COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS Epidemiological Profile on Alcohol, Tobacco

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
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
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
Department of Public Health
Community Guidance Center
Statistics Analyst
Criminal Justice Planning Agency
David Maratita
Elizabeth D. Rechebei, Ed.D.
Director
Department of Commerce
Alcohol Beverage & Tobacco Control Division
Researcher/Writer
CNMI SPF-SIG Evaluator
Reyna M. Saures
James H. Arriola
Prevention Services Manager
Project Brabu Manager
Department of Public Health
Community Guidance Center
Statistics Specialist
EPI. Chair (SEOW)
Department of Public Health
Community Guidance Center
Matilde Rosario
Vivian Nogis
Administrative Officer II
CNMI-SEOW Finance Manager
Department of Public Health
Community Guidance Center
Warrant Officer
Department of Finance
Customs Division
Jesse R. Aguon
Galvin Guerrero
Computer Specialist II
Project Brabu Data Manager
Department of Public Health
Community Guidance Center
Director
Northern Marianas College
Office of Institutional Effectiveness
Edward P. Diaz, Jr.
Sergeant James Guerrero
Epidemiologist
Department of Public Health
Division of Public Health
Officer in Charge (OIC)
Department of Public Safety
Communication and Technology Section
George Cruz
Chairperson
CNMI Substance Abuse Prevention Coalition
Rita A. Sablan, Ed.D
Commissioner of Education
Public School System CNMI
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
New Data Sources
New Data Sources
Num.
1
2
3
Data Source
Youth Risk
Behavior Survey
Health & Vital
Statistics Office
Data
Alcohol and
Tobacco Data
Registry
Year
2009
2009
2009
Agency
Data Type
Public School
System
CNMI
Department of
Public Health
Department of
Commerce ABTC
CNMI
Department of
Public Health
CNMI
Department of
Public Health
Youth alcohol, tobacco and
illicit drugs
4
Birth and Death
Health Registry
2009
5
Health & Vital
Statistics Office
Data
2009
6
CGC's Integrated
Client Database
System
2009
DPH –
Community
Guidance Center
7
Department of
Public Safety
20082009
Department of
Public Safety
8
Army & Air force
Exchange Service
20072008
Office of the
General Council
– Exchange
Division
Mortality alcohol, tobacco and
illicit drugs
Alcohol and tobacco licenses,
citations, minor sales, hearing
and suspensions
Births, Deaths and Fetal Death
Data
Pregnancy and alcohol and
tobacco
Number of persons aged 12
and older meeting DSM-IV
criteria for alcohol and illicit
drug abuse or dependence
Juvenile Criminal Offences,
alcohol, traffic, criminal
offenses and controlled
substances
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.
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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.
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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!
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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.
B.
C.
To create and implement a systematic collection, analysis, reporting, and
dissemination of accurate and comprehensive data related to substance abuse in
the CNMI.
To generate a broader awareness, among stakeholders in the community, of the
physical, mental, economic, and social impacts caused by substance abuse.
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
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
of Public Health / PO Box 500409 CK / Saipan, MP 96950 / Phone: 670-3234066 or 6560 / Fax: 670-323-6580.
Article V: Functions
Section 1.
A.
B.
C.
D.
E.
F.
G.
H.
I.
Secure sustainable funding to support SEOW work through grants and
leveraging of resources among stakeholders.
Recruit qualified staff and obtain professional services.
Train staff, SEOW members, advisory council members, policy makers and
stakeholders on the purpose and operational aspects of the SEOW.
Develop indicators on consequences, consumption and prevalence for alcohol,
tobacco and other drugs (ATOD).
Identify sources and reliability of data for each indicator.
Address logistical needs to conduct the routine collection, input, and analysis,
of data.
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.
Distribute the Epidemiological Profile to stakeholders to use in developing
effective prevention and intervention strategies.
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.
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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)
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
ALCOHOL
OHL
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
SEOW Construct 2003 YEAR 2005 2007 2009
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
Drinking & Driving PSS CATEGORY & YEAR Alcohol Source: PSS, CNMI Youth Risk Behavior Survey (YRBS), 2009.
13
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
T
Table
1.2
Perceentage of studeents who….. Categgory Drinking & Driving Year 2003 2005 2007 2009
9
Perceentage of studeents who drovee a car or otherr vehicle one orr more times d
during the past 3
30 days when tthey had been drinking alcohol 19.4 14.1 1
15.0 13.7
7
Perceentage of studeents who rode one or more times during tthe past 30 dayys in a car her vehicle drivven by someon
ne who had or oth
been drinking alcohol. 53.8 49.0 4
48.1 43.3
3
Sourcce: 2009 PSS YRBS Survey Results for the Northern Mariana Islands High
h School Drinkking and driiving has hisstorically beeen a large area
a
for conccern in the CNMI.
