Ultraviolet Tanning Research Articles

The paradoxical promotion of ultraviolet tanning by US tanning salons offering a sunless option: A cross-sectional secret shopper study

To the Editor: Sunless tanning (dihydroxyacetone spray) has emerged as an increasingly popular alternative to traditional UV tanning beds.1 Since 2011, Google searches for “spray tan” have surpassed those for “tanning bed,” suggesting a shift in consumer interest potentially portending an eventual decline in tanning bed usage.2 Yet, retail strategies employed by tanning salons to influence customer selection of UV versus sunless tanning are poorly characterized. To address this knowledge gap, we performed a secret shopper study of US tanning salons to characterize services offered, pricing, and recommendations made to customers.

Tanning Misinformation Posted by Businesses on Social Media and Related Perceptions of Adolescent and Young Adult White Non-Hispanic Women: Mixed Methods Study.

Indoor ultraviolet (UV) tanning is common and consequential, increasing the risk for cancers including melanoma and basal cell carcinoma. At-risk groups include adolescents and young adults, who often report beliefs about benefits of tanning. Adolescent and young adults are also among the most ubiquitous social media users. As previous studies support that content about tanning is common on social media, this may be a way that young women are exposed to influential content promoting tanning, including health misinformation. The purpose of this study was to evaluate health misinformation promoted by indoor tanning businesses via social media and to understand young women's perceptions of this misinformation. This mixed methods study included (1) retrospective observational content analysis of indoor tanning salons' content on Facebook over 1 year and (2) qualitative interviews with a purposeful national sample of 46 White non-Hispanic women, age 16 to 23 years, who had recently tanned indoors. We assessed experiences with tanning businesses' posted content on social media through interviews. We used the constant comparative approach for qualitative analyses. Content analysis findings included data from indoor tanning businesses (n=147) across 50 states, yielding 4956 total posts. Among 9 health misinformation topics identified, the most common was the promotion of UV tanning as a safe way to get Vitamin D (n=73, 1.5%). An example post was "Stop by Body and Sol to get your daily dose of Vitamin D." Another misinformation topic was promoting tanning for health benefits (n=31, 0.62%), an example post was "the flu is not a season, it's an inability to adapt due to decreased sun exposure…" A total of 46 participants completed interviews (age: mean 20 years, SD 2). Almost all participants (45/46, 98%) used Facebook, and 43.5% (20/46) followed an indoor tanning business on social media. Approximately half of participants reported seeing social media posts from tanning salons about Vitamin D, an example of a participant comment was "I have [seen that] a few times..." Among the participants, approximately half believed it was safe to get Vitamin D from indoor UV tanning; a participant stated: "I think it is a valid benefit to UV tanning." Despite the low frequency (range 0.5%-1.5%) of social media posts promoting health misinformation, participants commonly reported viewing these posts, and their perceptions aligned with health misinformation. Health education campaigns, possibly using social media to target at-risk populations, may be an innovative approach for tanning prevention messages.

Indoor Ultraviolet Tanning Among U.S. Adolescents and Young Adults: Results From a Prospective Study of Early Onset and Persistence

PurposeThe purpose of the study was to test whether those who initiate tanning during adolescence are more likely to continue tanning in young adulthood, potentially increasing their risk for melanoma. MethodsThe study included prospective data from the Growing Up Today Study, a cohort study started in 1996 (N = 5,882). ResultsAmong men and women who ever indoor UV tanned, those who indoor UV tan by age 17 years consistently indoor tanned at least twice the prevalence as those who did not indoor UV tan by age 17 years. Indoor tanning prevalence at age 27 years was nearly 4 times as high (18.8% vs. 4.8%) among men who started indoor tanning by age 17 years than those who did not indoor tan by age 17 years. These differences persisted through age 27 years and are more pronounced in men (18.8% vs. 4.8%) than in women (30.5% vs. 13.0%). ConclusionAdolescents who indoor UV tan by age 17 years are more likely to continue to indoor tan through young adulthood than those who begin indoor UV tanning at age 18 years or older. Our findings suggest that interventions to prevent indoor UV tanning among minors may substantially reduce years of exposure to this carcinogenic behavior in young adults.

Toward quantifying the abuse liability of ultraviolet tanning: A behavioral economic approach to tanning addiction.

