(Office of the Governor) — The Commonwealth Medicaid Agency recently partnered with the Commonwealth Cancer Association by providing more than 6,500 betel nut warning labels on all betel nut products sold in the CNMI on Wednesday, Oct. 8, at the CMA’s new office location at the Horiguchi Building in Garapan.
“We are very happy, here at the CMA, to announce that one of our community outreach…is to help sponsor the labeling for the betel nut,” said George Cruz, CMA director. “We are teaming up with the Commonwealth Cancer Association to print out the labels.”
CNMI Public Law 24-02 requires conspicuous warning labels to be placed on all betel nut products and containers that are imported or sold in the CNMI. It was signed into law by the late Gov. Arnold I. Palacios in June 2025. The labeling requirements and enforcement took effect on Oct. 1, 2025.
“The first two years the Commonwealth Cancer Association will provide the labels to the retailers,” said Jocelyn Deleon Guerrero, president for the Commonwealth Cancer Association board of directors.
The law requires retailers to track the monthly sales of betel nut and report to the Department of Commerce by the fifth business day of the follow month the previous months. At a minimum, the report must describe the types of products sold, to include the number of bags and the estimated amount per bag.
“One of the things that we are…teaming up with the CCA is to try and track some data,” Cruz said. “So moving forward, looking at how many retailers are in compliance and then hopefully over the next year or few years we will see a decrease in the number of off-island referrals for oral cancer.”
From fiscal years 2022 to 2024, the CMA paid $14 million for off-island care for 48 of its beneficiaries, Cruz said. It is, on average, about $289,000 in direct care per patient.
“The reasons why we are supporting this is because one of our goals is to help reduce oral cancer or the prevalence of oral cancer here in the CNMI,” Cruz said.
The CMA, in partnership with community partners like CCA, is looking toward a more preventative approach using education and awareness.
“If we can spend even a quarter of that [direct care cost] amount… on prevention such as labeling and educating the community, the goal is to reduce the occurrence of oral cancer here in the CNMI,” Cruz said.
The labeling initiative is to help educate betel nut consumers that betel nut can cause cancer, Deleon Guerrero said. If a person were to go into a store, pick up a bag, read the label and puts the betel nut back, it would be considered a win for our community, she said.
Getting support from CMA makes a big difference, Deleon Guerrero said.
“We are forever thankful to the Medicaid Office for offering to assist us in the purchase of these labels,” Deleon Guerrero said. “This goes a long way for us…for every person’s life we save from chewing betelnut is all good for the community.”
