Indoor Tanning Research Articles

Indoor Tanning Addiction: Biological Mechanisms and Association with Other Disorders.

Although many people who use tanning beds are aware of the negative consequences, they continue to indoor tan, possibly due to addictive properties. The purpose of this paper is to review the existing literature on tanning addiction, its potential biological mechanisms, and its association with psychological disorders. A PubMed search was conducted using the terms "Tanning Addiction," "UVR AND B-endorphin," and "tanning dependence AND gene." The articles were organized based on the following categories: endorphins, dopamine and the brain, genetic associations, and associations between tanning addiction and other disorders. Exposure to ultraviolet radiation leads to the synthesis of β-endorphins in the skin, the release of dopamine in the brain, and increased blood flow in brain regions associated with reinforcement and addiction. Genes associated with tanning addiction include PTCHD2 and ANKK1. Several psychiatric disorders are comorbidities of tanning addiction and excessive indoor tanning parallels many of the patterns of substance use disorders. In frequent indoor tanners, greater awareness of tanning's addictive potential and further development of interventions aimed at treating this addictive behaviour may be needed to stop indoor tanning.

Bills to Restrict Access to and Harm From Indoor Tanning Facilities in US State Legislatures, 1992‒2023.

Objectives. To describe progression, content, and stringency of state legislation regulating indoor tanning and association with state government political party leadership. Methods. Trained research assistants used legal mapping methods to code legislative bills on indoor tanning introduced in US states, the District of Columbia, and Puerto Rico. We calculated composite scores on the stringency of age restrictions and of warnings, operator requirements, and enforcement. We evaluated associations of the political party of the legislative sponsor and legislature majority. Results. Between 1992 and 2023, 184 bills were introduced in 49 of 50 states and DC (56 laws were enacted, and 126 bills failed). An under-18 ban was enacted in 22 states and DC. Party affiliation of the bill sponsor and legislature majority combined to affect bill passage and age restrictions. Conclusions. In many states, it took several years and proposed bills before a law on indoor tanning was enacted. Enacted bills were more stringent than failed bills. Public Health Implications. Increasing support for stringent regulations on indoor tanning is evident and may motivate other states or the federal government to prohibit minors from using indoor tanning facilities. (Am J Public Health. Published online ahead of print November 21, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307894).

Effects of a Tailored Mobile Messaging Intervention for Indoor Tanning Cessation in Young Females: A Randomized Clinical Trial.

Indoor tanning increases the risk of skin cancer and can become addictive. There is little research on indoor tanning cessation interventions. From 2019-2022, we conducted a clinical trial (n=265) testing a tailored mobile messaging cessation intervention in 18-30-year-old females screened for indoor tanning addiction. Participants were randomized to a control arm receiving standard risk education or a cessation intervention arm receiving tailored mobile messaging for 4 weeks. Main outcomes were indoor tanning cessation, motivation to quit, quit attempts, and indoor tanning cognitions assessed at end of treatment and 3 months later. At end of treatment, intervention participants were more likely to report quitting indoor tanning (OR = 2.10, 95% CI = 0.99 - 4.44, p <.05), but there were no significant differences by 3 months (OR = 1.54, 95% CI = 0.82 - 2.87, p = 0.17). Intervention participants who did not quit reported higher motivation to quit than control participants at the end of treatment (M = 3.40, SD = 1.72, M = 2.54, SD=1.63, p's < 0.01) and 3 months (M = 3.75, SD = 1.93, M = 2.85, SD = 1.85, p's < 0.01). Tailored mobile messaging successfully impacts indoor tanning cessation behaviors and cognitions in young adult females who meet screening criteria for tanning addiction. This trial provides preliminary support for the efficacy of a mobile cessation intervention for young adult females who meet screening for tanning addiction. Results indicate additional intervention features should be tested to increase durability of effects.

The Effect of Sun Knowledge and Self-Efficacy on Sun Protection Behavior in Skin Cancer Among Young People.

