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Discussion | Most Texas IT facilities complied with the ban on tanning by minors, underscoring the importance of legislation as a public health strategy for skin cancer prevention. Strategic goals of the Surgeon General's Call to Action to Prevent Skin Cancer (http://www.surgeongeneral.gov/library/calls/prevent-skin -cancer/call-to-action-prevent-skin-cancer.pdf) include reducing IT harms and promoting policies to advance prevention. An alarming proportion (83%) of facilities reported that clients could use tanning beds daily, in contrast to the US Food and Drug Administration's recommended schedule of no more than 3 sessions during the first week of IT. 4 Study limitations include the possibility that telephone calls may produce different results than in-person visits and tanning associates' responses may not accurately reflect facilities' practices. Because data were deidentified, we were unable to characterize facilities' geographic location, limiting our ability to evaluate factors associated with compliance, an understudied area. Because fitness centers and campus and residential housing were excluded, reported compliance may have been overestimated. Access to such IT facilities by minors represents an important focus for further research.This study is only the second to evaluate a state's ban on IT by minors. Our reported compliance rate was similar to a previous report, 5 suggesting that overall compliance is high.Our study is the first to examine compliance by facility type: findings support the need to educate businesses that offer IT but not exclusively, and thus may be less familiar with the law. The rationale to assess compliance is strongly supported by the Food and Drug Administration's recent proposal to restrict IT to individuals 18 years or older nationwide. 6 Evaluating and improving compliance with bans on IT by minors is critical to achieve their goal of reducing skin cancer incidence.

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