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Nurla LA, Wafi G, Tatar R, Dorobanțu AM, Chivu M, Popa LG, Giurcăneanu C, Orzan OA. Recent-Onset Melanoma and the Implications of the Excessive Use of Tanning Devices-Case Report and Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:187. [PMID: 38276066 PMCID: PMC10821341 DOI: 10.3390/medicina60010187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
Introduction: Melanoma, a malignant tumor arising from uncontrolled melanocytic proliferation, commonly found in the skin but capable of affecting extracutaneous sites, ranks fifth among diagnosed oncological entities and is a significant cause of cancer deaths, constituting over 80% of skin cancer mortality. Genetic factors and ultraviolet radiation (UVR) exposure, from both natural and artificial sources, are the primary risk factors. Case Presentation: We reported the case of a 25-year-old female with numerous pigmented nevi and notable changes attributed to extensive indoor tanning sessions. Dermatological examinations and dermoscopic evaluations revealed atypical features in two pigmented nevi, leading to surgical excision. Histopathological and immunohistochemical analyses confirmed a compound nevus in one lesion and superficial spreading melanoma in the other, emphasizing the importance of vigilant follow-up and the correct use of immunohistochemistry. Discussion: Indoor tanning significantly elevates the cutaneous melanoma risk, with initiation before age 35 amplifying the risk by up to 75%, especially in young women. The risk escalates with cumulative sessions, particularly exceeding 480, and individuals undergoing over 30 sessions face a 32% higher risk. UVR induces DNA damage, genetic mutations, and immunosuppression, contributing to oncogenesis. Genetic factors, like the PTCHD2 gene, may influence the tanning dependency. Legislation targeting minors has been enacted globally but only with partial efficacy. Tanning accelerators, though associated with minor side effects, correlate with high-risk behaviors. The case underscores the urgency of addressing indoor tanning risks, emphasizing targeted awareness efforts and legislative improvements. Conclusions: In conclusion, the reported case highlights the increased risk of cutaneous melanoma linked to indoor tanning, particularly among young women and specific sociodemographic groups. Despite legislative measures, challenges persist, suggesting the potential efficacy of online campaigns involving relatable influencers to raise awareness and discourage artificial tanning.
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Affiliation(s)
- Luana-Andreea Nurla
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
- Institute of Doctoral Studies, Doctoral School of Medicine, “Ovidius” University of Constanta, 900573 Constanta, Romania
| | - Gina Wafi
- Dermatovenerology Clinic, “Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandra Maria Dorobanțu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Mădălina Chivu
- Department of Pathology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Călin Giurcăneanu
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Olguța Anca Orzan
- Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania (O.A.O.)
- Dermatology Clinic, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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ÇELİK BA, KOÇ V. Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1112210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The incidence of skin cancer is increasing around the world every year. Although there are many reasons for the occurrence of skin cancer, UV radiation caused by sunlight is seen as the most important factor. Therefore, reducing exposure to UV radiation should be a top priority for skin cancer prevention. In addition, different demographic features also affect the amount of UV exposure. These include age, gender and professional groups. On the other hand, people can be exposed to UV radiation voluntarily. Sunbathing or using tanning devices can be shown as examples for this. For these reasons, interventions to reduce exposure to UV radiation should focus on demographic features and the desire to tan. At the same time, it is emphasized in the literature that theory-based and systematic interventions are more effective than others. In this context, we think that the Health Belief Model, which is an effective psychosocial model for health behaviors, will be useful in developing sun protection behaviors. In this review, interventions based on the Health Belief Model in the context of tanning behavior, age, gender, and outdoor activities for the prevention of skin cancer and the improvement of sun protection behaviors have been discussed.
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Carpenter CS, Churchill BF, Marcus M. Bad lighting: Effects of youth indoor tanning prohibitions. JOURNAL OF HEALTH ECONOMICS 2023; 88:102738. [PMID: 36808016 DOI: 10.1016/j.jhealeco.2023.102738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 12/13/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Indoor tanning beds (ITBs) emit UV light at high intensity and have been classified as carcinogenic to humans by the World Health Organization since 2009. We are the first to study the role of state laws prohibiting youths from indoor tanning using a difference-in-differences research design. We find that youth ITB prohibitions reduced population search intensity for tanning-related information. Among white teen girls, ITB prohibitions reduced self-reported indoor tanning and increased sun protective behaviors. We also find that youth ITB prohibitions significantly reduced the size of the indoor tanning market by increasing tanning salon closures and reducing tanning salon sales.
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Affiliation(s)
- Christopher S Carpenter
- University Distinguished Professor and E. Bronson Ingram Professor of Economics, Research Associate at the National Bureau of Economic Research, Vanderbilt University, 306 Calhoun Hall, Nashville, TN 37027, United States.
| | - Brandyn F Churchill
- Assistant Professor of Resource Economics, University of Massachusetts Amherst, 221 Stockbridge Hall, Amherst, MA 01003, United States.
| | - Michelle Marcus
- Assistant Professor of Economics, Vanderbilt University, Faculty Research Fellow, National Bureau of Economic Research, 306 Calhoun Hall, Nashville, TN 37027, United States.
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Female university students’ knowledge, attitudes, and behaviours towards sun exposure and the use of artificial tanning devices: the essence of reducing risky behaviours. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Aim
To investigate female university students’ knowledge, attitudes, and behaviours towards sun exposure and the use of artificial tanning devices.
Subject and methods
A descriptive correlational survey design using online questionnaires, targeting a population of female university students aged 18–25 from one university in the United Kingdom.
Results
Three hundred and thirty-five students participated (response rate = 26.4%). Students demonstrated average knowledge and good attitude to tanning behaviours, but neither were statistically significantly associated with tanning behaviours. Students showed a history of substantial tanning behaviours, including the use of sunbeds, primarily because having a tanned skin made them look good and thus feel better.
Conclusion
This study has re-affirmed that there is no simple correlation between individuals’ knowledge and attitudes and subsequent sun-tanning behaviours. Feeling good and looking good are critical attributes to female university students’ self-esteem, and these values and beliefs outweigh risk perception of sun-tanning behaviours, and female university students continue to engage in risky tanning behaviours. Focused health promotion activities by public health authorities and higher education institutions should target students’ principal belief of looking good feeling good, as such targeted health promotion may reduce harmful sun tanning behaviours and ultimately mitigate the rising incidence in skin cancers.
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Moreno MA, Jenkins MC, Lazovich D. Tanning Misinformation Posted by Businesses on Social Media and Related Perceptions of Adolescent and Young Adult White Non-Hispanic Women: Mixed Methods Study. JMIR DERMATOLOGY 2021; 4:e25661. [PMID: 37632797 PMCID: PMC10501515 DOI: 10.2196/25661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/05/2021] [Accepted: 04/04/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indoor ultraviolet (UV) tanning is common and consequential, increasing the risk for cancers including melanoma and basal cell carcinoma. At-risk groups include adolescents and young adults, who often report beliefs about benefits of tanning. Adolescent and young adults are also among the most ubiquitous social media users. As previous studies support that content about tanning is common on social media, this may be a way that young women are exposed to influential content promoting tanning, including health misinformation. OBJECTIVE The purpose of this study was to evaluate health misinformation promoted by indoor tanning businesses via social media and to understand young women's perceptions of this misinformation. METHODS This mixed methods study included (1) retrospective observational content analysis of indoor tanning salons' content on Facebook over 1 year and (2) qualitative interviews with a purposeful national sample of 46 White non-Hispanic women, age 16 to 23 years, who had recently tanned indoors. We assessed experiences with tanning businesses' posted content on social media through interviews. We used the constant comparative approach for qualitative analyses. RESULTS Content analysis findings included data from indoor tanning businesses (n=147) across 50 states, yielding 4956 total posts. Among 9 health misinformation topics identified, the most common was the promotion of UV tanning as a safe way to get Vitamin D (n=73, 1.5%). An example post was "Stop by Body and Sol to get your daily dose of Vitamin D." Another misinformation topic was promoting tanning for health benefits (n=31, 0.62%), an example post was "the flu is not a season, it's an inability to adapt due to decreased sun exposure…" A total of 46 participants completed interviews (age: mean 20 years, SD 2). Almost all participants (45/46, 98%) used Facebook, and 43.5% (20/46) followed an indoor tanning business on social media. Approximately half of participants reported seeing social media posts from tanning salons about Vitamin D, an example of a participant comment was "I have [seen that] a few times..." Among the participants, approximately half believed it was safe to get Vitamin D from indoor UV tanning; a participant stated: "I think it is a valid benefit to UV tanning." CONCLUSIONS Despite the low frequency (range 0.5%-1.5%) of social media posts promoting health misinformation, participants commonly reported viewing these posts, and their perceptions aligned with health misinformation. Health education campaigns, possibly using social media to target at-risk populations, may be an innovative approach for tanning prevention messages.
