Outreach Programs

Call for Volunteers for CCA's New Breast & Cervical Health Outreach Project

The Commonwealth Cancer Association is seeking volunteers to help support our new breast and cervical health outreach project.  We are specifically looking for motivated and inspiring volunteers who can commit to a six-week training program with CCA ( on Wednesday evenings and Saturday mornings for 2 hours a day), and a few hours every month thereafter for a year of volunteer service.

Outreach volunteers will play an important role in developing a breast and cervical health outreach plan aimed at educating and empowering women of all ages to reduce their cancer risk.

For more information, or to volunteer please call 682-0050 or emai us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Click here for volunteer applications .

This Breast & Cervical Health Outreach Project is paid for by funding from the Centers for Disease Control and Prevention, REACH U.S. program.  Funding was made possible by a cooperative agreement from CDC REACH U.S. through Pacific CEED, Department of Family Medicine and Community Health, JABSOM, University of Hawaii, award number 5U58DP000976-04.

Women urged to make health a top priority


National Women's Health Week is a weeklong campaign that is spearheaded by the U.S. Department of Health and Human Services' Office on Women's Health to bring together communities, businesses, government, health organizations, and other groups in an effort to empower women to make their health a top priority and take steps to improve their physical and mental health and lower their risks of certain diseases.

These steps include:

  • Getting at least 2 hours and 30 minutes of moderate physical activity, 1 hour and 15 minutes of vigorous physical activity, or a combination of both, each week
  • Eating a nutritious diet
  • Visiting a health care professional to receive regular checkups and preventive screenings
  • Avoiding risky behaviors, such as smoking and not wearing a seatbelt
  • Paying attention to mental health, including getting enough sleep and managing stress


In the CNMI, observance of National Women's Health Week is being coordinated by the Department of Public Health's Maternal and Child Health Program.  For more information about National Women's Health Week, visit http://www.womenshealth.gov/whw/index.cfm , or contact Ms. TaAnn Kabua at the CNMI Department of Public Health at 236-8703 or email This email address is being protected from spambots. You need JavaScript enabled to view it. .

Vision for a Cancer-Free World: the World Cancer Declaration

February 4 marks World Cancer Day

Led by the Union for International Cancer Control and its partner organizations, the World Cancer Day campaign aims to raise awareness about a disease that causes millions of deaths every year, and to gather at least 1 million people in support of a cancer-free world and the World Cancer Declaration. This support will be presented to international leaders at the first United Nations Summit on Non-Communicable Diseases in September 2011.

The World Cancer Declaration is a call to communities around the world to take immediate action to reduce the global cancer burden by committing to 11 Declaration targets and providing the resources and political support to achieve them by 2020.  These 11 Declaration targets include:

1)  Sustainable delivery systems will be in place to ensure that effective cancer control programs are available in all countries;

2) The measurement of the global cancer burden and the impact of cancer control interventions will have improved significantly;

3)  Global tobacco consumption, obesity and alcohol intake levels will have fallen significantly;

4)  Populations in the areas affected by HPV and HBV will be covered by universal vaccination programs;

5)  Public attitudes towards cancer will improve and damaging myths and misconceptions about the disease will be dispelled;

6)  Many more cancers will be diagnosed when still localized through the provision of screening and early detection programs and high levels of public and professional awareness about important cancer warning signs;

7)  Access to accurate cancer diagnosis, appropriate cancer treatments, supportive care, rehabilitation services and palliative care will have improved for all patients worldwide;

8)  Effective pain control measures will be available universally to all cancer patients in pain;

9)  The number of training opportunities available for health professionals in different aspects of cancer control will have improved significantly;

10)  Emigration of health workers with specialist training in cancer control will have reduced dramatically; and

11)  There will be major improvements in cancer survival rates in all countries.


To learn more about World Cancer Day and to sign the World Cancer Declaration, visit www.uicc.org/declaration or www.worldcancerday.org .  To learn more about the Union for International Cancer Control, visit www.uicc.org.



No Safe Level of Exposure to Tobacco Smoke

“The harmful effects of tobacco smoke do not end with the users of tobacco… Every inhalation of tobacco smoke exposes our children, our families, and our loved ones to dangerous chemicals that can damage their bodies and result in life-threatening diseases such as cancer and heart disease.”