Purpose: The aim of this study is to reveal the impact of skin cancer and sun knowledge on sun protection behavior in young people. In addition, identifying predictors influencing sun protection behaviors in young people is also aimed. Methods: A cross-sectional study was conducted with 424 young people in Turkey. Data were collected using Skin Cancer and Sun Knowledge Scale, Self-Efficacy Scale for Sun Protection, and Sun Protection Behavior Scale. The independent samples t-test was used to determine differences between the mean scores of sociodemographic characteristics, Bonferroni-corrected one-way ANOVA was used to determine differences among three or more groups, and the relationship between scale score means was analyzed using Pearson correlation analysis. Factors influencing sun protection behavior were identified using multiple linear regression. Results: Of the young people, 43.4% use sunscreen continuously throughout the year, 10.10% go to solarium, and 25.7% perform self-examinations of their skin. In youth, high sun protection self-efficacy (β = 0.486), being female (β = 0.077), regular use of sunscreen throughout the year (β = 0.464), and avoiding tanning beds (β = 0.075) positively influence sun protection behavior scores. Spending more than 6 hours in the sun during the summer months (β= -0.118) negatively affects sun protection behavior. Conclusion: The level of skin cancer sun knowledge, sun protection self-efficacy, and sun protection behaviors of young people are moderate and there is a positive correlation among them. The study's findings indicate the necessity to increase awareness of skin cancer risk factors among young people and initiate effective interventions to promote sun protection behaviors.

A Geospatial Analysis of the Association between Access to Tanning Bed Facilities and Melanoma in the United States New England Region.

Substantial geographic disparities in melanoma incidence and access to tanning bed facilities exist. In this spatial ecological study, we evaluate the relationship between access to tanning bed facilities and melanoma incidence. New England county-level melanoma incidence rates (2014-2018), tanning bed facilities location, demographic data, socioeconomic data, and geographic data were obtained from the National Cancer Institute State Cancer Profiles, Data Axle, American Community Survey, and United States Geological Survey. Spatial regression models were utilized to determine the association between melanoma incidence and access to tanning beds, adjusting for confounding factors. Adjusted spatial regression identified that for every 1-minute increase in average travel time to tanning facilities within 30 minutes travel time threshold, the melanoma incidence rate decreased by 3.46% in the same county and by 1.92% across New England. We found a negative association between average travel time to tanning facilities and county-level melanoma incidence rate, suggesting that policy aimed at decreasing access to indoor tanning facilities has the potential to reduce melanoma rates. High-risk clusters, with respect to county-level melanoma rate, were also identified. Targeting of interventions and resources to high-risk clusters may reduce geographic melanoma rates disparities.

Prevention and early detection of the most aggressive skin cancer: melanoma

Skin cancers are the most common cancers and they are divided into two types: melanoma and non-melanoma skin cancers (NMSCs). Melanoma is the most lethal and aggressive type of skin cancer. The incidence of this type of cancer is increasing. Mortality from melanoma can be reduced by avoidance of exposure to ultraviolet radiation and regular skin examination. Materials and methods of research English-language scientific literature available in the PubMed and Google Scholar databases was reviewed using the following keywords: ”melanoma”; ”early-detection”; ”self-screening”; ”tanning”; ”sunscreen”; ”dermatoscopy”; ”mortality”; ”prevention”; ”risk-factors”; ”UV protection”; ”epidemiology”. Aim of the study The purpose of this narrative review is to present risk factors, prevention and the importance of early detection of melanoma. This review also shows that it is possible to increase people's awareness of skin self-examination and the importance of UV protection through the use of modern technology (text messaging). Conclusions There are many risk factors for melanoma. People's awareness of the risks of UV exposure from both sunbathing and tanning beds is increasing. More and more people are starting to protect themselves from the sun and regularly check their skin. This behavior reduces the risk of developing melanoma and increases the chances of detecting melanoma in its early stages.

