Development of a Survey of Sunscreen Use and Attitudes among Adults in Two Coastal States, 2019

Karen Glanz,Jade Avelis,Kevin Cassel,Pui L Kwong

doi:10.3390/ijerph19052677

Abstract

Skin cancer is the most common form of cancer in the United States, and regular use of broad-spectrum sunscreens can prevent skin cancer. However, a new law in Hawaii that limits sunscreen choices due to the belief that some UV (ultraviolet) filters may damage coral reefs may reduce sunscreen use and increase skin-cancer risk. Because of this, there is a need for measurement tools to help understand consumer behavior and determinants of sunscreen purchase and use. The objectives of this study were (1) to test new questionnaire measures relevant to the Hawaii Sunscreen Ban; and (2) to assess adults’ knowledge, attitudes, and habits related to sunscreen in two other coastal states. This survey of adult residents of California and Florida was conducted in the summer of 2019. Newly developed scales addressed beliefs about effects of sunscreens on aquatic/marine environments and awareness of the Hawaii sunscreen ban. Respondents completed the survey twice to evaluate the test–retest reliability. Respondents (n = 162) were mainly female, White, and college-educated. New scales had moderate-to-high internal consistency and high test–retest reliability. Sunscreen use was high, sunburn was common, and knowledge and attitudes about sunscreen were modest. Most respondents did not know the specifics of the Hawaii Sunscreen Ban. In multivariate models, significant predictors of sunscreen use were being older, female, and having higher sunscreen knowledge. Sunscreen beliefs were not significantly associated with sunscreen use or sunburn. The findings support the use of the newly developed survey and suggest that more education about sunscreen and sunscreen ingredients is needed.

Highlights

Skin cancer is the most common form of cancer in the United States, and the incidence of melanoma continues to rise [1]
A total of 60.9% of respondents were from California, 32.3% from Florida, and 6.8% resided in another state
White middle-aged respondents to the study had moderately favorable knowledge and attitudes about sunscreen and had heard about the Hawaii Sunscreen Ban, but most did not know the key features of the law

Summary

Introduction

Skin cancer is the most common form of cancer in the United States, and the incidence of melanoma continues to rise [1]. Recent trials support the efficacy of broad-spectrum sunscreen to prevent skin cancer and photoaging [2]. Sunscreen is one of the most-often used skin-cancer-prevention strategies, but it is usually or always used by about one-third of adults [3] when outdoors [4]. An estimated 11–38% reduction in melanomas by 2031 would occur in the US White population with increased regular sunscreen use [5]. A new law that limits sunscreen availability and choice may lead to lower use of sunscreen and increased risk of skin cancer. In May 2018, the Hawaii State Legislature passed a law banning the sale and distribution of sunscreens containing oxybenzone or octinoxate in the state [6]

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