Tanning Salon Compliance Rates in States With Legislation to Protect Youth Access to UV Tanning

Abstract

has classified tanning beds as carcinogenic. Most states have enacted legislation to prevent or create barriers for minors accessing tanning establishments. Determining tanning salon compliance with legislation would provide an indication of the influence of legislation at preventing exposure to the carcinogen in minors.OBJECTIVES To investigate compliance rates in the 42 states and the District of Columbia with legislation restricting tanning bed use in minors and to identify differences in compliance based on population, regional location, salon ownership, age group being regulated, and time since the law was enacted. DESIGN, SETTING, AND PARTICIPANTSThis investigation was a cross-sectional telephone survey conducted between February 1, 2015, and April 30, 2016, by callers posing as minors attempting to schedule a tanning appointment. The setting was tanning salons in the 42 states and the District of Columbia that currently have legislation restricting tanning bed use in minors. Included in the study were 427 tanning salons, 10 randomly selected from each state or territory with tanning legislation. MAIN OUTCOMES AND MEASURESOverall compliance of tanning salons with state tanning legislation and differences in compliance based on community population, regional location, independent vs chain tanning salon, age group being regulated, and time since the law was enacted. RESULTSOf the 427 tanning salons surveyed, overall noncompliance with state legislation was 37.2% (n = 159). There were more noncompliant tanning salons in rural locations (45.5%; 95% CI, 37.5%-53.7%; P = .009), southern regions of the United States (49.4%; 95% CI, 41.4%-57.4%; P = .001), independently owned salons (43.9%; 95% CI, 37.3%-50.6%; P = .003), states with younger age groups being regulated (53.5%; 95% CI, 45.7%-61.2%; P < .001), and states with more than one tanning regulation (50.0%; 95% CI, 42.0%-58.0%; P < .001). No difference was found based on time since the law was enacted.CONCLUSIONS AND RELEVANCE Compliance with state legislation aimed at limiting tanning bed use among US minors is unsatisfactory, indicating that additional efforts to enforce the laws and education of the harmful effects of UV tanning are necessary, especially in rural, independently owned, and tanning salons in southern regions, which have decreased compliance rates.

A systematic review of compliance with indoor tanning legislation

“…Health and Safety Code Ann. 145.008 (2013) Ban under 18 Williams (2018) [ 28 ] US (42 states and DC) State level legislation for the included states (States with youth access legislation as of 2015/2016) c Ban under 14: GA, ID, ME, ND, WV Ban under 15: AL Ban under 16: PA, WI Ban under 17: CT, NJ, NY Ban under 18: CA, DE, DC, HI, IL, LA, MN, NV, NH, NC, OR, TX, VT, WA Parental consent under 15: VA Parental consent under 18: AZ, AR, MD, MI, MS, OH, RI, SC Parental accompaniment under 14: KY, MA, MS, TN Parental accompaniment under 15: WY Parental accompaniment under 16: NB, IN Parental accompaniment under 18: UT AL Alabama, AR Arkansas, AZ Arizona, CA California, CO Colorado, CT Connecticut, DC District of Columbia, DE Delaware, FL Florida, GA Georgia, HI Hawaii, ID Idaho, IL Illinois, LA Louisiana, MA Massachusetts, MD Maryland, ME Maine, MI Michigan, MN Minnesota, MS Mississippi, NC North Carolina, ND North Dakota, NH New Hampshire, NJ New Jersey, NV Nevada, NY New York, OH Ohio, OR Oregon, PA Pennsylvania, RI Rhode Island, SC South Carolina, TN Tennessee, TX Texas, UT Utah, VA Virginia, VT Vermont, WA Washington, WI Wisconsin, WV West Virginia b This regulation requires each sunlamp product to have a label that contains a warning statement with the words: “DANGER — Ultraviolet radiation. Follow instructions.…”

“…Nine studies investigated compliance with age restrictions by noting if IT facilities state age restrictions verbally and adhere to them. Age compliance was evaluated using underage telephone secret shopper requests to buy IT services [ 23 – 28 ], underage in-person secret shopper requests [ 29 ], or both [ 30 , 31 ].…”

“…In this case, operators reported that they would not permit someone under 13 to tan. In five US states with an under 14 age restriction (Georgia, Indiana, Maine, North Dakota, and West Virginia), compliance ranged from 10 to 70% (telephone inquiry) [ 28 ]. In one US state with an under 15 age restriction (Alabama), no IT facilities complied [ 28 ].…”

“… Tripp (2017) [ 27 ] US (TX) 2015 State Underage telephone shoppers ( N = 635) IT facilities and their operators Age: 81% of facilities complied with under 18 age restriction. Williams (2018) [ 28 ] US (42 states and the District of Columbia) 2015–2016 State Underage telephone shoppers ( N = 427) IT facilities and their operators Age: Percent of operators complying with age restrictions by state: Under 14: GA (50%), ID (10%), ME (70%), ND (70%), WV (20%) Under 15: AL (0%) Under 16: PA (70%), WI (80%) Under 17: CT (50%), NJ (70%), NY (70%) Under 18: CA (90%), DE (90%), DC (50%), HI (86%), IL (100%), LA (70%), MN (90%), NV (60%), NH (100%), NC (50%), OR (100%), TX (80%), VT (70%), WA (60%) Parental Consent: Percent of operators complying with parental consent by state: Under 15: VA (70%) Under 18: AZ (90%), AR (40%), MA (70%), MI (30%), MS (40%), OH (90%), RI (70%), SC (90%) Percent of operators complying with parental accompaniment by state: Under 14: KY (30%), MA (70%), MS (40%), TN (40%) Under 15: WY (30%) Under 16: NB (70%), IN (50%) Under 18: UT (90%) AL Alabama, AR Arkansas, AZ Arizona, CA California, CO Colorado, CT Connecticut, DC District of Columbia, DE Delaware, FL Florida, GA Georgia, HI Hawaii, ID Idaho, IL Illinois, LA Louisiana, MA Massachusetts, MD Maryland, ME Maine, MI Michigan, MN Minnesota, MS Mississippi, NC North Carolina, ND North Dakota, NH New Hampshire, NJ New Jersey, NV Nevada, NY New York, OH Ohio, OR Oregon, PA Pennsylvania, RI Rhode Island, SC South Carolina, TN Tennessee, TX Texas, UT Utah, VA Virginia, VT Vermont, WA Washington, WI Wisconsin, WV West Virginia a Language is consistent with what was found in the study with respect to the legislation. Detailed legislative requirements can be found in Table 2 …”

Addiction as an indicator of vulnerability: The case of indoor tanning

“…Indoor tanning is an appropriate context for exploring whether a measure of nonsubstance addiction is an indicator of vulnerability for four reasons: (a) ultraviolet (UV) light exposure offers immediate reward (Fell, Robinson, Mao, Woolf, & Fisher, 2014) and can be addictive (Nolan, Taylor, Liguori, & Feldman, 2009;Petit, Lejoyeux, Reynaud, & Karila, 2014;Warthan, Uchida, & Wagner, 2005); (b) consumption cues are ubiquitous since indoor tanning has been heavily marketed (Greenman & Jones, 2010); (c) indoor tanning has been proven to be dangerous (Kourosh, Harrington, & Adinoff, 2010); and (d) the indoor tanning industry is minimally regulated (Williams, Buhalog, Blumenthal, & Stratman, 2018).…”