Ultraviolet radiation from solariums: the main problems of measurement and evaluation of results

Introduction. Artificial tanning is now considered a public health issue. There is strong evidence linking tanning bed use to the risk of skin cancer. One measure to reduce the health risks associated with artificial tanning is to control exposure to ultraviolet radiation (UVR). Assessing the compliance of UV solariums with hygienic standards requires solving two main problems – methodological and instrumental support for the measurements taken. The purpose of the study was to substantiate methodological approaches to measuring UVR irradiance in solariums. Material and methods. Regulatory and methodological documents, as well as literary sources devoted to the issues of conducting UVR measurements of solariums and the criteria for assessing their compliance, were analyzed. To justify the conditions and scope of research, measurements of the energy illumination of the UVR of a mini-solarium, and pilot studies in a vertical turbo solarium using a UV Radiometer were carried out. Results. According to the results of UVR measurements at the minimum possible distance from the radiating block of the mini-solarium, the highest values ​​of energy illumination in all ranges were obtained at the central point, which was also confirmed by the results of scanning the radiating surface. Analysis of the research results in a vertical turbo solarium at a distance of 0.3 m from the central vertical axis of the solarium showed that the highest values ​​of energy illumination for the two blocks were obtained at different heights (1.0 m and 0.5 m from the supporting surface), which confirms the need to carry out measurements at several points along the height of each radiating block. Limitations. The results of the study can only be used when measuring the irradiance of ultraviolet radiation in solariums using UV radiometers. Conclusion. The proposed methodological approaches make it possible to measure the energy illumination of ultraviolet radiation in places where solariums are used, process and format of the results obtained, and evaluate them for compliance with current hygienic standards. Issues arised when carrying out measurements and assessing energy illumination in the spectral region of 200–400 nm when examining solariums are identified.

The National Cancer Aid monitoring (NCAM-online) of ultraviolet radiation risk and protection behavior: a population-based observational trend study with four annual online survey waves

BackgroundUltraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM.MethodsThe NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16–65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires.DiscussionThe findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027.

The Role of Health Literacy in Skin Cancer Preventative Behavior and Implications for Intervention: A Systematic Review.

Health literacy is essential for individuals to access, understand, and utilize information and services to inform health related decisions and actions. As one of the most diagnosed and preventable forms of cancer, skin cancer disease risk can be reduced through preventative behavior. Currently, there is no focused study looking specifically at health literacy and skin cancer. An understanding of how health literacy affects skin cancer-related preventive behaviors can improve current practices in skin cancer prevention. To systematically identify, synthesize, and summarize findings on the role of health literacy in skin cancers (including cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma), with a focus on preventive behaviors using studiesthat utilized quantifiablehealth literacy measurements. A literature search was performed by searching PubMed, Embase, PsycINFO, and CINAHL from inception until September 26, 2023 to identify cross-sectional, case-control, cohort, or randomized controlled studies that investigated the association between health literacy and skin cancer prevention and diagnosis. Health literacy levels varied across geographic regions, specific populations, and ethnicities. Most of the included studies found a positive association between higher health literacy and better skin cancer preventative behaviors. This included sun-protective behaviors such as: wearing sleeved shirts or shirts with collars, using gloves, covering head and face, limiting sun exposure, more sunscreen use, and less sunbathing or indoor tanning. Higher health literacy was associated with increased likelihood to engage in genetic testing and less family influence on health in one study which assessed determinants of interest in skin cancer genetic testing. Another study investigating family communication about skin cancer found that higher health literacy was associated with increased family communication regarding general cancer risk. One sun protection interventional education program was effective at increasing participants' knowledge, awareness of skin cancer risk, willingness to change sun protection, and use of sun protection, but results varied between ethnic groups. Skin cancer-related educational interventions can be effective in improving health literacy and potentially lessen the impact of skin cancer through positive behavior modification, early detection, and disease knowledge and awareness. Interventions need to be tailored to its target population to maximize effectiveness due to thevarying baseline of health literacy identified across different geographic and ethnic groups. Protocol Registration PROSPERO CRD42022340826.