Many adults engage in ultraviolet indoor tanning despite evidence of its association with skin cancer. The constellation of behaviors associated with ultraviolet indoor tanning is analogous to that in other behavioral addictions. Despite a growing literature on ultraviolet indoor tanning as an addiction, there remains no consensus on how to identify ultraviolet indoor tanning addictive tendencies. The purpose of the present study was to translate a behavioral economic task more commonly used in substance abuse to quantify the "abuse liability" of ultraviolet indoor tanning, establish construct validity, and determine convergent validity with the most commonly used diagnostic tools for ultraviolet indoor tanning addiction (i.e., mCAGE and mDSM-IV-TR). We conducted a between-groups study using a novel hypothetical Tanning Purchase Task to quantify intensity and elasticity of ultraviolet indoor tanning demand and permit statistical comparisons with the mCAGE and mDSM-IV-TR. Results suggest that behavioral economic demand is related to ultraviolet indoor tanning addiction status and adequately discriminates between potential addicted individuals from nonaddicted individuals. Moreover, we provide evidence that the Tanning Purchase Task renders behavioral economic indicators that are relevant to public health research. The present findings are limited to two ultraviolet indoor tanning addiction tools and a relatively small sample of high-risk ultraviolet indoor tanning users; however, these pilot data demonstrate the potential for behavioral economic assessment tools as diagnostic and research aids in ultraviolet indoor tanning addiction studies.

Indoor tanning promotions on social media in six US cities #UVTanning #tanning.

There is no research investigating indoor tanning advertising on social media. We assessed the use of social media to promote indoor tanning. We subscribed to social media platforms in six US cities and content-analyzed promotional messages received. We captured 662 messages on Twitter and Facebook, through salon emails, and in daily deal coupons. Salon postings were most frequent on Twitter and Facebook, with an average of 2-3 postings per week. National chains posted more frequently than local businesses. Forty percent of messages were devoid of tanning content and included photos, jokes, or popular references. Thirty percent mentioned price reductions, and 28% referenced an upcoming holiday. Sunless tanning (17%) was promoted more often than ultraviolet tanning (9%). Tanning salons actively use social media as a strategy for maintaining relationships with customers and offer pricing deals that promote loyalty and high-frequency tanning.

Tanning bed legislation and the dermatologist.

Indoor ultraviolet (UV) tanning correlates with increased risk of developing melanoma and other skin cancers. Because of the limited scope of individual counseling by physicians and other health care providers, prevention efforts now encompass population-based interventions in the form of legislation to discourage and decrease access to indoor tanning facilities. Legislation increasingly restricts indoor UV tanning at the national, territory, state, or local level and draws attention to the complexities surrounding enforcement and infraction penalties. Further research needs to better define the effect of decreased indoor UV tanning access on skin cancer incidence.

Compliance by California tanning facilities with the nation’s first statewide ban on use before the age of 18 years

Exposure to indoor tanning, especially at younger ages, is associated with increased risk of skin cancer. Even in states with parental consent requirements, teenagers used tanning facilities at high rates. In 2011, California became the first state to pass a complete ban on indoor tanning by those younger than 18 years. We sought to determine whether tanning facilities in California were in compliance with the new law. In a cross-sectional study, telephone calls were placed in May 2013 to a statewide random sample of tanning facilities by a study investigator indicating that she was 17 years old. Of 600 advertised indoor tanning facilities, 338 met inclusion criteria. A majority of respondents (77%, 95% confidence interval 72%-81%) told the underage caller that she could not use their ultraviolet tanning facility. Most facilities, however, denied any dangers from ultraviolet tanning (61%) and made unlawful claims of specific health benefits, including vitamin-D production (44%), skin disease treatment (22%), prevention of future sunburns (17%), and prevention or treatment of depression (8%). Tanning facilities may respond differently to a 17-year-old's request to tan in person versus by telephone. Given strong evidence linking indoor tanning to skin cancer, and the tanning industry's documented history of marketing specifically to teenagers, this study suggests that laws banning indoor tanning younger than 18 years can meaningfully impact access. Additional enforcement, however, may be required to bring about accurate disclosure of risk and prevent claims of unproven health benefits.

