Use of indoor tanning sunlamps by US youth, ages 11-18 years, and by their parent or guardian caregivers: prevalence and correlates.

BACKGROUND Tanning parlors have become common in the United States. Artificial ultraviolet radiation exposure from this source may be harmful and may increase the risk of melanoma, particularly when done for recreational purposes during childhood and early adult years. Population-based data on the prevalence and correlates of this activity is important in the evaluation of potential public health interventions for skin cancer prevention. STUDY DESIGN In 1998, we conducted a population-based telephone survey of youth and their primary caregiver. The sample (N = 1192) was weighted to represent the population of US youth living in households with a primary caregiver. Interviewers used a standardized questionnaire to document the characteristics of the participant and their practices, attitudes, and experiences regarding ultraviolet exposures. METHOD OF ANALYSIS: Weighted prevalence and adjusted prevalence odds ratios (aPOR) and 95% confidence interval (95% CI) were estimated. Independent factors were evaluated with multivariate logistic regression. RESULTS Ten percent of youth and 8% of their primary caregivers used indoor tanning sunlamps in the previous year. Thirty percent of the youth whose caregivers used indoor tanning sunlamps did so themselves as well. Independent predictors associated with indoor tanning sunlamp use were as follows: age 17 to 18 years (aPOR = 11.1; 95% CI: 5.0, 25.0); female (aPOR = 8.3; 95% CI: 3.6, 19.2); having a parent who used indoor tanning sunlamps in the previous year (aPOR = 8.7; 95% CI: 4.0, 18.9); nonuser of Sun Protection Factor 15 sunscreen at the beach or pool (aPOR = 1.9; 95% CI: 1.0, 3.4); and low sun sensitivity (aPOR = 2.3; 95% CI: 1.0, 5.3). CONCLUSION A substantial minority of American youth engages in indoor tanning. However, it is particularly prevalent among older youth, girls, and youth whose parents themselves use indoor tanning sunlamps. The knowledge of these trends may help focus public health initiatives.

[1]  S. Kondo,et al.  The roles of keratinocyte-derived cytokines in the epidermis and their possible responses to UVA-irradiation. , 1999, The journal of investigative dermatology. Symposium proceedings.

[2]  G. Fabbrocini,et al.  What do young people think about the dangers of sunbathing, skin cancer and sunbeds? A questionnaire survey among Italians , 2000, Photodermatology, photoimmunology & photomedicine.

[3]  R. Amonette,et al.  Tanning beds and skin cancer: artificial sun + old sol = real risk. , 1998, Clinics in dermatology.

[4]  T. Beasley,et al.  Factors that Influence Health Risk Behaviors Among Tanning Salon Patrons , 1997, Evaluation & the health professions.

[5]  M. Wick,et al.  Role of ultraviolet radiation in the induction of melanocytic tumors in hairless mice following 7,12-dimethylbenz(a)anthracene application and ultraviolet irradiation. , 1991, Cancer research.

[6]  C. Hertzman,et al.  The association of cutaneous malignant melanoma with the use of sunbeds and sunlamps. , 1990, American journal of epidemiology.

[7]  R. Turrisi,et al.  Application of Azjen's Theory of Planned Behavior to Predict Sunbathing, Tanning Salon Use, and Sunscreen Use Intentions and Behaviors , 1997, Journal of Behavioral Medicine.

[8]  M. Weinstock,et al.  Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. , 2001, Preventive medicine.

[9]  A. Lucci,et al.  Assessment of knowledge of melanoma risk factors, prevention, and detection principles in Texas teenagers. , 2001, The Journal of surgical research.

[10]  A. Fleischer North Carolina tanning operators: hazard on the horizon? , 1992, Journal of the American Academy of Dermatology.

[11]  M. Kopp,et al.  Why do young women use sunbeds? A comparative psychological study , 1997, The British journal of dermatology.

[12]  C. Potten,et al.  Tanning salon exposure and molecular alterations. , 2001, Journal of the American Academy of Dermatology.

[13]  Bruce K. Armstrong,et al.  Sunlight and cancer , 1997, Cancer Causes & Control.

[14]  C. McBride,et al.  The use of commercial tanning facilities by suburban Minnesota adolescents. , 1994, American journal of public health.

[15]  W. Willett,et al.  Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. , 1989, Pediatrics.

[16]  S. Woodruff,et al.  Compliance with federal and state legislation by indoor tanning facilities in San Diego. , 2001, Journal of the American Academy of Dermatology.

[17]  P. Fagan,et al.  Social Influences, Social Norms, Social Support, and Smoking Behavior among Adolescent Workers , 2001, American journal of health promotion : AJHP.

[18]  M. Weinstock,et al.  Do tanning lamps cause melanoma? An epidemiologic assessment. , 1998, Journal of the American Academy of Dermatology.

[19]  R. Turrisi,et al.  An Examination of Psychological Variables Relevant to Artificial Tanning Tendencies , 1999, Journal of health psychology.

[20]  D. Buller,et al.  Skin Cancer Prevention for Children: A Critical Review , 1999, Health education & behavior : the official publication of the Society for Public Health Education.

[21]  Valerie A. Clarke,et al.  Skin Type and Optimistic Bias in Relation to the Sun Protection and Suntanning Behaviors of Young Adults , 1997, Journal of Behavioral Medicine.

[22]  H. Randle,et al.  Suntanning: differences in perceptions throughout history. , 1997, Mayo Clinic proceedings.

[23]  M. Weinstock,et al.  Use of tanning devices and risk of basal cell and squamous cell skin cancers. , 2002, Journal of the National Cancer Institute.

[24]  M. Pathak Ultraviolet radiation and the development of non-melanoma and melanoma skin cancer: clinical and experimental evidence. , 1991, Skin pharmacology : the official journal of the Skin Pharmacology Society.

[25]  H. Beitner,et al.  Sunbed use in relation to phenotype, erythema, sunscreen use and skin diseases. A questionnaire survey among Swedish adolescents , 1996, The British journal of dermatology.

[26]  Elwood Jm Melanoma and sun exposure: contrasts between intermittent and chronic exposure. , 1992 .

[27]  H. Olsson,et al.  Risk of cutaneous malignant melanoma in relation to use of sunbeds: further evidence for UV-A carcinogenicity , 2000, British Journal of Cancer.

[28]  R. Beyth,et al.  Tanning salons: an area survey of proprietors' knowledge of risks and precautions. , 1991, Journal of the American Academy of Dermatology.

[29]  H M Rosenberg,et al.  Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. , 2001, Journal of the National Cancer Institute.

[30]  L. Labree,et al.  Parenting behaviors and the onset of smoking and alcohol use: a longitudinal study. , 1994, Pediatrics.

[31]  M. Leary,et al.  The Social Psychology of Tanning and Sunscreen Use: Self‐Presentational Motives as a Predictor of Health Risk1 , 1993 .

[32]  H. Olsson,et al.  Use of sunbeds or sunlamps and malignant melanoma in southern Sweden. , 1994, American journal of epidemiology.

[33]  P. Autier,et al.  Cutaneous malignant melanoma and exposure to sunlamps or sunbeds: An eortc multicenter case‐control study in Belgium, France and Germany , 1994 .

[34]  M. Berwick,et al.  Sunlamp use and the risk of cutaneous malignant melanoma: a population-based case-control study in Connecticut, USA. , 1998, International journal of epidemiology.

[35]  D. Gemson,et al.  Safety information provided to customers of New York City suntanning salons. , 1992, American journal of preventive medicine.

[36]  R. Silverman,et al.  Attitudes of teenagers toward sun exposure and sunscreen use. , 1992, Pediatrics.