Epidemiology and Risk Factors of Actinic Keratosis. What is New for The Management for Sun-Damaged Skin.

Actinic keratosis (AK) is considered a chronic skin disease mostly caused by long-term exposure to UV radiation and other risk factors such as immunosuppression, leading to an individual susceptibility for skin cancer manifestation. The treatment of AK is laborious and costly, and the incidence of skin cancer is forecasted to double until the year 2030 in an aging society.Risk factors in AK for malignant transformation in cutaneous squamous cell carcinoma (cSCC) are not fully understood, but studies suggest that histological features, such as atypia in the basal epidermal third and basal proliferation (PRO score) in AK play a pivotal role for development of malignancy. As the clinical appearance of AK does not correlate with the risk for malignancy, guidelines suggest treating every single AK lesion upon diagnosis. Skin imaging techniques, such as line-field confocal optical coherence tomography (LC-OCT) can help to provide an individual holistic follow-up for AK lesions by non-invasive visualization of atypia and basal proliferation. A follow-up for patients with AK may be critical for treatment success in terms of strengthening therapy adherence. When AK presents therapy refractory, cSCC manifests in nearly 30% of the cases after several years. Patients with AK suffering from field cancerization and immunosuppression are susceptible for a severe course of disease including metastasis and high mortality rates. Those vulnerable subgroups benefit from close skin cancer screening, early adequate treatment and chemoprevention, such as niacinamide or acitretin. Skin cancer prevention is substantial. Primary prevention should include chemical and physical UV-light protection and avoidance of indoor tanning. Secondary prevention is essential in high-risk populations, such as fair skin type elderly men and STORs. Tertiary prevention should comprise adequate treatment strategies to prevent therapy resistance, reoccurrence and cSCC, especially when field cancerization and immunosuppression are present.

Skin Cancer Diagnosis With Multi-Level Classification

Skin cancer arises from the uncontrolled proliferation of abnormal skin cells, primarily triggered by exposure to the harmful ultraviolet (UV) rays of the sun and the utilization of UV tanning beds. This condition poses a heightened risk due to its potential to progress into blood cancer and lead to rapid fatality. Extensive research efforts have been dedicated to advancing the treatment of this perilous ailment. This paper presents a system designed for the examination and diagnosis of pigmented skin lesions and melanoma. The system incorporates a supervised classification algorithm that combines Convolutional Neural Network (CNN) and Deep Neural Network (DNN) architectures with feature extraction techniques. It operates in two distinct stages: the initial stage classifies images into two categories, namely benign or malignant, while the subsequent stage further categorizes the images into one of three classes: basal cell carcinomas, squamous cell carcinomas, or melanoma. Consequently, the comprehensive system addresses four classes, namely benign, basal cell carcinomas, squamous cell carcinomas, and melanoma. This work contributes to the system's design in three significant ways. Firstly, it implements multiple iterations to select the most optimal images, resulting in the highest classification accuracy. Secondly, it employs various statistical methods to identify the most pertinent features, thereby enhancing the classifier's accuracy by focusing on the most informative features for the classification task. Lastly, a two-stage classification approach is implemented, employing two distinct classifiers at different levels within the overall system. Despite the inherent complexity of the real-world problem, the overall system attains a commendable level of classification accuracy. Following rigorous experimentation, the study identifies the top three models. Each approach culminates in a classifier for each stage. The first approach, utilizing a deep learning classifier, achieves an accuracy of 81.82% in the initial cancer discrimination stage and 58.33% in the subsequent stage. The second approach, employing a machine learning classifier, attains an accuracy of 74.63% in the first stage and 64.41% in the second stage. The third approach, utilizing a linear regression classifier, achieves an accuracy of 98% in the first stage and 90% in the second stage. These results underscore the significance of feature selection in influencing model accuracy and suggest the potential for further optimization.