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Affiliation(s)
- Megan Andreas Moreno
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Marina C Jenkins
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - DeAnn Lazovich
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States
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Menzies S, Daly S, O’Connor R, Kelly A, Fitzgerald M, Bourke J, McKenna DB. A re-evaluation of teenage sunbed use following the introduction of banning legislation for under 18-year-olds. J Public Health (Oxf) 2020; 42:588-593. [DOI: 10.1093/pubmed/fdz015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/26/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is little information on the effectiveness of introducing age restriction legislation alone to reduce the rate of sunbed usage by teenagers. Prior to the Public Health (Sunbed) Act of 2014 prohibiting the use of sunbeds in under 18-year-olds in Ireland we reported the rate of sunbed use at 7.5%.
Objectives
The aim of the study was to compare the rate of sunbed usage among Irish teenagers before and after the introduction of banning legislation to determine if it had the desired effect of reducing its rate of use.
Methods
In a cross-sectional survey, students from the same schools as in our previous study completed an anonymous, written questionnaire pertaining to sunbed usage.
Results
In total, 783 questionnaires, from 13 schools across Ireland, were completed. The rate of sunbed use in the current study was 7.2%, compared to 7.5% in the pre-ban study, (P = 0.76). A higher rate of sunbed use was observed in Dublin schools and female public students.
Conclusion
Our study suggests that legislation alone is ineffective at reducing sunbed usage in a teenage population. A multifaceted approach is required that includes enforcement of the legislation together with targeted public education and awareness campaigns using all aspects of the media.
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Affiliation(s)
- S Menzies
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - S Daly
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - R O’Connor
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - A Kelly
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - M Fitzgerald
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - J Bourke
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - D B McKenna
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
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Julian AK, Thorburn S, Geldhof GJ. Tanning benefits, seasonal effects, and concerns about sunscreen: Measuring health beliefs about UV among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:395-402. [PMID: 30849298 DOI: 10.1080/07448481.2019.1574800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/23/2018] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
Objective: To develop and validate a scale measuring health beliefs about UV in cloudy climates that may impact UV exposure behaviors. Participants: Students at a large university in Oregon completed pilot (N = 115) and final (N = 335) scales online March-July, 2016. Five participants underwent cognitive interviews. Methods: Expert feedback, cognitive interviews, and pilot data guided item development and refinement. We conducted factor analysis and invariance testing. Results: The final four-factor model fit well (χ2 = 37.97, df = 37, RMSEA = 0.000, CFI = 1.000). HBAU subscales are Sunscreen Toxicity, Seasonal Effects, Health Benefits of Tanning, and Tanning Through the Winter. Invariance testing supported strong invariance across sex and tanning status. Conclusion: The HBAU measures beliefs that encourage UV exposure and discourage protection (eg, the belief that sunscreen ingredients are toxic). This scale will enable more comprehensive measurement of cognitive predictors of UV exposure for student health, clinical, and research purposes.
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Affiliation(s)
- Anne K Julian
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Sheryl Thorburn
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - G John Geldhof
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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8
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Nguyen J, Gilbert L, Priede L, Heckman C. The Reach of the “Don’t Fry Day” Twitter Campaign: Content Analysis. JMIR DERMATOLOGY 2019. [DOI: 10.2196/14137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Skin cancer is the most common cancer in the United States, disproportionately affecting young women. Since many young adults use Twitter, it may be an effective channel to communicate skin cancer prevention information.
Objective
The study aimed to assess the reach of the National Council on Skin Cancer Prevention (NCSCP)’s 2018 Don’t Fry Day Twitter campaign, categorize the types of individuals or tweeters who engaged in the campaign, and identify themes of the tweets.
Methods
Descriptive statistics were used, and a content analysis of Twitter activity during the 2018 Don’t Fry Day campaign was conducted. The NCSCP tweeted about Don’t Fry Day and skin cancer prevention for 14 days in May 2018. Twitter contributors were categorized into groups. The number of impressions (potential views) and retweets were recorded. Content analysis was used to describe the text of the tweets.
Results
A total of 1881 Twitter accounts, largely health professionals, used the Don’t Fry Day hashtag, generating over 45 million impressions. These accounts were grouped into nine categories (eg, news or media and public figures). The qualitative content analysis revealed informative, minimally informative, and self-interest campaign promotion themes. Informative tweets involved individuals and organizations who would mention and give further context and information about the #DontFryDay campaign. Subthemes of the informative theme were sun safety, contextual, and epidemiologic information. Minimally informative tweets used the hashtag (#DontFryDay) and other types of hashtags but did not give any further context or original material in the tweets. Self-interest campaign promotion involved businesses, firms, and medical practices that would utilize and promote the campaign to boost their own ventures.
Conclusions
These analyses demonstrate the large potential reach of social media public health campaigns. However, limitations of such campaigns were also identified, for example, the relatively homogeneous groups actively engaged in the campaign. This study contributes to the understanding of the types of accounts and messages engaged in social media campaigns utilizing a hashtag, providing insight into the messages and participants that are effective and those that are not to achieve campaign goals. Further research on the potential impact of social media on health behaviors and outcomes is necessary to ensure wide-reaching implications.
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9
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Gandini S, Doré JF, Autier P, Greinert R, Boniol M. Epidemiological evidence of carcinogenicity of sunbed use and of efficacy of preventive measures. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:57-62. [PMID: 30811691 DOI: 10.1111/jdv.15320] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/29/2022]
Abstract
The International Agency for Research on Cancer classified, in July 2009, exposure to artificial tanning devices (sunbeds) as carcinogenic to humans. This classification was based on evidence from epidemiological and experimental animal studies. The present chapter will review these epidemiological evidences. The summary risk estimates from 27 epidemiological studies obtained through a meta-analysis showed an increased risk of melanoma: summary relative risk (SRR) = 1.20 [95% confidence interval (CI) 1.08-1.34]. The risk was higher when exposure took place at younger age (SRR = 1.59; 95% CI 1.36-1.85). The risk was independent of skin sensitivity or population and a dose response was evident. A meta-analysis of 12 studies was conducted for non-melanoma skin cancers and showed a significantly increased risk for basal cell carcinoma (SRR = 1.29; 95% CI 1.08-1.53) and for squamous cell carcinoma (SRR = 1.67; 95% CI 1.29-2.17). As for melanoma, the risk for other skin cancers increased for first exposures at young age. Epidemiological studies have gradually strengthened the evidence for a causal relationship between indoor tanning and skin cancer and they fit with prior knowledge on relationship between UV exposure and skin cancer. Additionally, several case-control studies provided consistent evidence of a positive association between use of sunbed and ocular melanoma, also with greater risk for first exposures at younger age. Preventive measures based on information on risk or by requiring parental authorization for young users proved to be inefficient in several studies. The significant impact of strong actions or total ban, such as performed in Iceland, or a total ban of sunbed use, as in Brazil or Australian states, needs to be further assessed.
