Current Use (Cocaine)

Percentage of students who used any form of cocaine, including powder, crack, or freebase one or more times during the past 30 days 3.6 2.3 2.9 2.4

Lifetime Use (Cocaine)

Percentage of students who used any form of cocaine, including powder, crack, or freebase one or more times during their life. 5.3 5.1 4.7 4.5

Lifetime Use (Heroin) Percentage of students who used heroin one or more times during their life 4.2 3.6 3.5 3.5

Lifetime Use (Methamphetamines)

Percentage of students who used methamphetamines one or more times during their life 6.9 4.9 4.9 4.6

Lifetime Use (Ecstasy) Percentage of students who used ecstasy one or more times during their life 6.4 5.4 4.7 3.8

SEOW

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mphetamines one

y one or more tim

CNMI Publ

CNM

T

CATEGORY & YE

M

entage of studehe first time be

entage of studeor more times

entage of studeor more times vior Survey, 200

Tntage of stude

marijuana onelife

any form of co, or freebase olife.

heroin one or

methamphetag their life

ecstasy one or

ce: 2009 PSS Y

F

vior Survey, 200

0.

re times during …

caine, including …

during their life

or more times …

mes during their …

ic School Sy

MI Epidemiolog

27

Table 3.2

EAR

Marijuana

ents who triedefore age 13 ye

ents who usedduring the pas

ents who usedduring their lif

09.

Table 3.3 ents who…..

e or more times

ocaine, includinne or more tim

more times du

mines one or

r more times d

RBS Survey Re

Figure 3.1

09.

.0 10.0 20.0 3

ystem ‐ YRBS

gical Profile, 2

marijuana ears

marijuana st 30 days

marijuana fe

s during

ng powder, mes during

uring their

more times

uring their

sults for the N

30.0 40.0 50.0

S Lifetime Us

2010 Addendum

2003

24.8

41.2

68.1

2003

68.1

5.3

4.2

6.9

6.4

orthern Maria

60.0 70.0

se Data

m, CNMI SEO

YEAR

2005 20

20.9 1

29.8 3

58.1 5

Year

2005 20

58.1 5

5.1

3.6

4.9

5.4

na Islands High

2009

2007

2005

2003

W

007 2009

19.9 18.6

31.9 30.8

54.9 57.1

007 2009

54.9 57.1

4.7 4.5

3.5 3.5

4.9 4.6

4.7 3.8

h School

9

6

8

1

9

1

5

5

6

8


28

Table 3.4

CNMI Department of Public Health ‐ Illicit Drug‐Related Mortality

Year

2006 2007 2008 2009


Illicit drug use 0 0 1 0




Figure 3.2


Table 3.5

Number of persons aged 12 and older meeting DSM-IV Criteria for ILLICIT DRUG abuse or dependence Year 2009 Age Group Female Male 12-17 Year 0 2 18-20 Year 0 3 21-34 Year 1 7 35-64 Year 2 13 65 and Over 0 0 Grand Total 3 25 Source: CGC's Integrated Client Database System

174

0

141

0

178

1

195

0

2006 2007 2008 2009

CNMI Department of Public Health ‐ Illicit Drug‐

Related Mortality

Total Mortality Il l icit drug use

Source

Source

e: CGC's Integ

Cr

Burg

Con

Dist

Frau

Gen

Juve

Polic

Prop

Sex

Viol

e: CNMI Depa

grated Client D

Juvenile Crim

riminal Offense

glary, Robbery,

trolled Substan

urbance

ud

eral Crime

enile Crime

ce Assistance

perty Offense

Offense

ent Crime

Grand Tota

artment of Publ

12‐17 Year 1

02

Persons 12

CNM

F

Database System

minal Offenses

Gr

e Class

, Theft

nce

al

lic Safety, 200

18‐20 Year 21

03

2 and older mDrug abu

Fe

MI Epidemiolog

29

Figure 3.3

m

Table 3.6

per Ethnic Gro

Ethnic oup and Sex

Carolinia

F

1

1

2

1

2

3

10

8.

1‐34 Year 35‐6

1

7

meeting DSMse or depend

emale Male

gical Profile, 2

oup/Sex Calend

an

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6

6

4

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27

64 Year 65 aOv

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e

2010 Addendum

dar 2008

Chamorro

F M

2 25

5

4 26

1

2 10

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1 17

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26 141

and ver

0

or Illicit

m, CNMI SEO

W


30

Alcohol, Tobacco and Illicit Drug Comparative

Data

illicitcomp marijin alcdespidata omarijthe otrepre

Age atPercen

their fage 13smoke13 yea

tried m

Source

Alcoho In this sec

t drugs compprehensive lo

Table 4.1 uana at age

cohol and tobite the increaof tobacco fruana usage bther statistic

esented in oth

t first Use ntage of studen

first drink of al3 years ed a whole cigaars

marijuana for t

e: 2009 PSS Y

20

20

20

20

ol, Tobac

ction we revparatively toook at the ite

and figure 4of first use. bacco. Alcohase in 2007 prom 2003-20because alth

cs and not jusher data sets

nts who…..