Resolutive Treatment of Actinic Keratosis through Peptides Extracted from Zebrafish Conveyed Across Laser-assisted Transcutaneous Delivery (Cryopass Therapy).

Actinic keratoses (AKs) are humans' most common keratinocyte-derived precancerous lesions. They can be observed predominantly in fair-skinned individuals on sun-exposed surfaces. Another name for AKs is solar keratosis. The primary risk factor for AKs is cumulative UV exposure from sunlight and/or tanning salons. AKs may present on a patient as a few detectable lesions. Clinically, they present as scaly erythema lesions with various pigmentations. Surgery treatment is the only approach that can definitively resolve the illness. The research aims to demonstrate the effectiveness of treating relapsing AKs through the use of factors present during organogenesis extracted from zebrafish caviar conveyed through a cryopass therapy device (cryolaser phoresis). These factors are peptides present during specific phases of organogenesis and have shown the capacity to reverse cancer and neurodegeneration processes through gene, transcriptional, translational, and post-translational regulation. We found that 90% of patients responded. The percentage of responding patients was 100% among females and 80% among men. Our results confirm previous findings about the effectiveness of stem cell differentiation stage factors (SCDFs) in cancer and open new ways to integrate treatment.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

Enhancing Skin Disease Diagnosis Through Deep Learning: A Comprehensive Study on Dermoscopic Image Preprocessing and Classification

ABSTRACTSkin cancer occurs when abnormal cells in the top layer of the skin, known as the epidermis, undergo uncontrolled growth due to unrepaired DNA damage, leading to the development of mutations. These mutations lead to rapid cell growth and development of cancerous tumors. The type of cancerous tumor depends on the cells of origin. Overexposure to ultraviolet rays from the sun, tanning beds, or sunlamps is a primary factor in the occurrence of skin cancer. Since skin cancer is one of the most common types of cancer and has a high mortality, early diagnosis is extremely important. The dermatology literature has many studies of computer‐aided diagnosis for early and highly accurate skin cancer detection. In this study, the classification of skin cancer was provided by Regnet x006, EfficientNetv2 B0, and InceptionResnetv2 deep learning methods. To increase the classification performance, hairs and black pixels in the corners due to the nature of dermoscopic images, which could create noise for deep learning, were eliminated in the preprocessing step. Preprocessing was done by hair removal, cropping, segmentation, and applying a median filter to dermoscopic images. To measure the performance of the proposed preprocessing technique, the results were obtained with both raw images and preprocessed images. The model developed to provide a solution to the classification problem is based on deep learning architectures. In the four experiments carried out within the scope of the study, classification was made for the eight classes in the dataset, squamous cell carcinoma and basal cell carcinoma classification, benign keratosis and actinic keratosis classification, and finally benign and malignant disease classification. According to the results obtained, the best accuracy values of the experiments were obtained as 0.858, 0.929, 0.917, and 0.906, respectively. The study underscores the significance of early and accurate diagnosis in addressing skin cancer, a prevalent and potentially fatal condition. The primary aim of the preprocessing procedures was to attain enhanced performance results by concentrating solely on the area spanning the lesion instead of analyzing the complete image. Combining the suggested preprocessing strategy with deep learning techniques shows potential for enhancing skin cancer diagnosis, particularly in terms of sensitivity and specificity.