C
Therre
has been
b
an efforrt to focus onn understandding the undeer lying causses of why thhere is such a
high precedence for drivingg under thee influence and how too target thee core of thhe
p
a
at
probllem. Figure 1.1 highlighhts that althhough the raates have dropped; the percentage
whichh drinking an
nd driving sttill occurs iss alarmingly high.
F
Figure
1.1
CNMI Pu
ublic School System ‐ Drrinking & Driving Y
YRBS Data
20
009
Percentagge of students w
who rode one or mo
ore times during thee past 30 days in a ccar or other vehicle drriven by someone who had been drinking alcohol.
20
007
20
005
20
003
0.0
2
20.0
40.0
60.0
Sourcee: 2009 PSS YR
RBS Survey Ressults for the No
orthern Marian
na Islands High
h School
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CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Table 1.3
Percentage of students who….. Binge Drinking 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
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
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
2003
2005
2007
2009
Source: PSS, CNMI Youth Risk Behavior Survey (YRBS), 2009.
Table 1.4
2008
2009
Alcohol License
Issued
656
615
Alcohol Citations
Issued
15
7
2008
0
2009
2
Source: CNMI Department of Commerce, ABTC Division.
15
Hearings
15
7
Sold to minors
Sold to minors
License Suspension
14
7
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Figure 1.3
Department of Commerce ‐ Alcohol & Tobacco Data
2008
2009
800
600
400
200
0
Source: CNMI Department of Commerce, ABTC
Table 1.5
CNMI Department of Public Health ‐ Alcohol Use During Pregnancy. Year 2006 Total Birth 2007 2008 2009
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. Source: CNMI Department of Public Health, Division of Public Health.
Figure 1.4
CNMI Department of Public Health ‐ Alcohol Use During Pregnancy
2009
Unknown
2008
Alcohol Use During
Pregnancy
2007
Total Birth
2006
‐
500
1,000
1,500
2,000
Source: CNMI Department of Public Health, Division of Public Health.
16
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Table 1.6
CNMI Department of Public Health ‐ Alcohol‐Related Mortality Year 2006 2007 2008 2009
174 141 178 195
Liver disease 3 3 1 5
Suicide 4 3 3 2
Homicide 4 0 1 4
Total Mortality Source: RPMS, Health & Vital Statistics Office, Dept. of Public Health Note: Mortality deaths are not necessarily tobacco and alcohol related. Source: CNMI Department of Public Health, Division of Public Health.
Figure 1.5
CNMI Department of Public Health ‐ Alcohol‐Related Mortality
Year 2006
174
Year 2007
Year 2008
Year 2009
195
178
141
3
Total Mortality
3 1
5
4 3
Liver disease
3 2
Suicide
4
0 1 4
Homicide
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
17
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m, CNMI SEOW
F
Figure
1.6
Persons 12 and
a older meeeting DSM-IV criteria forr Alcohol
abuse or dependen
nce
Feemale
Malee
28
21
0
2
12‐17 Year
1
1
3
18
8‐20 Year
1
0
21
1‐34 Year
35‐‐64 Year
0
0
65
5 and O
Over
Sourcee: CGC's Integ
grated Client Database
D
System
m
T
Table
1.8
Juvenile Criminal Offense
es, Alcohol Invo
olved, Calendar 2008 Alcohol Invvolved Criminal Offense Class Unknown No U
N
Yes Burglary, Rob
bbery, Theft 56 13 8 Controlled SSubstance 4 5
5 3 Disturb
bance 32 13 26 Frau
ud 1 General Crime 16 3
3 13 Juvenile Crime 48 5
5 51 Police Asssistance 1 Property O
Offense 21 7
7 6 Sex Offfense 2 Violent Crime 50 17 27 Totaal 231 63 134 Traffic Offe
ense Class U
Unknown N
No Yes Traffic Offense T
Accident/Rpt
5 3
3 2 Traffic Offeense DUI 24 Traffic Offense
T
e Equipment 2 Traffic Offen
nse Lic/reg 1 9
9 10 Traffic Offense Moving 14 36 49 Traffic Offense T
Vehicle Theft
2 2 Totaal 22 4
48 89 Graand Total: 253 1
111 223 Sourcee: CNMI Depaartment of Publlic Safety, 2008.