--Regina Benjamin, U.S. Surgeon General, How Tobacco Smoke Causes Disease (2010)


Since 1964, U.S. Surgeons General  have issued more than 30 reports detailing the hazards of tobacco smoke exposure.  The most recent report, How Tobacco Smoke Causes Disease, issued in 2010, is a comprehensive and scientific discussion of how tobacco smoke exposures damage the human body, based on decades of research.

The picture that is clearly and consistently emerging from these studies is that there is no safe level of exposure to tobacco smoke.  According to the Surgeon General, tobacco smoke contains more than 7,000 chemicals, hundreds of which are toxic, and at least 69 of which cause cancer.  The Surgeon General’s 2010 report shows that the harmful effects of tobacco smoke are immediate: the chemicals are rapidly absorbed by the body, damaging blood vessels, weakening the immune system, and inflaming the delicate lining in the lungs.  For both smokers and nonsmokers, exposure to tobacco smoke increases risk for heart disease, respiratory disease, diabetes, and cancer.   For cancer patients, exposure to tobacco smoke weakens the body’s ability to fight cancer and can promote tumor growth.   For diabetics, exposure to tobacco smoke increases risk of heart and kidney disease, amputation, eye disease, nerve damage, and poor circulation.  Across the nation, more than 440,000 people die every year from diseases related to smoking and exposure to tobacco smoke.

Many people are at least generally familiar with the hazards of firsthand and secondhand smoke.  Less commonly known, but still hazardous to human health, is thirdhand smoke.  Thirdhand smoke consists of the pollutants in tobacco smoke that linger in rooms and react with other compounds found in the indoor environment, long after cigarettes have been extinguished.  According to a 2010 study led by researchers at the Lawrence Berkeley National Laboratory, the reactions between the chemicals in thirdhand smoke and other common indoor pollutants can produce carcinogens for days, weeks, and even months after smoking in the room has stopped.  Contrary to what some may believe, thirdhand smoke is much more than a lingering odor or an aesthetic irritation: it is a health hazard.  Semivolatile compounds from thirdhand smoke settle on indoor surfaces, mix with dust and air, and are absorbed by carpets, upholstery, fabric, or other porous materials commonly found indoors.  Infants and young children are especially at risk for exposure to thirdhand smoke because of common behaviors at their age that include crawling and hand-to-mouth contact, as well as because of their immature respiratory and immune systems.  Nonsmokers who live or work in indoor environments where smoking occurs are also at risk of health complications because of frequent and/or prolonged exposure to both secondhand and thirdhand smoke.

In her preface to How Tobacco Smoke Causes Disease, the Surgeon General notes, “The cost [of smoking and exposure to smoke] to the nation is tremendous: a staggering amount is spent on medical care and lost productivity.  But more importantly there is immeasurable cost in human suffering and loss.”



One of the most effective ways to improve public health and protect communities from exposure to tobacco smoke is to ban smoking in public places. According to the National Conference of State Legislatures, studies have shown that the benefits of smoke-free laws around the country include significant declines in hospital admissions for heart attack; reduced coronary disease; reduced public exposure to tobacco smoke; encouragement to smokers to quit; and either no effect or a positive effect on total restaurant and bar revenues.   In the state of Hawaii, a 2008 study commissioned by the Hawaii  State Department of Health showed that tourism and hospitality economic indicators were unaffected by the state’s smoke-free law one year after its enactment.  Hawaii, like the CNMI, is heavily dependent on tourism, including tourism from Asian countries.

Indeed, public smoking bans have become a common trend, and have been implemented across the nation and around the world.  As of 2010, as many as 36 states, plus the Virgin Islands, Puerto Rico, Guam, and the CNMI, and many other cities and municipalities in countries around the world, including Japan, China, Korea, Hong Kong, Taiwan, Australia, New Zealand, and the Philippines, have enacted smoke-free laws to protect public health.