A scoping review: Screening questionnaires for identifying tanning addiction

AbstractIntroductionThere is a growing body of evidence that ultraviolet (UV) tanning, whether practiced in indoor tanning salons or outdoors in the sun, is not only linked to detrimental health outcomes but is also addictive through both psychological and physiological mechanisms. In clinical practice, it can be challenging to determine which patients will continue tanning despite being at high risk for developing skin cancer. Our study seeks to identify all available screening questionnaires for tanning addiction that could be used in clinical practice and report on published measures of validity for each screening questionnaire.MethodsAn exhaustive literature search of EMBASE, PubMed, PsycINFO, and Scopus was performed using search criteria including the concepts “UV” and “Addiction.” The most recent search was performed in March 2024 and included all articles from database inception to the time of the search. Studies were included if they reported on screening questionnaires for UV addiction. Articles were excluded from the study if they did not report primary data or did not report on measures of questionnaire validity. Methodology was created using best practices for scoping reviews.ResultsAfter identifying 171 articles, 106 articles underwent full‐text review, and 26 were included in data extraction. We identified nine questionnaires for tanning addiction, with the modified Cut‐down, Annoyed, Guilty, Eye‐opener (mCAGE), and modified Diagnostic and Statistical Manual of Mental Disorders (mDSM) being most frequently reported on, and the Behavioral Addiction Indoor Tanning Screener (BAITS) being the most promising for future use.ConclusionsThis information should be used to choose questionnaires to be studied against a “gold‐standard” of a panel of psychologists. After defining accuracy of diagnostic tests, studies can be designed to examine interventions for treating tanning addiction, so at‐risk patients can receive specialized therapy, reducing the overall burden of skin cancers.

Molecular effects of indoor tanning.

Tanning bed users have a significantly increased risk of melanoma, but it remains unclear how indoor tanning drives melanomagenesis. Tanning bed radiation is often thought of as a substitute for natural UV radiation despite differences in the maximum doses, UV content, body sites exposed, and patterns of melanoma that arise. To better understand the epidemiologic trends and etiology of melanoma associated with tanning bed use, we described the patterns of melanoma in patients with quantifiable tanning bed usage and performed exome sequencing of 182 melanocytes from normal skin of a subset of these patients. Tanning bed users were more likely than non-users to have melanoma on body sites with low cumulative levels of sun damage and were more likely to have multiple melanomas. The melanocytes in normal appearing skin from tanning bed users had higher mutation burdens, a higher proportion of melanocytes with pathogenic mutations, and distinct mutational signatures. These differences were most prominent over body sites that experience comparatively less exposure to natural sunlight. We conclude that tanning bed radiation induces melanoma by increasing the mutation burden of melanocytes and by mutagenizing a broader field of melanocytes than are typically exposed to natural sunlight. The unique signatures of mutations in skin cells of tanning users may be attributable to the distinct spectra of radiation emitted from solariums.

Beliefs, behaviours, and attitudes towards tanning and melanoma in the Irish population.

The incidence of melanoma continues to rise in Ireland. Skin cancer prevention campaigns rely on promoting knowledge to improve sun-related behaviour. To explore beliefs, behaviours, and attitudes towards tanning, and confidence in identifying signs of melanoma in the Irish population. A cross-sectional study was performed via an online questionnaire, with questions related to tanning, sun exposure, and skin cancer behaviours. Respondents were recruited according to gender, age and geographic region. The questionnaire was completed by 1043 respondents (response rate 85%). Mean age was 41years (range 20-72years). Participants had mixed awareness of risk reduction strategies for melanoma but had high perceived concerns about developing melanoma. However, 48.9% regularly sunbathed when sunny in Ireland and 41.5% had used tanning beds. The most common reason for not photoprotecting while sunbathing was because it prevented tanning. Nearly half (45.9%) of those who sunbathed agreed that it was worth getting sunburned to get a tan, and 69.4% reported feeling and looking better with a tan. Less than half (42.4%) felt confident about what to look for when checking their skin for melanoma. This study underscores the importance of addressing the cultural and aesthetic aspects of sun-tanning behaviour in skin cancer prevention efforts, as well as increasing awareness of skin cancer signs and self-examination. Further research into the potential addictive nature of UV-seeking behaviour may offer new avenues for intervention and support for individuals who are addicted to tanning.

A prospective cohort study exploring the joint influence of sunlight exposure and tanning bed use on basal cell carcinoma, squamous cell carcinoma, and melanoma risk.