Category lcohol other tha

arette for the fi

the first time b

YRBS Survey R

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05

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09

CNMI Pub

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cco and Il

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ems as a who

4.1 provide uWe can see hol trends arpercentages 009 shows ahough we dost from the 2s reported he

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an a few sips b

first time before

before age 13 y

Results for the

F

20.0 40.0

blic School Suse

MI Epidemiolog

31

llicit Dru

harts that relstatistical treole.

us a look at tthat we have

re important from the 200n almost 50% see a decrea

2007 data buere as well.

Table 4.1

before

e age

years

Northern Mari

Figure 4.1

0 60.0

ystem ‐ YRBe Data

gical Profile, 2

ug Comp

late the areasends in juxta

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05 numbers.% decrease. ase it is muc

ut total for al

2003 2

29.8

40.1

24.8

iana Islands H

BS Age At Fir

tried marfirst time 13 years

smoked acigarette time befoyears

2010 Addendum

arative D

s of alcohol, apose for a m

tobacco ande significantr as they dec. Further the The area for

ch less compll years. This

Year 2005 2

26.1 2

34.0 2

20.9 1

igh School

rst

rijuana for the before age

a whole for the first ore age 13

m, CNMI SEO

Data

tobacco andmore

d specificallyt deductions creased

long term r focus is on

pelling than s is

007 20

27.4 24

28.6 23

19.9 18

W

d

y

n

009

4.6

3.6

8.6


32

Source: 2009 PSS YRBS Survey Results for the Northern Mariana Islands High School In this section we focus on table and figure 4.2 to look at the current use of alcohol, tobacco, specifically marijuana as well as other illicit substances. These items provide a good perspective over the past 7 years.

We see that with alcohol there has been a steady move downward from the alarming initial 49% reported in 2003.

Again tobacco is to be highlighted in the trends not just from the 2007-2009 reporting but over all trends since 2003.

Marijuana as mentioned before has had a slight decrease but still above the initial decline from 29.8% in 2005 when there was a great decrease from the 2003 41.2 percent. This is an area that needs more research and detailed understanding of cultural, national and global trends and its impact particularly in small island communities such as those within the CNMI.

The information on illicit drugs is also something that needs continued asserted scrutiny as we have also seen the initial decrease and increase from 2003-2007. It is good however that we have seen a slight decrease in the percentage of 2009 from the previous 2007 numbers, but the decrease is minimal and a much more detailed look into the area of these drugs has been made a priority through our departments as well as affiliated agencies.

Table 4.2 Current Use Percentage of students who…..

Category

Year

2003 2005 2007 2009

had at least one drink of alcohol on one or more of the past 30 days 49.0 43.6 41.1 38.8

smoked cigarettes on one or more of the past 30 days 48.8 35.8 31.1 26.8

used marijuana one or more times during the past 30 days 41.2 29.8 31.9 30.8

used chewing tobacco snuff, or dip on one or more of the past 30 days 42.5 36.9 36.3 31.9

used any form of cocaine, including powder, crack, or freebase one or more times during the past 30 days 3.6 2.3 2.9 2.4

Source: 2009 PSS YRBS Survey Results for the Northern Mariana Islands High School

Source

e: 2009 PSS Y

had at leam

smoked

used ma

used chewor

usedpowde

YRBS Survey R

ast one drink of alcmore of the past 3

cigarettes on onepast 30 day

rijuana one or mothe past 30 da

wing tobacco snufr more of the past

d any form of cocar, crack, or freeba

CNMI Publ

CNM

F

Results for the

0

cohol on one or 30 days

e or more of the ys

ore times during ays

ff, or dip on one 30 days

aine, including se one or more …

lic School Sy

MI Epidemiolog

33

Figure 4.2

Northern Mari

.0 10.0 20.0

ystem ‐ YRBS

gical Profile, 2

iana Islands H

0 30.0 40.0

S Current Us

2010 Addendum

igh School

50.0

se Data

2

2

2

2

m, CNMI SEO

2009

2007

2005

2003

W


34

ADDITIONAL STATISTICS

CNMI

Numbreport

Numb

Source

Source

CNMI

Total B

Total M

Total FCauseSource

I Department o

ber of violent cred to police

ber of property

e: CNMI CJPA

e: CNMI CJPA

I Department o

Birth

Mortality

Fetal Death s of fetal deathe: RPMS, Heal

of Public Safety

rimes (aggrava

crimes (larcen

A & Departme

A & Departme

of Public Healt

h unknown lth & Vital Sta

CNMI DepCrim

Numberassaults

Numberreporte

CNM

Additio

T

y - Violent Cr

Category

ated assaults, se

ny, burglary, M

ent of Public Sa

F

ent of Public Sa

T

th - Births, Dea

2006

1,440

174

18

atistics Office, D

2007

171

2190

partment ofme and Prop

r of violent crims, and robberie

r of property cd to police

MI Epidemiolog

35

onal Stati

Table 5.1

rime and Prope

exual assaults,

MV theft) report

afety-UCR/IBR

Figure 5.1

afety-UCR/IBR

Table 5.2

aths and Fetal D

6

0

4

8

Dept. of Public

20

130

f Public Safeperty Crime

mes (aggravatees) reported to

rimes (larceny

gical Profile, 2

istics

erty Crime Data

and robberies)

ted to police

R Activity Rep

R Activity Rep

Death Data.

