Indoor Tanning Among High School Students in the United States, 2009 and 2011

Abstract

IMPORTANCE Indoor tanning is associated with an increased risk of skin cancer, including melanoma, and is particularly dangerous for younger and more frequent indoor tanners. OBJECTIVE To examine the prevalence of indoor tanning and frequent indoor tanning (≥10 times during the 12 months before each survey) and their association with health-related behaviors. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study examined data from the 2009 and 2011 national Youth Risk Behavior Surveys, which used nationally representative samples of US high school students representing approximately 15.5 million students each survey year. The study included 25 861 students who answered the indoor tanning question. MAIN OUTCOMES AND MEASURES The prevalence of indoor tanning and frequent indoor tanning were examined as well as their association with demographic characteristics and health-related behaviors using multivariable logistic regression modeling. RESULTS The prevalence of indoor tanning was greater among female, older, and non-Hispanic white students. Indoor tanning was highest among female students aged 18 years or older, with 31.5% engaging in indoor tanning in 2011, and among non-Hispanic white female students, with 29.3% engaging in indoor tanning in 2011. Among female students, the adjusted prevalence of indoor tanning decreased from 26.4% in 2009 to 20.7% in 2011. Among female and male students, indoor tanning was associated with other risk-taking behaviors, such as binge drinking (P < .001 and P = .006, respectively), unhealthy weight control practices (P < .001, for both), and having sexual intercourse (P < .001, for both). Additionally, indoor tanning among female students was associated with using illegal drugs (P < .001) and having sexual intercourse with 4 or more persons (P = .03); use among male students was associated with taking steroids without a physician’s prescription (P < .001), smoking cigarettes daily (P = .03), and attempting suicide (P = .006). More than half of respondents engaging in indoor tanning reported frequent use of the devices. CONCLUSIONS AND RELEVANCE Indoor tanning is common among high school students. Public health efforts are needed to change social norms regarding tanned skin and to increase awareness, knowledge, and behaviors related to indoor tanning. The clustering of risky behaviors suggests a need for coordinated, multifaceted approaches, including primary care physician counseling, to address such behaviors among adolescents.

Tanning bed burns reported on Twitter: over 15,000 in 2013

“…A meta-analysis of 88 studies from Western countries found the prevalence of ever exposure to indoor tanning to be 55 % for all university students and 19 % for all adolescents, with female university students (69 %) and adolescents (32 %) tanning at a higher prevalence than males (40 and 14 %, respectively) [3]. Further, surveys of American high school students reveal that tanning bed use is a frequent behavior, with 54 % of female and 41 % of male tanners using a tanning bed ten or more times in the past year [4]. These high rates of tanning bed use contribute to a substantial number of skin cancer cases annually.…”

Health behaviours associated with indoor tanning based on the 2012/13 Manitoba Youth Health Survey

“…The NSS2 also found that indoor tanning is more common among females, particularly young women, a finding echoed by research conducted elsewhere. [12][13][14][15][16][17][18][19][20][21][22] Fewer studies, however, have explored the sex differences in behaviours to do with indoor tanning. [16][17][18]21,24 Robust crosssectional and longitudinal surveys about indoor tanning behaviours are rare, no less so than in Canada.…”

“…25 Indoor tanning is also correlated with smoking and susceptibility to smoking, binge drinking and drug use. 12,13,16,18,[20][21][22]24,26 It may be that adolescents who tan indoors are more susceptible to engage in risk behaviours despite the risks being well documented. The association between indoor tanning and risk behaviours that are unrelated to appearance enhancement suggests that some engage in these behaviours for other purposes, such as to cope with anxiety.…”

“…For instance, a significant proportion of indoor tanners report that tanning lifts their spirits and is relaxing. 20 While the literature examining the relationship between indoor tanning and the use of sunscreen outdoors is inconsistent, 14,15,17,18 the relationship between indoor tanning and physical activity is also unclear. Several studies have found that adolescents who play on a sports team are more likely to tan indoors.…”

“…Several studies have found that adolescents who play on a sports team are more likely to tan indoors. 18,27 Conversely, Demko et al 16 found that physical activity among female adolescents is associated with a lower likelihood of indoor tanning. Controlling for size of peer group and sun exposure through outdoor physical activity may shed some light on these conflicting findings.…”