Here in the CNMI, several bills have been introduced that would amend the Smoke-Free Air Act of 2010 in order to expand smoking in public places.  One of the main objectives of these bills is to increase the percentage of smoking-designated rooms in hotels in response to requests made by the hospitality industry and the Saipan Chamber of Commerce.  Currently, CNMI hotels are allowed to designate up to 20% of their rooms as smoking rooms.  Earlier this month, the House of Representatives passed House Bill 17-70, HS1 to permit hotels to designate up to 80% of their rooms for smoking.  (The original bill also proposed to allow smoking in restaurants, but that provision was deleted in the version that ultimately passed the House.)  The House bill is now before the Senate for action, along with another bill, Senate Bill 17-37, which proposes to allow hotels to designate up to 30% of their rooms for smoking, and to further permit smoking in professional offices and in bars (including attached bars in restaurants) as long as the areas are “fully ventilated.” (The law presently allows smoking in bars and attached bars in restaurants after the kitchens have closed, provided that smoke from these places does not infiltrate into areas where smoking is prohibited).  Some senators have indicated that additional amendments are likely to be proposed on the Senate floor at their next session, including one that will limit the scope of legislation to allow smoking in up to 30% of hotel rooms and balconies only, and another that would allow smoking in restaurants.

Both the House and the Senate bills indicate that economic reasons are the primary force behind the effort to expand smoking areas in the CNMI.  Neither bill, however, cites any studies to show that the CNMI’s Smoke-Free Air Act has had any negative economic impact on the hospitality industry, or on any other industry.  The statistics that are cited in the bills relate to the prevalence of smoking in countries from which many of the CNMI's tourists originate; however, these statistics warrant further examination.  For example, Senate Bill 17-37 states that 350 million people smoke in China; this equates to approximately less than 30% of China’s total population.  In other words, more than 70% of the people in China do not smoke.  As another example, the same bill states that 40% of the Japanese male population are smokers; overall, however, the actual prevalence of smoking in Japan as of 2010 is approximately 24%, a record low for that country for the 15th consecutive year.  Russia has a high prevalence of smoking (53% according to the Senate bill, but more like 43% according to other reports), but even Russia is today contemplating smoke-free laws for public places.

The Senate is scheduled to act on the proposed amendments to the CNMI’s smoke-free law this Friday, January 28, 2011 at 1:30pm at the Senate Chamber.  No public hearings have been held by either chamber on either of the bills pending in the legislature.  Written or oral testimonies will be accepted, however, at the Senate session on Friday during the public comments period.   Interested persons who would like to review the bills or submit comments may contact Senator Ralph Torres, Chair of the Senate Health & Welfare Committee at This email address is being protected from spambots. You need JavaScript enabled to view it. or 664-8874.  House Bill 17-70 and 17-70, HS1 may also be viewed at http://www.cnmileg.gov.mp/leg_sts.asp?legID=966&secID=1 ; and Senate Bill 17-37 may be viewed at http://www.cnmileg.gov.mp/leg_sts.asp?legID=1574&secID=2 .

Meanwhile, the Community Guidance Center at the Department of Public Health is planning to conduct surveys of CNMI tourists regarding their views of the CNMI’s smoke-free law, and to compile local tobacco-related data including tobacco-related deaths, medical referral costs, and other health and economic impacts.  Many health advocates believe that more objective studies on the economic and health impacts of the CNMI’s Smoke-Free Air Act, as well as more public hearings, are critical for informing the community and policymakers in making evidence-based decisions regarding policies that affect public health.

Colorectal Cancer: The Cancer No One Wanted to Talk About

Retired local physician Dr. Jack Hardy remembers what happened a few years ago when the Commonwealth Cancer Association (CCA) launched a project to develop an educational DVD about colorectal cancer in the CNMI: the project failed.   

“We identified several survivors of colorectal cancer who were well-known, respected members of the community and asked them to participate in the project.  We felt that personal stories would be a particularly powerful way to get the message out about this very common, vey preventable, form of cancer,” Dr. Hardy recalls.  “But no one wanted to talk about it.” 

The social and emotional stigmas associated with cancers of the colon and rectum proved too great.  The CCA suspended the project.   

Dr. Hardy serves as senior advisor to the Commonwealth Cancer Association, the local cancer support organization for the CNMI.  Like many other public health officials, he believes that the need to break through the sensitivity and silence surrounding colorectal cancer has never been more urgent.  “There is a high incidence rate here in the CNMI,” Dr. Hardy says.  “We absolutely need to talk about colorectal cancer.  We need to talk about it openly, and we need to talk about it now.”