18
Total 77 12 71 1 32 104 1 34 2 94 428 Total 10 24 2 20 99 4 159 587 CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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 Traffic Offense Accident/Rpt Female Male Traffic Offense DUI Female Male Traffic Offense Equipment Female Male Traffic Offense Lic/reg Female Male Total 0 Grant Total: 8 Source: CNMI Department of Public Safety, 2008.
19
10 ‐ 12 1 2 26 13 ‐ 15 1 4 9 106 16 ‐ 18 2 3 1 9 3 4 67 281 19 ‐ 20 3 1 2 12 1 1 2 6 81 166 Total 6
4
3
21
1
1
6
14
159 587
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
TOBACCO
20
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
SEOW Construct Age at First Use PSS CATEGORY & YEAR Tobacco Percentage of students who smoked a whole cigarette for the first time before age 13 years Daily Use Percentage of students who smoked cigarettes on one or more of the past 30 days Percentage of students who smoked cigarettes on 20 or more of the past 30 days Current Use (Smokeless Tobacco) Percentage of students who used chewing tobacco snuff, or dip on one or more of the past 30 days Current Use Source: PSS, CNMI Youth Risk Behavior Survey, 2009.
21
2003 YEAR 2005 2007 2009
40.1 34.0 28.6 23.6
48.8 35.8 31.1 26.8
16.8 11.1 8.2 7.5
42.5 36.9 36.3 31.9
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Figure 2.1
Percentage of students who smoked cigarettes on 20 or
more of the past 30 days
16.8
11.1
8.2
2003
2005
7.5
2007
2009
Year
Source: PSS, CNMI Youth Risk Behavior Survey (YRBS), 2009.
Table 2.2
2008
2009
Tobacco License
Issued
Tobacco Citations
Issued
Hearings
License Suspension
318
284
23
11
15
7
14
7
2008
14
2009
9
Source: CNMI Department of Commerce, ABTC Division.
Sold to minors
Sold to minors
Figure 2.2
Department of Commerce ‐ Alcohol & Tobacco Data
2008
800
600
400
200
0
Source: CNMI Department of Commerce, ABTC
22
2009
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Table 2.3
CNMI Department of Public Health ‐ Tobacco Use During Pregnancy. Year 2006 Total Birth 1,440 Tobacco Use During Pregnancy Unknown 2007 1,441 2008 2009
1,428 1,432 84 81 76 57
0 0 2 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. Source: CNMI Department of Public Health, Division of Public Health.
Figure 2.3
CNMI Department of Public Health ‐ Tobacco Use During Pregnancy
Total Birth
2009
2008
2007
2006
0
2
0
0
Tobacco Use During Pregnancy
Unknown
57
1,432
76
1,428
81
1,441
84
1,440
Source: CNMI Department of Public Health, Division of Public Health.
Table 2.4
CNMI Department of Public Health – Tobacco‐Related Mortality Year 2006 2007 2008 2009
174 141 178 195
Lung cancer 9 7 6 2
COPD 2 4 4 6
Cardiovascular disease 5 10 6 5
Total Mortality Source: RPMS, Health & Vital Statistics Office, Dept. of Public Health Note: Mortality deaths are not necessarily tobacco and alcohol related. 23
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Figure 2.4
CNMI Department of Public Health ‐ Tobacco‐Related Mortality
Total Mortality
Lung cancer
COPD
Cardiovascular disease
195
178
174
141
9 2 5
2006
7 4 10
6
2007
4 6
2008
Source: CNMI Department of Public Health, Division of Public Health.
24
2 6 5
2009
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
ILLICIT DRUGS
25
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
SEOW Construct Current Use (Cocaine) Lifetime Use (Cocaine) Lifetime Use (Heroin) Lifetime Use (Methamphetamines) Lifetime Use (Ecstasy) PSS CATEGORY & YEAR Illicit Drugs Percentage of students who used any form of cocaine, including powder, crack, or freebase one or more times during the past 30 days Percentage of students who used any form of cocaine, including powder, crack, or freebase one or more times during their life. Percentage of students who used heroin one or more times during their life Percentage of students who used methamphetamines one or more times during their life Percentage of students who used ecstasy one or more times during their life Source: PSS, CNMI Youth Risk Behavior Survey, 2009.
