Adolescents’ Use of Indoor Tanning: A Large-Scale Evaluation of Psychosocial, Environmental, and Policy-Level Correlates

Abstract

Objectives We evaluated psychosocial, built-environmental, and policy-related correlates of adolescents’ indoor tanning use. Methods We developed 5 discrete data sets in the 100 most populous US cities, based on interviews of 6125 adolescents (aged 14–17 years) and their parents, analysis of state indoor tanning laws, interviews with enforcement experts, computed density of tanning facilities, and evaluations of these 3399 facilities’ practices regarding access by youths. After univariate analyses, we constructed multilevel models with generalized linear mixed models (GLMMs). Results In the past year, 17.1% of girls and 3.2% of boys had used indoor tanning. The GLMMs indicated that several psychosocial or demographic variables significantly predicted use, including being female, older, and White; having a larger allowance and a parent who used indoor tanning and allowed their adolescent to use it; and holding certain beliefs about indoor tanning’s consequences. Living within 2 miles of a tanning facility also was a significant predictor. Residing in a state with youth-access legislation was not significantly associated with use. Conclusions Current laws appear ineffective in reducing indoor tanning; bans likely are needed. Parents have an important role in prevention efforts.

Preventing Skin Cancer Through Reduction of Indoor Tanning

“…In addition to age and gender differences, adolescents with a more positive attitude toward tanning or tanned skin are more likely to use indoor tanning devices. [30][31][32][33][34][35][36][37][38][39] Perceived social norms regarding tanning and tanned skin (e.g., reporting that one's friends are tan or use indoor tanning devices) are also associated with indoor tanning among adolescents. 30,32,35,36,38 Indoor tanning is associated with other risky behaviors as well, such as alcohol, tobacco, and recreational drug use; poor sun protection behaviors; and unhealthy eating behaviors (such as dieting frequently to lose weight or using laxatives and vomiting to control weight).…”

“…[30][31][32][33][34][35][36][37][38][39] Perceived social norms regarding tanning and tanned skin (e.g., reporting that one's friends are tan or use indoor tanning devices) are also associated with indoor tanning among adolescents. 30,32,35,36,38 Indoor tanning is associated with other risky behaviors as well, such as alcohol, tobacco, and recreational drug use; poor sun protection behaviors; and unhealthy eating behaviors (such as dieting frequently to lose weight or using laxatives and vomiting to control weight). 32,34,38,39 One large study 39 found adolescents who had a college-educated mother were less likely to tan, and female adolescents who participated in physical activity were less likely to tan than peers who did not.…”

“…Parental permission to tan and parental tanning bed use are consistently identified in the literature as strong predictors of indoor tanning among teenagers. 30,33,36,38,40 A study 36 of 6125 adolescents found that living within 2 miles of a tanning facility was associated with more tanning. Few studies have assessed the association between state indoor tanning laws restricting youth access and the indoor tanning behavior of adolescents, and those that have did not find an association.…”

“…Few studies have assessed the association between state indoor tanning laws restricting youth access and the indoor tanning behavior of adolescents, and those that have did not find an association. 33,36 Caucasian, and have unhealthy behaviors, such as frequent alcohol use, binge drinking, smoking, recreational drug use, a poor diet, and nonregular sunscreen use. [41][42][43] Indoor tanning is also associated with self-esteem, and indoor tanners are more likely to be appearance-oriented and to view tanned skin as attractive.…”

“…81 There is limited evidence regarding the effects of other environmental and system-level options on indoor tanning device use, and some studies that have attempted to examine the relationship between the presence of local laws and indoor tanning device use have failed to find an association. 36 Some have suggested that regulation of the indoor tanning industry would be a more effective approach than voluntary industry standards or education. 57 To have the greatest impact on behavior, environmental and systems efforts will still require adequate compliance, monitoring, and enforcement.…”