Background: The suntanning industry has grown up over the last decade in Europe, mainly because tanned skin is considered socially desirable and attractive. Because of the potential negative impact of artificial tanning on public health, this study was to investigate tanning bed use behaviour, UV related risk perception and beliefs about tanning in the German population.

The increased skin cancer incidences are important public health problems. In spite of the strong promotion of the UV-index as essential UV risk education tool, only few studies have investigated peoples understanding of the UV-index. This paper is the first to present representative data on UV-index understanding in Germany. In 2007, a representative telephone survey was carried out among 1,501 German residents aged 14 years and older. Only 27% of the respondents had heard of the UV-index before and 17% of the German respondents claimed to consider the index for their sun habits. Less than 10% of the German population was able to attribute the correct meaning to the UV-index as well as know their own skin type. The results of the present study suggest that informing the public about the UV-index has very limited impact on the public's understanding of the UV-index as well as on their attitude toward sun exposure. The results warrant the question whether the UV-index in the present form is a useful education tool in UV risk communication.

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In summary, participants' perception and assessment of the various health risks of UV exposure seem to be realistic, but the UV risk assessment it is not related to the perception of personal risk. One must therefore assume that UV health risk information and education campaigns do not necessarily lead to a change in the perception of personal UV risk. Rather than addressing primarily risk knowledge, UV risk communication should focus more on motivational aspects and consider the role of UV benefit perception.

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