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Affiliation(s)
- S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J-F Doré
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052, Lyon, France
| | - P Autier
- International Prevention Research Institute, Lyon, France
| | - R Greinert
- Department of Molecular Cell biology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany
| | - M Boniol
- International Prevention Research Institute, Lyon, France
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Reimann J, McWhirter JE, Cimino A, Papadopoulos A, Dewey C. Impact of legislation on youth indoor tanning behaviour: A systematic review. Prev Med 2019; 123:299-307. [PMID: 30940571 DOI: 10.1016/j.ypmed.2019.03.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/21/2019] [Accepted: 03/28/2019] [Indexed: 11/29/2022]
Abstract
Jurisdictions around the world have implemented indoor tanning legislations, which aim to protect all individuals, especially youth, from dangers of artificial ultraviolet radiation exposure. The objective of this study was to conduct a systematic review to synthesize the available peer-reviewed literature to determine whether indoor tanning legislation has impacted the prevalence of youth indoor tanning. Following PRISMA guidelines, six databases were searched in 2016. Reference lists from relevant articles were also searched. An updated literature search was conducted in 2018. Each article was critically appraised using a merged checklist created from two previously validated checklists. All articles meeting the inclusion criteria were retained after appraisal. Seven studies, all conducted in the U.S., met the inclusion criteria. All studies used an observational, cross-sectional design. There were small absolute decreases in youth indoor tanning prevalence after legislation vs before (n = 3, mean = 3% decrease, range = 1%-6% decrease). Prevalence of youth indoor tanning was significantly lower in states with indoor tanning legislation vs states without legislation (n = 4, mean = 5% lower, range = 1%-18% lower). Prevalence of youth indoor tanning was lower in states with longer standing indoor tanning legislation vs states with more recently implemented legislation (n = 2, mean = 9% lower, range = 2%-20% lower). Indoor tanning legislation is generally associated with lower indoor tanning prevalence among youth. The small percent differences equate to millions of youth at the population level. Longer time lapses from legislation implementation to evaluation, coupled with greater enforcement, compliance, legislative stringency, and public education may result in even more pronounced declines in youth indoor tanning prevalence.
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Affiliation(s)
- Jessica Reimann
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Jennifer E McWhirter
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Andrea Cimino
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Andrew Papadopoulos
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Cate Dewey
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
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Longo M, Bulliard J, Correia O, Maier H, Magnússon S, Konno P, Goad N, Duarte A, Oláh J, Nilsen L, Peris K, Karls R, Forsea A, del Marmol V. Sunbed use legislation in Europe: assessment of current status. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:89-96. [DOI: 10.1111/jdv.15317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- M.I. Longo
- Department of Dermatology; University of Florida College of Medicine; Gainesville FL USA
| | - J.L. Bulliard
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital; Lausanne Switzerland
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - H. Maier
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | | | - P. Konno
- Department of Dermatology; East Tallinn Central Hospital; Tallinn Estonia
| | - N. Goad
- British Association of Dermatologists; London UK
| | - A.F. Duarte
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - J. Oláh
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - L.T.N. Nilsen
- Norwegian Radiation Protection Authority; Østerås Norway
| | - K. Peris
- Department of Dermatology; Catholic University of the Sacred Heart; Milano Italy
| | - R. Karls
- Department of Infectology and Dermatology; Riga Stradins University; Riga Latvia
| | - A.M. Forsea
- Department of Dermatology; Elias University Hospital; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - V. del Marmol
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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12
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Owen AL, Grogan S, Clark-Carter D, Buckley E. The impact of an appearance-focused facial-ageing intervention on adolescents' attitudes toward sun protection. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjsn.2018.13.9.436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alison Leah Owen
- Lecturer in psychology, Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent
| | - Sarah Grogan
- Professor, Department of Psychology, Manchester Metropolitan University, Manchester
| | - David Clark-Carter
- Professor of psychological research methods, Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent
| | - Emily Buckley
- Head of department—Psychology, Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent
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13
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Nadalin V, Marrett LD, Cawley C, Atkinson J, Tenkate T, McWhirter J, Rosen CF. Assessing a ban on the use of UV tanning devices among adolescents in Ontario, Canada: first-year results. Canadian Journal of Public Health 2018; 109:473-479. [PMID: 30264195 DOI: 10.17269/s41997-018-0129-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 08/23/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the effect of the first year of a ban on UV tanning device (beds, lamps) use among those under 18 years of age in Ontario, Canada. METHODS Online questionnaires were completed by adolescents in grades 7 to 12, aged less than 18 years: one when the ban was enacted (May 2014) and a second a year later (May 2015). Questionnaires asked grade, age, sex, and about use of UV tanning devices in the previous year. Recent users were asked about length, frequency, and location of use; service refusals and reasons; awareness of signs/warning labels; and use of eye protection. Weighted estimates and confidence intervals were generated. RESULTS There were 1561 participants in 2014 and 2305 in 2015. No reduction was observed in UV tanning device use (6.9% vs. 7.9%) in the 12 months preceding the survey. In 2015, most respondents used UV tanning devices in beauty establishments, which was a shift away from gyms and fitness centres as seen in 2014. Non-significant increases occurred in the proportions noticing warning signs/labels (57% vs. 71%), required to wear eye protection (92% vs. 99%), and refused service (17% vs. 21%). Most adolescents who were refused service did not use tanning devices that year (72%). CONCLUSION Use did not change in the year following enactment of a ban on UV tanning devices among youth in Ontario. The ban did lead to improvements in service refusal, awareness of warning signage, and use of eye protection. As service refusal deterred future use, enhanced enforcement is important.
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Affiliation(s)
| | - Loraine D Marrett
- Cancer Care Ontario, Toronto, Canada. .,University of Toronto, Toronto, Canada.
| | | | | | | | | | - Cheryl F Rosen
- University Health Network and University of Toronto, Toronto, Canada
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14
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Affiliation(s)
- Alan C Geller
- Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
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15
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Qin J, Holman DM, Jones SE, Berkowitz Z, Guy GP. State Indoor Tanning Laws and Prevalence of Indoor Tanning Among US High School Students, 2009-2015. Am J Public Health 2018; 108:951-956. [PMID: 29771612 DOI: 10.2105/ajph.2018.304414] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To examine the association between state indoor tanning laws and indoor tanning behavior using nationally representative samples of US high school students younger than 18 years. METHODS We combined data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Surveys (n = 41 313) to analyze the association between 2 types of state indoor tanning laws (age restriction and parental permission) and the prevalence of indoor tanning during the 12 months before the survey, adjusting for age, race/ethnicity, and survey year, and stratified by gender. RESULTS Age restriction laws were associated with a 47% (P < .001) lower indoor tanning prevalence among female high school students. Parental permission laws were not found to be associated with indoor tanning prevalence among either female or male high school students. CONCLUSIONS Age restriction laws could contribute to less indoor tanning, particularly among female high school students. Such reductions may reduce the health and economic burden of skin cancer.
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Affiliation(s)
- Jin Qin
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dawn M Holman
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sherry Everett Jones
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zahava Berkowitz
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gery P Guy
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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16
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Bleakley A, Jordan A, Ellithorpe ME, Lazovich D, Grossman S, Glanz K. A national survey of young women’s beliefs about quitting indoor tanning: implications for health communication messages. Transl Behav Med 2018; 8:898-906. [DOI: 10.1093/tbm/ibx007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Amy Bleakley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Jordan
- School of Communication and Information, Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | - Morgan E Ellithorpe
- Department of Advertising & PR, College of Communication Arts and Sciences, Michigan State University, Lansing, MI, USA
| | - DeAnn Lazovich
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Sara Grossman
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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17
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Nahar VK, Rosenthal M, Lemon SC, Kane K, Cheng J, Oleski JL, Li W, Hillhouse JJ, Pagoto SL. Youth access to indoor tanning salons in urban versus rural/suburban communities. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:112-116. [PMID: 29080373 DOI: 10.1111/phpp.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE Research suggests that youth proximity to tanning salons may promote use; however, little is known about tanning salon proximity to schools. We assessed the proximity of tanning salons to schools in urban versus rural/suburban communities across Worcester County, Massachusetts (population > 800K). To put findings in context, we compared school proximity to tanning salons to school proximity to McDonald's restaurants, a large franchise that also caters to young people. MATERIALS & METHODS Accessibility was measured by ArcGIS 10.2 Network Analyzer (ESRI, Redlands, CA, USA) and the most current road network data layer from Massachusetts Department of Transportation (MassDOT). RESULTS A total of 145 schools were observed in the study area, of which about 39% of schools were within 1 mile from a tanning salon. Urban schools (53.41%) had a higher proportion within 1 mile of a tanning salon than rural/suburban schools (17.54%; P < .001). More schools (39.31%) were within 1 mile of a tanning salon than schools within 1 mile of a McDonald's (22.70%; P < .001). CONCLUSIONS Schools may be particularly impactful for implementing skin cancer prevention programing.