26
2003 YEAR 2005 2007 2009
3.6 2.3 2.9 2.4
5.3 5.1 4.7 4.5
4.2 3.6 3.5 3.5
6.9 4.9 4.9 4.6
6.4 5.4 4.7 3.8
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
T
Table
3.2
SEOW
W Construct Curreent Use (Marijuana) PSS C
CATEGORY & YEEAR M
Marijuana Perceentage of studeents who tried marijuana for th
he first time beefore age 13 yeears Perceentage of studeents who used marijuana one o
or more times during the passt 30 days Lifetiime Use (Marijjuana) Perceentage of studeents who used marijuana one o
or more times during their liffe Age aat First Use (M
Marijuana) 2003 YEAR 2005 20
007 2009
9
24.8 20.9 1
19.9 18.6
6
41.2 29.8 3
31.9 30.8
8
68.1 58.1 5
54.9 57.1
1
Sourcee: PSS, CNMI Youth Risk Behavvior Survey, 20009.
T
Table
3.3
Lifetim
me Use Percentage of studeents who….. used m
marijuana onee or more timess during their llife used aany form of co
ocaine, includin
ng powder, crack,, or freebase one or more tim
mes during their llife. used h
heroin one or more times du
uring their life 2003 Year 2005 20
007 2009
9
68.1 58.1 5
54.9 57.1
1
5.3 5.1 4.7 4.5
5
4.2 3.6 3.5 3.5
5
used m
methamphetamines one or more times duringg their life 6.9 4.9 4.9 4.6
6
used eecstasy one orr more times during their life 6.4 5.4 4.7 3.8
8
Sourcce: 2009 PSS YRBS Survey Results for the Northern Mariana Islands High
h School F
Figure
3.1
CNMI Public School Syystem ‐ YRBSS Lifetime Usse Data
used ecstasy one or more tim
mes during their …
used metham
mphetamines one or more times …
2009
2007
used heroin on
ne or more times d
during their life
2005
use
ed any form of coccaine, including …
2003
used marrijuana one or morre times during …
0..0 10.0 20.0 30.0
3
40.0 50.0 60.0 70.0
Sourcee: PSS, CNMI Youth Risk Behavvior Survey, 20009.
27
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Table 3.4
CNMI Department of Public Health ‐ Illicit Drug‐Related Mortality Year Total Mortality 2006 2007 2008 2009
174 141 178 195
0 0 1 0
Illicit drug use Source: RPMS, Health & Vital Statistics Office, Dept. of Public Health Note: Mortality deaths are not necessarily tobacco and alcohol related. Source: CNMI Department of Public Health, Division of Public Health.
Figure 3.2
CNMI Department of Public Health ‐ Illicit Drug‐
Related Mortality
Total Mortality
Illicit drug use
195
178
174
141
0
2006
1
0
2007
2008
0
2009
Source: CNMI Department of Public Health, Division of Public Health.
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
28
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
F
Figure
3.3
Persons 122 and older meeting
m
DSM
M-IV criteria fo
or Illicit
Drug abuse or depend
dence
Feemale
Malee
13
7
0
2
0
3
2
1
12‐17 Year 18‐20 Year
1
21
1‐34 Year 35‐6
64 Year
0 0
65 aand Ovver
Sourcee: CGC's Integ
grated Client Database
D
System
m
Table 3.6
Juvenile Crim
minal Offenses per Ethnic Gro
oup/Sex Calend
dar 2008 Ethnic Group and Sex Caroliniaan Crriminal Offensee Class F M Burgglary, Robbery,, Theft 1 Controlled Substan
nce Disturbance 1 Frau
ud General Crime 2 Juve
enile Crime 1 Policce Assistance Prop
perty Offense 2 Sex Offense Violent Crime 3 Grand Totaal 10 27 Sourcee: CNMI Depaartment of Publlic Safety, 2008.
29
6 6 4 3 8 Chamorro F M 2 25 5 4 26 1 2 10 14 28 1 17 1 3 28 26 141 CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Alcohol, Tobacco and
Illicit Drug Comparative
Data
30
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
Alcoho
ol, Tobaccco and Illlicit Dru
ug Comparative Data
D
In this secction we review a few chharts that rellate the areass of alcohol, tobacco andd
illicitt drugs comp
paratively to look at the statistical treends in juxtaapose for a more
m
compprehensive lo
ook at the iteems as a whoole.
Table 4.1 and figure 4.1
4 provide us
u a look at the
t alcohol, tobacco andd specificallyy
marijuana at age of first use. We can see that we havee made somee significantt deductions
in alccohol and tob
bacco. Alcohhol trends arre important to note hearr as they deccreased
despiite the increaase in 2007 percentages
p
from the 20005 numbers.. Further the long term
data of
o tobacco frrom 2003-20009 shows an almost 50%
% decrease. The area forr focus is onn
marijuana usage because
b
althhough we do see a decreaase it is mucch less comppelling than
the otther statisticcs and not jusst from the 2007
2
data buut total for alll years. Thiss is
repreesented in oth
her data setss reported heere as well.