Year

2007

1,441

141

19

c Health

08

0

1862

ety ‐ Violent Data

ed assaults, sex police

y, burglary, MV

2010 Addendum

a

2

)

2

port

port

2008

1,428

178

6

xual

V theft)

m, CNMI SEO

Year

007 2

171

190 1

20

1,4

1

W

2008

130

1862

009

432

195

10


36

Figure 5.2


Table 5.3 Juvenile Criminal Offenses per Age/Sex Calendar 2008

Age Group

Criminal Offense Class/Sex < 10 10 ‐ 12 13 ‐ 15 16 ‐ 18 19 ‐ 20 Total

Burglary, Robbery, Theft

Female 1 4 1 1 7

Male 4 13 21 27 5 70

Controlled Substance

Male 11 1 12

Disturbance

Female 1 7 2 2 12

Male 1 6 32 20 59

Fraud

Male 1 1

General Crime

Female 1 1 2 4

Property Offense

Female 1 3 1 5

Male 3 17 9 29

Sex Offense

Female 1 1

Male 1 1

Violent Crime

Female 1 4 5 4 14

Male 1 2 13 42 22 80


‐ 500 1,000 1,500 2,000

2006

2007

2008

2009

CNMI Department of Public Health - Births, Deaths and Fetal Death

Total Fetal Death

Total Mortality

Total Birth


37

We are very fortunate to get a total sales listing of tobacco, wine, beer and spirits from the Army & Air Force Exchange Service (AAFES). There has been a great discussion as to capturing these figures as the CNMI, who has a large portion of the population in relation to its size serving in the U.S. Military, purchases many items from AAFES of which the benefits extend to dependants of service men and women as well. In the chart below we are able to see a picture of the total sales of each item and overall figures of alcohol and tobacco sales which have been unaccounted for in our total sales for the CNMI in our data systems aside from the general public imports shared to us through the Customs division. The sales for FY 2007 to FY 2008 have decreased overall. There are several reasons that need to be further researched to determine the cause of this but for the purposes of the report the primary focus is on the total numbers as seen below and the total difference between the fiscal years. For tobacco we see a $20,583.35 decrease between FY 2007-2008. For wine we see a $1,728.58 decrease between FY 2007-2008. For beer we see a $61,361.60 decrease between FY 2007-2008. And for spirits we a $6,555.78 decrease between FY 2007-2008. So for totals between FY 2007-2008 we see a $90,229.31 decrease in sales. We are very fortunate and thankful to the AAFES Office of the General Council to have received this data as it provides for us another important component to alcohol and tobacco imports that can be researched from various perspectives. With this current information and the import data we are hoping to get illegal import data in the future to complete a more comprehensive picture of the consumption statistics of these items. In doing so we hope as we endeavor forward to create a better understanding of the community’s expenditure and intake trends in tobacco and alcohol from as many possible sources as possible for reporting and prevention in ameliorating the issues we face here in our islands.

6148110100 GUAM AND SAIPAN TROOP STORE

Departments FY 2007 FY 2008

10-Tobacco $186,177.89 $165,594.54

22-Wine $92,174.00 $90,445.42

23-Beer $949,081.92 $887,720.32

25-Spirit $77, 922.45 $71,366.67

TOTAL $1,305,356.26 $1,215,126.95 Source: Army & Air Force Exchange Service (AAFES), Office of the General Council – Exchange Division 2007-2008


38

References CNMI Department of Public Health. Division of Public Health, Saipan, 2010. CNMI Department of Public Safety. Saipan, 2010. CNMI Public School System. (2009). 2009 YRBS Results: Northern Mariana Islands High School Survey Trend Analysis Report. CNMI PSS. Saipan. DPH- Community Guidance Center. “CGC's Integrated Client Database System”. Saipan, 2010.

Guam Substance Abuse Epidemiological Profile, 2008 Update, 3rd

Quarter, 2009. Guam DMHSA: Guam State Epidemiological Outcomes Workgroup. CNMI Epidemiological Profile on Alcohol, Tobacco and Other Illicit Drug Use 2008. DPH-CGC: Saipan, 2008. State Epidemiological Outcomes Workgroup. CNMI Epidemiological Profile on Alcohol, Tobacco and Other Illicit Drug Use 2009 (Revised/Updated). DPH-CGC: Saipan, 2009. WHO Western Pacific Regional Office. World Health Organization Regional Office for the Western Pacific. 2010. World Health Organization. April 2010. <http://www.wpro.who.int/media_centre/fact_sheets/fs_20020528.htm.>

Documents

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS - …cgcspn.net/forms/8.pdf · the Commonwealth of the Northern Mariana Islands-State Epidemiological Outcomes Workgroup (CNMI SEOW) for