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Affiliation(s)
- Vinayak K Nahar
- Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, USA.,Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, USA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kevin Kane
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jie Cheng
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Wenjun Li
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Joel J Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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18
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Gilkey MB, Mays D, Asgari MM, Kornides ML, McRee AL. Parental Support for Age-based Indoor Tanning Restrictions. Am J Prev Med 2017; 53:473-480. [PMID: 28522236 PMCID: PMC5610053 DOI: 10.1016/j.amepre.2017.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 02/07/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Regulatory agencies, including the U.S. Food and Drug Administration, are considering policies to ban indoor tanning for youth aged <18 years. Using data from a nationally representative sample, this study assessed parental support for age-based bans as well as less restrictive parental permission requirements. METHODS Data came from an online survey completed by 1,244 parents of adolescents aged 11-17 years. Weighted multivariable logistic regression models assessed correlates of supporting an indoor tanning ban for youth aged <18 years. Data collection and analysis occurred in 2016. RESULTS Almost two thirds (65%) of parents agreed with indoor tanning bans for youth, with smaller proportions having no opinion (23%) or disagreeing (12%). Support for bans increased with greater perceived harm of indoor tanning for adolescents (OR=2.66, 95% CI=1.97, 3.59) and decreased with greater perceived benefits (OR=0.49, 95% CI=0.36, 0.67). Compared with support for bans, support for parental permission requirements was somewhat higher, with 79% of parents agreeing with the policy. Most parents (60%) agreed with both policies; only 4% disagreed with both. CONCLUSIONS Age-based indoor tanning restrictions, including bans, engender broad-based support among parents. Communicating the harm of indoor tanning may facilitate the implementation of these policies.
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Affiliation(s)
- Melissa B Gilkey
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts; Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
| | - Darren Mays
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia; Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Maryam M Asgari
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts; Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Melanie L Kornides
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts; Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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19
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Meyer MKH, Køster B, Juul L, Tolstrup JS, Bendtsen P, Dalum P, Christensen ASP. Sunbed use among 64,000 Danish students and the associations with demographic factors, health-related behaviours, and appearance-related factors. Prev Med 2017; 100:17-24. [PMID: 28336336 DOI: 10.1016/j.ypmed.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 02/24/2017] [Accepted: 03/12/2017] [Indexed: 11/19/2022]
Abstract
Sunbed use is associated with an increased risk for skin cancer and is particularly dangerous for younger persons. The objective of this study was to assess how demographic factors, health-related behaviours and appearance-related factors are associated with sunbed use. Cross-sectional data from the Danish National Youth Study collected by the National Institute of Public Health during 2014 was used. A total of 64,382 students aged 15-25years were included in the present study. Multilevel logistic regression analyses were used to determine associations. Sunbed use during the past 12months was reported by 22% of students, with a higher proportion among females (29%) than males (12%). Factors associated with sunbed use were older age, studying at a vocational college or a higher preparatory examination school compared to upper secondary school, and lower parental education. Furthermore, being a smoker, been binge-drinking, longer duration of exercise and been dieting were also associated with sunbed use. For females, poor dietary habits were also associated with sunbed use. Feeling overweight was associated with lower odds for sunbed use for males, but with higher odds for females. Lower body satisfaction was associated with higher odds of sunbed use, except for overweight males. Students who were underweight had lower odds for sunbed use, than normal weight students. Conclusively, we found evidence of associations between demographic factors, health-related behaviours and appearance-related factors and sunbed use. Understanding these relations could help to identify high-risk groups and guide preventive strategies for sunbed use and skin cancer prevention.
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Affiliation(s)
| | - Brian Køster
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
| | - Lise Juul
- Department of Public Health, Section of Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| | | | | | - Peter Dalum
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
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20
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Mounessa JS, Pagoto SL, Baker K, Antonishak J, Dellavalle RP. Creating the first indoor tan-free skin smart college campus. Prev Med Rep 2017; 6:44-46. [PMID: 28271019 PMCID: PMC5328714 DOI: 10.1016/j.pmedr.2017.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/14/2017] [Accepted: 02/18/2017] [Indexed: 11/11/2022] Open
Abstract
Given the prevalence and risk associated with indoor tanning among college students, university campuses constitute a prime target for skin cancer prevention. This report identifies the successes and challenges faced in promoting a campus-wide tan-free policy through the National Council on Skin Cancer Prevention (NCSCP) Indoor Tan-Free Skin Smart Campus Initiative. Beginning in February 2016, we communicated with university faculty or staff members who have participated in skin cancer prevention via education, clinical care, or research at 20 universities regarding the steps to adopt the tan-free policy. One campus, East Tennessee State University (ETSU), successfully fulfilled all criteria and implemented the policy change to become the first US Indoor Tan-Free Skin Smart Campus. The greatest challenge faced in recruiting campuses was gaining administrative support. Reported reasons for not adopting the policy change included wanting to wait for other schools to join first and not seeing it as a top priority. Despite the importance of improving skin cancer awareness and decreasing tanning among university students, we faced several challenges in promoting campus-wide policy change. We identify a need for research on effective ways to disseminate university health policies and increased involvement of healthcare providers in policy-related work.
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Affiliation(s)
- Jessica S. Mounessa
- University of Colorado School of Medicine, Department of Dermatology, Aurora, CO 80045, USA
- Denver Veterans Affairs Medical Center (VAMC), Department of Dermatology, Denver, CO 80220, USA
| | - Sherry L. Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Katie Baker
- East Tennessee State University, College of Public Health, Johnson City, TN 37614, USA
| | - John Antonishak
- National Council on Skin Cancer Prevention, Washington, D.C. 21771, USA
| | - Robert P. Dellavalle
- University of Colorado School of Medicine, Department of Dermatology, Aurora, CO 80045, USA
- Denver Veterans Affairs Medical Center (VAMC), Department of Dermatology, Denver, CO 80220, USA
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21
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Ventenilla J, França K, Lotti T, Keri J. Psychosocial aspects associated with use of sunscreen, natural sunlight exposure, and artificial tanning. Wien Med Wochenschr 2017; 168:236-242. [PMID: 28181031 DOI: 10.1007/s10354-017-0541-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
Abstract
Natural and artificial tanning have become very popular in Western culture, yet at the same time, there is still a psychodermatology concern for this activity. Not much has been examined with the psychological aspects of tanning and sunscreen use. The purpose of this study is to examine the psychosocial effects associated with sun protection, natural, and artificial tanning among individuals 18 years old or older visiting the University of Miami Dermatology Outpatient Clinic. We distributed a survey on tanning and sunscreen use to 150 dermatology outpatients, hospital employees, and hospital visitors for three weeks during June/July 2015 asking about how often they tan, use sunscreen, and how they feel about this topic. Demographics, such as gender, ethnicity, and education were taken into consideration to examine the different responses in each category. Our results suggest that people's perception to tanning and sunscreen use have evolved over time. Most people in South Florida nowadays feel guilty when exposed to natural sunlight without sunscreen and do not tan frequently. The majority of the people, specifically women, utilize the recommended amount of sunscreen with a sun protection factor of 30-50. However, we can conclude that communication between social media and the general public can affect people's decision-making on tanning and sunscreen use with physician advice being the most effective method of encouraging people to use sunscreen. This study will add to the growing knowledge about psychodermatology.
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Affiliation(s)
| | - Katlein França
- Centro Studi per la Ricerca Multidisciplinare e Rigenerativa, Università Degli Studi "G. Marconi", Rome, Italy. .,Department of Dermatology & Cutaneous Surgery, Department of Psychiatry and Behavioral Sciences, Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Torello Lotti
- Centro Studi per la Ricerca Multidisciplinare e Rigenerativa, Università Degli Studi "G. Marconi", Rome, Italy
| | - Jonette Keri
- Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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22
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Ghiasvand R, Rueegg CS, Weiderpass E, Green AC, Lund E, Veierød MB. Ghiasvand et al. Respond to "Indoor Tanning-A Melanoma Accelerator?". Am J Epidemiol 2017; 185:160-161. [PMID: 28077361 DOI: 10.1093/aje/kww150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 09/29/2016] [Indexed: 01/02/2023] Open
Affiliation(s)
- Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Blindern,Oslo, Norway
| | - Corina S Rueegg
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Australia
- The University of Queensland, School of Public Health, Herston Road, Herston, Australia
- Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom
| | - Eiliv Lund
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marit B Veierød
- Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
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23
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Pagoto SL, Baker K, Griffith J, Oleski JL, Palumbo A, Walkosz BJ, Hillhouse J, Henry KL, Buller DB. Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e228. [PMID: 27899339 PMCID: PMC5147712 DOI: 10.2196/resprot.6624] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/25/2016] [Accepted: 10/28/2016] [Indexed: 12/13/2022] Open
Abstract
Background Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. Methods The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning, teenage daughters’ perception of their mothers’ permissiveness, and indoor tanning by both mothers and daughters. Results The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. Conclusions This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. ClinicalTrial Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE).