T
Table
4.1
Age att first Use
Percenntage of studen
nts who…..
Category
their first
f
drink of allcohol other thaan a few sips before
b
age 133 years
smokeed a whole ciga
arette for the first
fi time beforee age
13 yeaars
2003
Year
22005
2007
20009
29.8
26.1
2
27.4
244.6
40.1
34.0
2
28.6
233.6
tried marijuana
m
for the
t first time before
b
age 13 years
y
24.8
20.9
1
19.9
188.6
Sourcee: 2009 PSS YRBS
Y
Survey Results
R
for the Northern Mariiana Islands High School
F
Figure
4.1
CNMI Pub
blic School System ‐ YRB
BS Age At Firrst use
e Data
tried marrijuana for the first time before age 13 years
2009
2007
2005
2003
0.0
2
20.0
40.0
0
60.0
31
smoked aa whole cigarette for the first ore age 13 time befo
years
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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…..
Year
Category
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
32
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
F
Figure
4.2
CNMI Publlic School Syystem ‐ YRBSS Current Usse Data
used
d any form of cocaaine, including powder, crack, or freebase one or more …
wing tobacco snufff, or dip on one used chew
orr more of the past 30 days
2
2009
ore times during used marijuana one or mo
the past 30 daays
2
2007
2
2005
smoked cigarettes on onee or more of the past 30 dayys
2
2003
had at leaast one drink of alccohol on one or more of the past 3
m
30 days
0.0
10.0 20.0
0 30.0 40.0 50.0
Sourcee: 2009 PSS YRBS
Y
Survey Results
R
for the Northern Mariiana Islands High School
33
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
ADDITIONAL
STATISTICS
34
CNM
MI Epidemiologgical Profile, 2010
2
Addendum
m, CNMI SEOW
Additioonal Statiistics
T
Table
5.1
CNMII Department of
o Public Safetyy - Violent Crrime and Propeerty Crime Dataa
Year
Category
Numbber of violent crrimes (aggravaated assaults, seexual assaults, and robberies))
reported to police
Numbber of property crimes (larcenny, burglary, MV
M theft) reportted to police
2007
2
2008
171
130
2190
1
1862
Sourcee: CNMI CJPA
A & Departmeent of Public Saafety-UCR/IBR
R Activity Repport
F
Figure
5.1
CNMI Dep
partment off Public Safe
ety ‐ Violent Crim
me and Prop
perty Crime Data
Numberr of violent crim
mes (aggravateed assaults, sexxual assaultss, and robberiees) reported to police
Numberr of property crimes (larcenyy, burglary, MV
V theft) reported to police
2190
1862
171
0
130
2007
2008
Sourcee: CNMI CJPA
A & Departmeent of Public Saafety-UCR/IBR
R Activity Repport
T
Table
5.2
CNMII Department of
o Public Healtth - Births, Deaaths and Fetal Death
D
Data.
Year
Total Birth
B
Total Mortality
M
20066
2007
2008
20009
1,4400
1,441
1,428
1,4432
1744
141
178
1
195
6
10
Total Fetal
F
Death
188
19
Causes of fetal death
h unknown
D
of Publicc Health
Sourcee: RPMS, Heallth & Vital Staatistics Office, Dept.
35
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
Figure 5.2
CNMI Department of Public Health - Births, Deaths and
Fetal Death
2009
2008
Total Fetal Death
Total Mortality
2007
Total Birth
2006
‐
500 1,000 1,500 2,000 Source: RPMS, Health & Vital Statistics Office, Dept. of Public Health
Table 5.3
Juvenile Criminal Offenses per Age/Sex Calendar 2008 Age Group < Criminal Offense Class/Sex 10 10 ‐ 12 13 ‐ 15 16 ‐ 18 Burglary, Robbery, Theft Female 1 4 1 Male 4 13 21 27 Controlled Substance Male 11 Disturbance Female 1 7 2 Male 1 6 32 Fraud Male 1 General Crime Female 1 1 Property Offense Female 1 3 Male 3 17 Sex Offense Female 1 Male 1 Violent Crime Female 1 4 5 Male 1 2 13 42 Source: CNMI Department of Public Safety, 2008.
36
19 ‐ 20 1 5 1 2 20 2 1 9 4 22 Total 7 70 12 12 59 1 4 5 29 1 1 14 80 CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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
37
CNMI Epidemiological Profile, 2010 Addendum, CNMI SEOW
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.
rd
Guam Substance Abuse Epidemiological Profile, 2008 Update, 3 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.>
38