This study examined health belief model (HBM) relevant constructs in the context of indoor tanning cessation. Telephone interviews were conducted between December 2011 and April 2012 with participants drawn from the Growing Up Today Study (GUTS) population, specifically, former tanning bed users (N=14, all females; mean age, 25.65 years) who reported frequent use in 2007, but had quit by 2010. Participants identified important motivations for quitting including health and financial reasons and the central role of family and friends in providing encouragement for indoor tanning cessation. However, participants also noted substantial barriers to maintaining indoor tanning quitting (e.g., social pressures to look good, tanning salon incentives). Participants' experience of withdrawal highlighted psychological factors more often than physical factors; some were open to resuming use in the future. The findings will be useful in intervention development to encourage cessation, the strengthening of policies to regulate the indoor tanning industry, as well as public health messaging to raise awareness of this prevalent, easily accessible cancer risk behavior.
KeywordsHealth belief model, Indoor tanning, Tanning cessation, Tanning quitting, Qualitative research Indoor tanning is a strong risk factor for melanoma [2]. In 2009, the World Health Organization's International Agency for Research on Cancer Working Group (IARC) classified ultraviolet (UV)-emitting tanning devices (tanning beds, lamps, and booths) as carcinogenic to humans [3]. Results from recent meta-analysis that included 27 observational studies published within the past 30 years, showed that the risk of cutaneous melanoma was increased by 20 % for ever users of indoor tanning devices with artificial ultraviolet light, and the risk of melanoma was doubled when use started before the age of 35 years [2]. Besides melanoma, indoor tanners are at high risk for nonmelanoma skin cancers (squamous cell carcinoma, basal cell carcinoma) [4], premature aging including loss of skin firmness, solar elastosis, and wrinkles [5, 6], skin burns [7], and eye damage [8,9]. Therefore, even though perceptions that indoor tanning is a safe way to tan are prevalent and predict use [10], there is strong evidence that indoor tanning carries important risks.Despite the health risks associated with indoor tanning, it is a common practice, particularly among Whites, women, and adults aged 18-25 years. Approximately 30 % of white women aged 18-25 report use of indoor tanning facilities in the past 12 months [11]. Increased use has been reported among white women aged 18-21 years (referring to non-Hispanic white women who tanned in the past 12 months), with an average of 27.6 sessions per year. As well, over half (58 %) of white female indoor tanning users, and 40 %