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Affiliation(s)
- Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Katie Baker
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | | | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ashley Palumbo
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Joel Hillhouse
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States.,Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
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Tripp MK, Watson M, Balk SJ, Swetter SM, Gershenwald JE. State of the science on prevention and screening to reduce melanoma incidence and mortality: The time is now. CA Cancer J Clin 2016; 66:460-480. [PMID: 27232110 PMCID: PMC5124531 DOI: 10.3322/caac.21352] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. CA Cancer J Clin 2016;66:460-480. © 2016 American Cancer Society.
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Affiliation(s)
- Mary K Tripp
- Instructor, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Meg Watson
- Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sophie J Balk
- Attending Pediatrician, Children's Hospital at Montefiore, and Professor of Clinical Pediatrics, Albert Einstein College of Medicine, Bronx, NY
| | - Susan M Swetter
- Professor, Department of Dermatology, and Director, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Stanford, CA
- Professor and Assistant Chief, Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jeffrey E Gershenwald
- Dr. John M. Skibber Professor, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Professor, Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Medical Director, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX
- Co-Leader, Melanoma Moon Shot, The University of Texas MD Anderson Cancer Center, Houston, TX
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25
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Carcioppolo N. When Does Perceived Susceptibility to Skin Cancer Influence Indoor Tanning? The Moderating Role of Two Risk Perception Beliefs. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1170-1178. [PMID: 27786607 DOI: 10.1080/10810730.2016.1237593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Previous research has demonstrated an inconsistent relationship between perceived susceptibility to skin cancer and indoor tanning. The current study explored potential moderators of this relationship to better understand how risk perceptions can impact indoor tanning intentions and behavior. A national online survey (N = 267) was administered in the United States to establish the relationship between perceived susceptibility to skin cancer, cancer fatalism, and external risk attribution beliefs on indoor tanning intentions and behavior. Results revealed significant 3-way interactions among these risk perceptions on both intentions and behavior that run contrary to much of the published research on perceived susceptibility and health behavior. These findings suggest that the relationship between perceived susceptibility to skin cancer and indoor tanning is conditional on other risk perceptions. These results are discussed in terms of their theoretical and practical implications.
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Affiliation(s)
- Nick Carcioppolo
- a Department of Communication Studies , University of Miami , Coral Gables , Florida , USA
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26
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Nadalin V, Marrett L, Atkinson J, Tenkate T, Rosen CF. Tanning among Ontario adolescents pre-legislation: Prevalence and beliefs. Prev Med 2016; 91:244-249. [PMID: 27576785 DOI: 10.1016/j.ypmed.2016.08.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 07/04/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
To establish adolescent tanning beliefs and behaviors, prevalence and location of UV tanning device (beds/lamps) use, awareness of risk and restriction signage, and frequency of tanning service refusal, noting differences by grade and sex, prior to a ban on UV tanning device use among those under 18 in Ontario, Canada. Data were collected May 5 to 20 of 2014. Children in grades 7 to 12, and under age 18 completed an on-line questionnaire that asked their age, sex, grade, methods used to tan, frequency, length and location of UV tanning device use, if services were refused and why, awareness and content of signs/warning labels, tanning beliefs and knowledge, and use of eye protection. Of 1561 participants (10% response rate), 49% were male, 51% female. There were significant differences between the sexes regarding tanning behaviors (e.g. not tanning, tanning outside). Seven percent (108) had 'ever' used UV tanning devices, females more than males (p=0.0026). Over half (57%) of the 104 using UV tanning devices in the past 12months noticed warning signs/labels, of which most noticed that UV tanning devices can cause cancer (65%), and that UV exposure can contribute to premature aging (67%). While most (66%) tanned at tanning salons/studios and beauty salons/studios, gyms/fitness clubs (35%) and home use were common (25%). A relatively low proportion of adolescents used UV tanning devices prior to the ban, with use more common among females and those in higher grades.
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Affiliation(s)
- V Nadalin
- Prevention & Cancer Control, Cancer Care Ontario, Toronto, Canada.
| | - L Marrett
- Prevention & Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - J Atkinson
- Cancer Prevention and Tobacco Control, Canadian Cancer Society, Ontario Division, Toronto, Canada
| | - T Tenkate
- School of Occupational and Public Health Ryerson University, Toronto, Canada
| | - C F Rosen
- Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, Canada
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27
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Harland E, Griffith J, Lu H, Erickson T, Magsino K. Health behaviours associated with indoor tanning based on the 2012/13 Manitoba Youth Health Survey. Health Promot Chronic Dis Prev Can 2016; 36:149-62. [PMID: 27556919 PMCID: PMC5215182 DOI: 10.24095/hpcdp.36.8.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Although indoor tanning causes cancer, it remains relatively common among adolescents. Little is known about indoor tanning prevalence and habits in Canada, and even less about associated behaviours. This study explores the prevalence of adolescent indoor tanning in Manitoba and its association with other demographic characteristics and health behaviours. METHODS We conducted secondary analyses of the 2012/13 Manitoba Youth Health Survey data collected from Grade 7 to 12 students (n = 64 174) and examined associations between indoor tanning (whether participants had ever used artificial tanning equipment) and 25 variables. Variables with statistically significant associations to indoor tanning were tested for collinearity and grouped based on strong associations. For each group of highly associated variables, the variable with the greatest effect upon indoor tanning was placed into the final logistic regression model. Separate analyses were conducted for males and females to better understand sex-based differences, and analyses were adjusted for age. RESULTS Overall, 4% of male and 9% of female students reported indoor tanning, and prevalence increased with age. Relationships between indoor tanning and other variables were similar for male and female students. Binary logistic regression models indicated that several variables significantly predicted indoor tanning, including having part-time work, being physically active, engaging in various risk behaviours such as driving after drinking for males and unplanned sex after alcohol/drugs for females, experiencing someone say something bad about one's body shape/size/appearance, identifying as trans or with another gender, consuming creatine/other supplements and, for females only, never/rarely using sun protection. CONCLUSION Indoor tanning among adolescents was associated with age, part-time work, physical activity and many consumption behaviours and lifestyle risk factors. Though legislation prohibiting adolescent indoor tanning is critical, health promotion to discourage indoor tanning may be most beneficial if it also addresses these associated factors.
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Affiliation(s)
- E Harland
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - J Griffith
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - H Lu
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - T Erickson
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - K Magsino
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Le Clair MZ, Cockburn MG. Tanning bed use and melanoma: Establishing risk and improving prevention interventions. Prev Med Rep 2016; 3:139-44. [PMID: 27419006 PMCID: PMC4929140 DOI: 10.1016/j.pmedr.2015.11.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Exposure to ultraviolet radiation (UVR) from indoor tanning devices is thought to cause melanoma and other negative health consequences. Despite these findings, the practice of indoor tanning in the United States remains prevalent. In this paper we aim to present a clear discussion of the relationship between indoor tanning and melanoma risk, and to identify potential strategies for effective melanoma prevention by addressing indoor tanning device use. BASIC PROCEDURES We reviewed relevant literature on the risks of indoor tanning, current indoor tanning legislation, and trends in indoor tanning and melanoma incidence. Study was conducted at the University of Southern California, Los Angeles, CA between the years of 2014 and 2015. MAIN FINDINGS Our findings reaffirm the relationship between indoor tanning and melanoma risk, and suggest a widespread public misunderstanding of the negative effects of indoor tanning. PRINCIPAL CONCLUSIONS This review argues for an aggressive initiative to reduce indoor tanning in the United States, to design prevention efforts tailored towards specific high risk groups, and the need to better inform the public of the risks of indoor tanning.