Exposure to solar ultraviolet (UV) radiation and use of UV-emitting tanning devices are known risk factors for skin cancer. Few studies have explored the interaction between these risk factors, namely how the risk of skin cancer increases among those who both have been exposed to high levels of natural sunlight and regularly use tanning beds. Nurses' Health Study II followed 116,430 women, aged 25-42, from 1991 to 2011. Cumulative average UV exposure was based on participants' residences at follow-up periods. History of severe sunburn during ages 15-20 was used as a proxy for early-life sunlight exposure. Tanning bed use in early life data was collected. Participants reported melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) diagnoses. We built multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of skin cancer associated with joint effects of sunlight exposure and tanning bed use. Participants with high sunlight exposure and tanning bed use during high school/college had an increased risk of BCC (HR = 1.53, 95%CI 1.37-1.71, Pinteraction=0.01; vs. low sun exposure and no tanning bed use). Participants with a history of severe sunburns and tanning bed use during high school/college were at increased risk of BCC (HR = 1.62, 95%CI 1.47-1.79, Pinteraction=0.02; vs. no sunburns and no tanning bed use). No significant interactions were found between sunlight exposure and tanning bed use on SCC and melanoma risk. We found significant interactions between sunlight exposure and tanning bed use on the risk of BCC.

A photoaging smartphone application to promote sun safety behaviors among youth in late childhood and adolescence.

Ultraviolet (UV)-exposure behaviors can directly impact an individual's skin cancer risk, with many habits formed during childhood and adolescence. We explored the utility of a photoaging smartphone application to motivate youth to improve sun safety practices. Participants completed a preintervention survey to gather baseline sun safety perceptions and behaviors. Participants then used a photoaging mobile application to view the projected effects of chronic UV exposure on participants' self-face image over time, followed by a postintervention survey to assess motivation to engage in future sun safety practices. The study sample included 87 participants (median [interquartile (IQR)] age, 14 [11-16] years). Most participants were White (50.6%) and reported skin type that burns a little and tans easily (42.5%). Preintervention sun exposure behaviors among participants revealed that 33 (37.9%) mostly or always used sunscreen on a sunny day, 48 (55.2%) experienced at least one sunburn over the past year, 26 (30.6%) engaged in outdoor sunbathing at least once during the past year, and zero (0%) used indoor tanning beds. Non-skin of color (18 [41.9%], p = .02) and older (24 [41.4%], p = .007) participants more often agreed they felt better with a tan. Most participants agreed the intervention increased their motivation to practice sun-protective behaviors (wear sunscreen, 74 [85.1%]; wear hats, 64 [74.4%]; avoid indoor tanning, 73 [83.9%]; avoid outdoor tanning, 68 [79%]). The findings of this cross-sectional study suggest that a photoaging smartphone application may serve as a useful tool to promote sun safety behaviors from a young age.

Assessing the Feasibility and Effectiveness of Screening for Indoor Tanning in the Primary Care Setting: A Report of Preliminary Findings

Introduction: Indoor tanning is a major modifiable risk factor in the development of both melanontic and non-melanotic skin cancers. Investigation of behavior-altering interventions is an area of active research. As with other preventative measures, screening of high-risk populations can be an important aspect of a multimodality public health intervention. We sought to further the limited understanding of indoor tanning screening practices in the primary care setting.Methods: Physicians practicing within the scope of primary care in the northeast were surveyed in 2022 on practice patterns around frequency of indoor tanning screening, barriers encountered with implementing screening, and actions taken with a positive screen. Research methodology adhered to the Joanna Briggs Institute research study critical appraisal checklist.Results: Of 26 primary care physicians (PCPs), only 7.7% routinely screened for indoor tanning. Barriers identified included time limitations (76.9%) and prioritization of other health concerns (96.2%). All PCPs (100%) reacted to reports of indoor tanning with an intervention, most commonly counseling on the risks of indoor tanning (92.6%).Conclusions: Our data suggests that screening for indoor tanning use could be improved. We recommend the incorporation of a standardized screening question regarding indoor tanning in intake forms.