Indoor Ultraviolet Tanning: What the Data Do and Do Not Show Regarding Risk of Melanoma and Keratinocyte Malignancies

Recreational indoor tanning with ultraviolet (UV) radiation has become popular in recent decades, particularly among teenagers and young adults. The consequences for public health have become an important area of concern. The link between this form of UV exposure and both melanoma and non-melanoma skin cancers has been clarified through multiple lines of evidence from epidemiology and laboratory science reflected in recent reports by multiple prestigious bodies. Some have suggested that this form of indoor tanning has a role in vitamin D generation, but a review of existing evidence suggests that indoor tanning is neither a reliable nor advisable source. In addition, laboratory data suggest that tanning promotes a common molecular intermediate in skin carcinogenesis, DNA damage, which thus precludes the concept of a "safe tan." Finally, emerging evidence links UV signaling in skin to dependency/addiction, thus having implications for the organic (rather than cosmetic) impact of the process. This article presents the epidemiologic and mechanistic data relevant to the safety considerations for indoor tanning.

Indoor ultraviolet tanning and skin cancer: health risks and opportunities

Skin cancer incidence is higher than that of any other human malignancy, and yet one of its root causes [ultraviolet (UV) radiation] is perhaps better understood than any other human carcinogen. The roles of UV radiation exposure and indoor tanning behaviors on skin cancer risk are explored here. Studies from the past several years have shown a significant association between ever-use of an indoor tanning facility and an increased risk of basal cell carcinoma, squamous cell carcinoma, and melanoma. The association between indoor tanning and skin cancer is particularly strong among those who first used a tanning facility in early adulthood. Elevated vitamin D levels have been suggested to protect against various internal malignancies and other disease states, but sources of vitamin D that do not require UV exposure are easily available. Although additional research is needed to understand fully the relationship between UV and skin cancer, it is already clear that indoor tanning bed use represents an avoidable risk factor for melanoma and nonmelanoma skin cancer - both of which may be lethal. Acting upon this information provides a unique opportunity for protecting the public health.

The Benefits and Risks of Ultraviolet Tanning and Its Alternatives: The Role of Prudent Sun Exposure

Sunlight- and indoor ultraviolet (UV)-induced tanning is a common behavior, especially among adolescents, young adults, and individuals who have lighter skin. Excessive sun exposure is associated with several health risks, including the acceleration of skin aging and the promotion of skin cancers. Several health benefits of UV exposure include vitamin D production and improved mood. This article analyzes these health risks and benefits and discusses pertinent issues surrounding indoor tanning, the role of sunless tanning products, and prudent sun exposure.

Consistency of reported tanning behaviors and sunburn history among sorority and fraternity students

Reliable measurements of behavior are crucial to evaluating health promotion efforts. The goal of this reliability study was to examine the consistency of recalled tanning behaviors in a population with a potentially high use. We used the test-retest reliability of a self-administered survey to examine the consistency of reporting behavior patterns regarding artificial ultraviolet (UV) tanning, sunburns and sun sensitivity among sorority- and fraternity-affiliated university students. High reliability on test-retest for questions evaluating the number of artificial UV tanning sessions and the number of sunburns during specific time periods was found. Overall, this study suggests that this sub-population of 18-23-year-olds, with a wider range of exposures than other 18-23-year-olds and older subjects, report lifetime artificial UV tanning consistently when required to recall time period-specific exposures before estimating their lifetime exposure.

Ultraviolet tanning equipment: six questions

Recreational tanning, particularly as promoted by commercial salons with 'sunbeds' or booths, has generated increasing attention from the regulatory and the biomedical communities. Several agencies have weighed in with opinions on recommended modifications in guidelines, training procedures, regulatory controls, and consumer awareness. Currently there is little uniformity in the guidance provided by trade groups, in recommendations supplied by health agencies and medical associations, or in regulatory approaches taken or proposed by the many countries involved. In an effort to provide a clearer focus for its concerns in this area, the EU Directorate General Health and Consumer Affairs formulated six questions on ultraviolet (UV) tanning, all of a technical or biomedical nature. The questions were stimulated in part by the fact that the European Commission no longer regards the European standard EN 60335-2-27:1997 ('Particular requirements for appliances for skin exposure to ultraviolet and infrared radiation') as giving presumption of conformity to the Low Voltage Directive 73/23/EEC. (The latter Directive governs marketing of electrical devices in EC countries.) Initially, the questions were posed to an EU Scientific Committee. Subsequently, industry representatives and the European Commission jointly requested that the scientific community provide answers to the questions. We received the questions with a request for our technical responses and opinions. Our response was in the form of the following essay, submitted earlier this year to the European Commission. We offer it here in the hope of stimulating constructive discussion and comment.

Injuries Associated with Ultraviolet Tanning Devices — Wisconsin

Injuries Associated with Ultraviolet Tanning Devices — Wisconsin