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Affiliation(s)
- Marie Z. Le Clair
- Keck School of Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90089, USA
| | - Myles G. Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90089, USA
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Kelley DE, Noar SM, Myrick JG, Morales-Pico B, Zeitany A, Thomas NE. An Empirical Analysis of Indoor Tanners: Implications for Audience Segmentation in Campaigns. JOURNAL OF HEALTH COMMUNICATION 2016; 21:564-574. [PMID: 27115046 DOI: 10.1080/10810730.2015.1114051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tanning bed use before age 35 has been strongly associated with several types of skin cancer. The current study sought to advance an understanding of audience segmentation for indoor tanning among young women. Panhellenic sorority systems at two universities in the Southeastern United States participated in this study. A total of 1,481 young women took the survey; 421 (28%) had tanned indoors in the previous 12 months and were the focus of the analyses reported in this article. Results suggested two distinct tanner types: regular (n = 60) and irregular (n = 353) tanners. Regular tanners tanned more frequently (M = 36.2 vs. 8.6 times per year) and reported significantly higher positive outcome expectations (p < .001) and lower negative outcome expectations (p < .01) than irregular tanners, among other significant differences. Hierarchical logistic regression analysis revealed several significant (p < .001) predictors of regular tanning type, with tanning dependence emerging as the strongest predictor of this classification (OR = 2.25). Implications for developing anti-tanning messages directed at regular and irregular tanners are discussed.
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Affiliation(s)
- Dannielle E Kelley
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Seth M Noar
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | | | - Brenda Morales-Pico
- d School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Alexandra Zeitany
- d School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Nancy E Thomas
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
- d School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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Stanganelli I, Naldi L, Falcini F, Magi S, Mazzoni L, Medri M, Bertoncini R, Calderoni O, Agnoletti V, Nadiani L, Palmieri G, Di Nuzzo S, Pagliarello C, Gandini S. Parental Use and Educational Campaigns on Sunbed Use Among Teenagers and Adolescents. Medicine (Baltimore) 2016; 95:e3034. [PMID: 26986121 PMCID: PMC4839902 DOI: 10.1097/md.0000000000003034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study aimed to evaluate the prevalence of sunbed use among teenagers and the association between familial behavior and the adoption of UV-protective practices in this age group. We also assessed the impact of an educational program on students' knowledge about the potential risks of sunbed use. The educational intervention focused on: (i) skin effects of UV radiation, (ii) photoaging and photocarcinogenesis, (iii) risk factors for skin cancer, (iv) indoor sun tanning and misleading concepts such as possible protective effect of sunbed use on skin cancer risk, (v) sun protection and relation with skin phototype, and (vi) early diagnosis of melanoma using the ABCDE check list and the ugly duckling sign. We carried out a survey of 3098 students and found a strong association between parental sunbed use and students' use of the same (P < 0.0001). Students who attended the educational intervention were more aware that sunbed use cannot prevent sunburns (P = 0.03) than those who did not attend, making adjustments for confounding variables. However, sunbed use by parents influenced the desire to use a sunbed more than participation in the educational intervention (P < 0.0001). In conclusion, although our results indicate that educational interventions can improve knowledge of the risk of sunbed use. They also reveal a strong correlation between sunbed use by teenagers and parental behavior that highlights the importance of educational interventions involving families.
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Affiliation(s)
- Ignazio Stanganelli
- From the Skin Cancer Unit (IS, SM, LM, MM), Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola; Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia-Fondazione per la Ricerca (LN), Ospedale Maggiore Presidio Ospedaliero Matteo Rota, Bergamo; Romagna Cancer Registry (FF), Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola; Istituto Oncologico Romagnolo (RB, LN) (IOR), Forli; Dermatology Unit (OC), Azienda Unità Sanitaria Locale della Romagna, Ravenna; Centro Studi Avanzati sull'Umanizzazione delle Cure e sulla Salute sociale (Ce.Um.S.) (VA), Sociology Department, University of Bologna; Unit of Cancer Genetics (GP), Institute of Biomolecular Chemistry, National Research Council (CNR), Sassari; Clinica dermatologica (SDN, CP), University of Parma; and Division of Epidemiology and Biostatistics (SG), European Institute of Oncology, Milan, Italy
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Heckman CJ, Darlow SD, Kloss JD, Munshi T, Manne SL. Contextual factors, indoor tanning, and tanning dependence in young women. Am J Health Behav 2015; 39:372-9. [PMID: 25741682 DOI: 10.5993/ajhb.39.3.10] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the association of contextual factors such as cost, tanning accessibility, regulations, or marketing and indoor tanning or tanning dependence. METHODS One hundred thirty-nine college-aged female indoor tanners completed a questionnaire between 2009 and 2011. RESULTS Higher scores on tanning dependence and assessment in the spring/summer (versus the fall/winter) were associated with more frequent indoor tanning in the last 30 days (ps < .05). More frequent indoor tanning, greater session length, and more trouble paying for tanning were associated with higher scores on tanning dependence (ps < .05). CONCLUSIONS Public health research and practice could benefit from attention to such contextual factors as tanning cost and regulations regarding session length.
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Affiliation(s)
- Carolyn J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Susan D Darlow
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Teja Munshi
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Chen YC(Y, Ohanehi DC, Redican KJ. An Evaluation of UV-Monitoring Enhanced Skin Cancer Prevention Among Farm Youth in Rural Virginia. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2014.999966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Seidenberg AB, Mahalingam-Dhingra A, Weinstock MA, Sinclair C, Geller AC. Youth indoor tanning and skin cancer prevention: lessons from tobacco control. Am J Prev Med 2015; 48:188-194. [PMID: 25442227 DOI: 10.1016/j.amepre.2014.08.034] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 07/29/2014] [Accepted: 08/24/2014] [Indexed: 11/30/2022]
Abstract
Youth use of ultraviolet-emitting indoor tanning beds represents a present and emerging public health crisis. Nearly 30% of white female high school students report tanning indoors, and a quarter of high school tanners have used a tanning bed more than 20 times in the past year. Despite the significant health risks of tanning beds, including potentially deadly melanoma and eye problems, limited actions have been taken in the U.S. to protect youth. Tobacco control policies and campaigns, which have sharply reduced youth smoking, may provide a useful framework to control indoor tanning among young people. This article describes several evidence-based tobacco control strategies with potential applicability to indoor tanning within the context of the U.S. Further, current tobacco control policies and current indoor tanning policies in the U.S. are compared, and recommendations on how to curtail youth indoor tanning are discussed.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Social & Behavioral Sciences, School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Martin A Weinstock
- Dermatoepidemiology Unit, Veterans Affairs Medical Center and Department of Dermatology, Rhode Island Hospital; Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island, U.S
| | - Craig Sinclair
- Cancer Prevention Centre, Cancer Council Victoria, Carlton, Victoria, Australia
| | - Alan C Geller
- Department of Social & Behavioral Sciences, School of Public Health, Harvard University, Boston, Massachusetts.
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Decrease in Self-Reported Tanning Frequency among Utah Teens following the Passage of Utah Senate Bill 41: An Analysis of the Effects of Youth-Access Restriction Laws on Tanning Behaviors. J Skin Cancer 2014; 2014:839601. [PMID: 25215240 PMCID: PMC4158105 DOI: 10.1155/2014/839601] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Adolescent use of indoor tanning facilities is associated with an increased risk in later development of melanoma skin cancers. States that have imposed age restrictions on access to indoor tanning generally show lower self-reported rates of indoor tanning than states with no restrictions, but currently no studies have assessed indoor tanning use before and after such restrictions. Methods. In 2013, we compared self-reported indoor tanning data collected in the Prevention Needs Assessment (PNA) survey in 2011 to PNA 2013 data. We also assessed predictors of continued tanning after passage of the bill. Results. Prior to the passage of Senate Bill 41, 12% of students reported at least one incident of indoor tanning in the past 12 months. After passage, only 7% of students reported indoor tanning in the past 12 months (P < 0.0001). Students who continued indoor tanning were more likely to be older and female and to engage in other risk behaviors, including smoking and alcohol use. Lower parental education levels were also associated with continued tanning. Conclusion. Indoor tanning restrictions showed beneficial impact on tanning rates in adolescents in Utah. Stricter restrictions may show even greater impact than restrictions that allow for parental waivers. Stronger enforcement of bans is needed to further reduce youth access.
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Guy GP, Berkowitz Z, Tai E, Holman DM, Everett Jones S, Richardson LC. Indoor tanning among high school students in the United States, 2009 and 2011. JAMA Dermatol 2014; 150:501-11. [PMID: 24577222 DOI: 10.1001/jamadermatol.2013.7124] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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.
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Vogel RI, Ahmed RL, Nelson HH, Berwick M, Weinstock MA, Lazovich D. Exposure to indoor tanning without burning and melanoma risk by sunburn history. J Natl Cancer Inst 2014; 106:dju219. [PMID: 25031276 DOI: 10.1093/jnci/dju219] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case-control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning-related burns, stratified by their number of lifetime sunburns (0, 1-2, 3-5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure.
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Affiliation(s)
- Rachel Isaksson Vogel
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Rehana L Ahmed
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Heather H Nelson
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Marianne Berwick
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Martin A Weinstock
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - DeAnn Lazovich
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
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Leong CM, Palos GR. Oncology Nurses and Indoor Tanning: Stylish or Risky Behavior? Clin J Oncol Nurs 2014; 18:363-5. [DOI: 10.1188/14.cjon.363-365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Vogel RI, Ahmed RL, Nelson HH, Berwick M, Weinstock MA, Lazovich D. Exposure to indoor tanning without burning and melanoma risk by sunburn history. J Natl Cancer Inst 2014; 106:dju112. [PMID: 24872541 DOI: 10.1093/jnci/dju112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Indoor tanning is carcinogenic to humans. Individuals report that they tan indoors before planning to be in the sun to prevent sunburns, but whether skin cancer is subsequently reduced is unknown. Using a population-based case-control study, we calculated the association between melanoma and indoor tanning after excluding exposed participants reporting indoor tanning-related burns, stratified by their number of lifetime sunburns (0, 1-2, 3-5, >5). Confounding was addressed using propensity score analysis methods. All statistical tests were two-sided. We observed increased risk of melanoma across all sunburn categories for participants who had tanned indoors without burning compared with those who never tanned indoors, including those who reported zero lifetime sunburns (odds ratio = 3.87; 95% confidence interval = 1.68 to 8.91; P = .002). These data provide evidence that indoor tanning is a risk factor for melanoma even among persons who reported never experiencing burns from indoor tanning or outdoor sun exposure.
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Affiliation(s)
- Rachel Isaksson Vogel
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Rehana L Ahmed
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Heather H Nelson
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Marianne Berwick
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - Martin A Weinstock
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW)
| | - DeAnn Lazovich
- Affiliations of authors: Masonic Cancer Center (RIV, HHN, DL), Department of Dermatology (RLA), and Division of Epidemiology and Community Health (HHN, DL), University of Minnesota, Minneapolis, MN; Department of Internal Medicine and University of New Mexico Cancer Center, Albuquerque, NM (MB); Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM (MB); Dermatoepidemiology Unit, VA Medical Center, Providence, RI (MAW); Department of Dermatology, Rhode Island Hospital, Providence, RI (MAW); Departments of Dermatology and Community Health, Brown University, Providence, RI (MAW).
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Guy GP, Berkowitz Z, Jones SE, Olsen EO, Miyamoto JN, Michael SL, Saraiya M. State indoor tanning laws and adolescent indoor tanning. Am J Public Health 2014; 104:e69-74. [PMID: 24524515 PMCID: PMC4025696 DOI: 10.2105/ajph.2013.301850] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Recently, several state indoor tanning laws, including age restrictions, were promulgated to reduce indoor tanning among minors. We examined the effects of these laws on adolescent indoor tanning. METHODS We used nationally representative data from the 2009 and 2011 national Youth Risk Behavior Surveys (n = 31 835). Using multivariable logistic regression, we examined the association between state indoor tanning laws and indoor tanning among US high school students. RESULTS Female students in states with indoor tanning laws were less likely to engage in indoor tanning than those in states without any laws. We observed a stronger association among female students in states with systems access, parental permission, and age restriction laws than among those in states without any laws. We found no significant association among female students in states with only systems access and parental permission laws or among male students. CONCLUSIONS Indoor tanning laws, particularly those including age restrictions, may be effective in reducing indoor tanning among female high school students, for whom rates are the highest. Such reductions have the potential to reduce the health and economic burden of skin cancer.
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Affiliation(s)
- Gery P Guy
- Gery P. Guy Jr, Zahava Berkowitz, and Mona Saraiya are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones, Emily O'Malley Olsen, and Shannon L. Michael are with the Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Justin N. Miyamoto is with the Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
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Abstract
Although pediatric melanoma is a rare disease, diagnosis and management of pigmented lesions in the pediatric population, particularly dysplastic nevi and Spitz nevi, can be challenging. In this article, we provide an overview of pigmented lesions in children, including melanoma and management of melanoma risk factors and melanocytic nevi in the pediatric population. Congenital melanocytic nevi, Spitz nevi, dysplastic and acquired nevi, and changes over time are reviewed. We discuss considerations for excision and management of pigmented lesions in children.
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Affiliation(s)
- Elena B Hawryluk
- Dermatology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Marilyn G Liang
- Dermatology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Pagoto S, Hillhouse J, Heckman CJ, Coups EJ, Stapleton J, Buller D, Turrisi R, Robinson J, Geller AC. Society of Behavioral Medicine (SBM) position statement: ban indoor tanning for minors. Transl Behav Med 2014; 4:124-6. [PMID: 24653783 DOI: 10.1007/s13142-013-0240-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The Society of Behavioral Medicine (SBM), an interdisciplinary professional organization focused on the science of health behavior joins the American Academy of Dermatology, the American Academy of Pediatrics, and a host of other national and international organizations in support of a total ban on indoor tanning for minors under the age of 18. According to the International Agency for Research on Cancer, artificial sources of ultraviolet radiation are in the highest category of carcinogens, joining tobacco and asbestos. Strong evidence links indoor tanning to increased risk for melanoma with repeated exposure during childhood being associated with the greatest increase in risk. Several countries and five US states have passed legislation banning indoor tanning in minors. We strongly encourage the remaining US states to do the same in an effort to protect children and prevent new cases of melanoma. SBM also strongly encourages research that explores the use of tanning beds in the home. Home-based indoor tanning has the potential to be especially dangerous given the complete absence of safety regulations. Children are currently protected from exposure to health-harming substances like tobacco and lead; thus, legislation protecting them from artificial sources of ultraviolet radiation is yet another important step forward in improving public health.
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Affiliation(s)
- Sherry Pagoto
- University of Massachusetts Medical School, Worcester, MA USA
| | | | | | - Elliot J Coups
- University of Medicine and Dentistry New Jersey, New Brunswick, NJ USA
| | - Jerod Stapleton
- University of Medicine and Dentistry New Jersey, New Brunswick, NJ USA
| | | | - Rob Turrisi
- Penn State University, University Park, PA USA
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O’Leary RE, Diehl J, Levins PC. Update on tanning: More risks, fewer benefits. J Am Acad Dermatol 2014; 70:562-8. [DOI: 10.1016/j.jaad.2013.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/05/2013] [Accepted: 11/10/2013] [Indexed: 01/14/2023]
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The effect of a school-based intervention on sunbed use in Danish pupils at continuation schools: a cluster-randomized controlled trial. J Adolesc Health 2014; 54:214-20. [PMID: 24119418 DOI: 10.1016/j.jadohealth.2013.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/25/2013] [Accepted: 08/16/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the effect of an educational intervention on sunbed use and intentions and attitudes toward sunbed use in 14- to 18-year-olds at continuation schools. METHODS We randomized 33 continuation schools either to receive the educational intervention (n = 16) or to be controls (n = 17). Intervention schools received an e-magazine addressing the health risks of sunbed use. Information on behavior and intentions and attitudes toward sunbed use was gathered through self-administrated questionnaires before the intervention and at 6 months as a follow-up. The effect of the intervention was examined by multilevel linear regression and logistic regression. RESULTS Sunbed use was significantly lower at follow-up among pupils at intervention schools versus pupils at control schools (girls: odds ratio .60, 95% confidence interval .42-.86; Boys: odds ratio .58, 95% confidence interval .35-.96). The intervention had no effect on intention to use sunbeds or attitudes toward sunbed use. The analyses revealed a significant impact of school on attitudes toward sunbed; the intraclass correlation coefficient was estimated to be 6.0% and 7.8% for girls and boys, respectively. CONCLUSIONS The findings from the present study provide new evidence of a positive effect of an educational intervention on sunbed use among pupils aged 14-18 years at continuation schools.
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Austin SB, Gordon AR, Kennedy GA, Sonneville KR, Blossom J, Blood EA. Spatial distribution of cosmetic-procedure businesses in two U.S. cities: a pilot mapping and validation study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6832-62. [PMID: 24322394 PMCID: PMC3881144 DOI: 10.3390/ijerph10126832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/21/2013] [Accepted: 11/22/2013] [Indexed: 11/16/2022]
Abstract
Cosmetic procedures have proliferated rapidly over the past few decades, with over $11 billion spent on cosmetic surgeries and other minimally invasive procedures and another $2.9 billion spent on U.V. indoor tanning in 2012 in the United States alone. While research interest is increasing in tandem with the growth of the industry, methods have yet to be developed to identify and geographically locate the myriad types of businesses purveying cosmetic procedures. Geographic location of cosmetic-procedure businesses is a critical element in understanding the public health impact of this industry; however no studies we are aware of have developed valid and feasible methods for spatial analyses of these types of businesses. The aim of this pilot validation study was to establish the feasibility of identifying businesses offering surgical and minimally invasive cosmetic procedures and to characterize the spatial distribution of these businesses. We developed and tested three methods for creating a geocoded list of cosmetic-procedure businesses in Boston (MA) and Seattle (WA), USA, comparing each method on sensitivity and staff time required per confirmed cosmetic-procedure business. Methods varied substantially. Our findings represent an important step toward enabling rigorous health-linked spatial analyses of the health implications of this little-understood industry.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA; E-Mail:
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +1-617-355-8194
| | - Allegra R. Gordon
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA; E-Mail:
| | - Grace A. Kennedy
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
| | - Kendrin R. Sonneville
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Jeffrey Blossom
- Center for Geographic Analysis, Harvard University, Boston, MA 02115, USA; E-Mail:
| | - Emily A. Blood
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, 333 Longwood Ave., #634, Boston, MA 02115, USA; E-Mails: (G.A.K.); (K.R.S.); (E.A.B.)
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Clinical Research Center, Boston Children’s Hospital, Boston, MA 02115, USA
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Grewal SK, Haas AF, Pletcher MJ, Resneck JS. Compliance by California tanning facilities with the nation’s first statewide ban on use before the age of 18 years. J Am Acad Dermatol 2013; 69:883-889.e4. [DOI: 10.1016/j.jaad.2013.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 08/31/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
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Abstract
In Denmark, melanoma is the most common type of cancer in individuals aged 15-34 years. Ultraviolet radiation from sunbeds is a risk factor for melanoma. Knowledge of the characteristics of sunbed users is important in the development and implementation of prevention strategies of sunbed use. The objective of this study was to examine sunbed use and its association with smoking, parental socioeconomic status (SES), friends' attitudes towards artificial tanning, and school environment among adolescents aged 14-18 years at continuation schools in Denmark. We conducted a survey among adolescents in Danish continuation schools in 2011. We examined sunbed use and its association with age, smoking, friends' attitudes towards artificial tanning, parental SES, and shared environment of the continuation school, using logistic regression. Within the past 12 months, 38% of the pupils had used a sunbed (70% girls and 28% boys). There was no difference in sunbed use according to age. Smoking and friends' positive attitudes towards, and higher use of sunbeds were associated with increased use of sunbeds. High SES of mothers' was associated with lower odds for sunbed use among girls. The association of school environment with sunbed use was modest compared with the other variables. Adolescents in continuation schools report a higher use of sunbeds than Danish adolescents as such. Educational interventions should be targeted at preteens, as sunbed use is common in 14-year-olds. Special educational tools are tested in the continuation school environment and may prove effective in this population.
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Using research data to impact consumer protection legislation: lessons learned from CITY100 dissemination efforts. Transl Behav Med 2013; 3:264-70. [PMID: 24073177 DOI: 10.1007/s13142-012-0182-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The Correlates of Indoor Tanning in Youth (CITY100) project evaluated individual, built-environmental, and policy correlates of indoor tanning by adolescents in the 100 most populous US cities. After CITY100's completion, the research team obtained supplemental dissemination funding to strategically share data with stakeholders. The primary CITY100 dissemination message was to encourage state-level banning of indoor tanning among youth. We created a user-friendly website to broadly share the most relevant CITY100 data. Journalists were a primary target audience, as were health organizations that would be well positioned to advocate for legislative change. CITY100 data were used to pass the first US state law to ban indoor tanning among those under 18 (CA, USA), as well as in other legislative advocacy activities. This paper concludes with lessons learned from CITY100 dissemination activities that we hope will encourage more health researchers to proactively address policy implications of their data and to design relevant, effective dissemination strategies.
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Gosis B, Sampson BP, Seidenberg AB, Balk SJ, Gottlieb M, Geller AC. Comprehensive evaluation of indoor tanning regulations: a 50-state analysis, 2012. J Invest Dermatol 2013; 134:620-627. [PMID: 23974917 DOI: 10.1038/jid.2013.357] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 07/06/2013] [Accepted: 07/20/2013] [Indexed: 12/17/2022]
Abstract
Teenage use of indoor tanning has reached epidemic proportions. There is no federal ban on teen use; rather, it is left to each state to determine policy. We conducted a state-by-state analysis using data from each state's statutes and regulations and supplementary information from the National Conference of State Legislatures. First, we refined an earlier 35-item instrument to now include 56 items that extensively measures age bans, parental involvement, warnings/information, enforcement, and operating requirements. To grade each tanning law, we developed a uniform scoring system with a goal of providing performance data for future comparisons. As of August 2012, 13 states had no tanning facility statute or regulation for minors. In states with some regulations, teen bans are lax-nearly uniformly, most young children under the age of 14 can legally tan with or without suboptimal parental consent or accompaniment laws. Strong Food and Drug Administration involvement can simplify and unify the inconsistencies that exist among states' indoor tanning laws. Until consistent regulations are promulgated and enforced, such an instrument can provide a benchmark for state investigations into the deficiencies and progress of their laws, as well as facilitate direct comparison between states for research and educational purposes.
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Affiliation(s)
- Bridget Gosis
- Harvard School of Public Health, Boston, Massachusetts, USA
| | - Blake P Sampson
- Boise Internal Medicine Residency, University of Washington School of Medicine, Boise, Idaho, USA
| | | | - Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mark Gottlieb
- Public Health Advocacy Institute at Northeastern University School of Law, Boston, Massachusetts, USA
| | - Alan C Geller
- Harvard School of Public Health, Boston, Massachusetts, USA.
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Lee SI, Macherianakis A, Roberts LM. Sunbed use, attitudes, and knowledge after the under-18s ban: a school-based survey of adolescents aged 15 to 17 years in Sandwell, United Kingdom. J Prim Care Community Health 2013; 4:265-74. [PMID: 23799669 DOI: 10.1177/2150131913482142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sunbed use in childhood increases risk of melanoma. The under-18s sunbed ban was introduced in England, April 2011. Impact on use has not been investigated since. This cross-sectional study estimates the prevalence of under-18s' use in Sandwell after the commercial ban and identifies factors associated with use/intention. METHODS Adolescents aged 15 to 17 years in schools were surveyed using self-completed anonymous questionnaires. Data collected include demographics, sunbed use, tanning attitudes, knowledge of risks and ban awareness. All Sandwell schools were approached; adolescents available on the survey days were included. RESULTS Five out of 22 schools participated, 407 adolescents responded (95.1%). Twenty participants (5.3%; 95% confidence interval [CI] = 3.4-8.0) had used sunbeds, of who 16 reported use in commercial settings. After exclusion of one school cohort with atypical use (possibly associated with beauty vocational course and European migrants), the prevalence of use was 1.7% (95% CI = 0.7-3.9, n = 5). Less than half of all were aware of the ban (48.2%; 95% CI = 43.2-53.3). Users/potential users were less aware of associated risks. Being female, having family/friends who use sunbeds increased use/intention 2- to 4-fold. CONCLUSION Strategies targeting parents, stricter enforcement, and greater publicity of the ban are needed. Further research exploring the possible association between certain vocational courses, migrants, and sunbed use is required.
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Preventing skin cancer through reduction of indoor tanning: current evidence. Am J Prev Med 2013; 44:682-9. [PMID: 23683987 PMCID: PMC4535424 DOI: 10.1016/j.amepre.2013.02.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 12/31/2022]
Abstract
Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.
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