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Newton J, Ochoa L, Reinschmidt A, Vassar J, Wellman A, Vargas M, Kenyon D, Frohm M. Is beauty worth the risk? Self-confidence is the key motivating factor driving tanning bed use among undergraduate students at South Dakota universities. Int J Womens Dermatol 2024; 10:e128. [PMID: 38572264 PMCID: PMC10986912 DOI: 10.1097/jw9.0000000000000128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/16/2023] [Indexed: 04/05/2024] Open
Abstract
Background Exposure to ultraviolet radiation is a leading risk factor for developing all types of skin cancer. In the United States, an estimated 7.8 million young adults engage in indoor tanning. Objective Here, it is hypothesized that certain populations of students at undergraduate universities, namely sorority members, have a greater frequency of tanning bed usage than other groups of students and that regardless of sorority status, the most important motivating factor will be the intent to enhance one's appearance. Methods Undergraduate students at 2 state-funded universities were recruited for participation in this institutional review board-exempt survey via distribution to e-mail addresses and social media accounts affiliated with student organizations/clubs. Results Among all respondents, the most common motivating factors for tanning bed use were the perception of improved self-appearance and boosted self-confidence. Female sorority members were more likely to use tanning beds and also more likely to report being motivated by enhanced appearance and self-confidence, than their female counterparts who were not sorority members. Limitations The sample size (n = 321) and population of this study allows data to only be generalizable to surrounding states with similar demographics. The findings of this study are subject to recall bias as the data is self-reported. Conclusion Tanning bed use remains a popular practice among young people. Understanding motivations for tanning bed use among populations at increased risk of partaking in this behavior allows for educating these groups on the risks associated with ultraviolet radiation exposure. It is crucial that providers continue to promote skin health and take steps to dissuade detrimental practices and possible habit-forming behaviors at the individual and state levels.
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Affiliation(s)
- Jazmin Newton
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Lauren Ochoa
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Aly Reinschmidt
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - John Vassar
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Allen Wellman
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Minga Vargas
- Office of Diversity and Inclusion, University of South Dakota School of Health Sciences, Vermillion, South Dakota
| | - DenYelle Kenyon
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
- Office of Diversity and Inclusion, University of South Dakota School of Health Sciences, Vermillion, South Dakota
| | - Marcus Frohm
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
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Wilkerson AH, Davis RE, Sharma M, Harmon MB, McCowan HK, Mockbee CS, Ford MA, Nahar VK. Use of the multi-theory model (MTM) in explaining initiation and sustenance of indoor tanning cessation among college students. Arch Dermatol Res 2023; 315:191-199. [PMID: 35235004 DOI: 10.1007/s00403-022-02338-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/22/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
Skin cancer, including melanoma, is the most common cancer worldwide and a significant public health concern. A significant risk factor for melanoma is through increased exposure to ultraviolet (UV) radiation through the use of indoor tanning beds. Although rates of indoor tanning bed use have decreased in recent years, young adults, particularly White, college-age women, comprise the majority of indoor tanning bed users in the United States. The purpose of this cross-sectional study was to explore and explain the initiation and sustenance of indoor tanning cessation among college students using the multi-theory model (MTM) of health behavior change. Data were collected from 254 college students who reported current indoor tanning use using a validated 46-item survey to assess demographics and the MTM constructs. Data were analyzed using multiple linear regression to determine the ability of the MTM constructs to predict the initiation and sustenance of indoor tanning cessation. For initiation of indoor tanning cessation, participatory dialogue: advantages (B = 0.038, p = 0.001), behavioral confidence (B = 0.129, p < 0.001) and changes in the physical environment (B = 0.088, p < 0.001) were significantly associated with indoor tanning cessation following covariate adjustment. For sustenance, only emotional transformation (B = 0.140, p < 0.001) demonstrated a significant relationship with indoor tanning cessation, following adjustment. Findings from this study demonstrate the utility of the MTM in explaining indoor tanning cessation and designing intervention strategies and clinical recommendations to encourage indoor tanning cessation among college students.
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Affiliation(s)
- Amanda H Wilkerson
- Department of Health Science, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Robert E Davis
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Mallory B Harmon
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street - L216, Jackson, MS, 39216, USA
| | - Hannah K McCowan
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street - L216, Jackson, MS, 39216, USA
| | - Chelsea S Mockbee
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street - L216, Jackson, MS, 39216, USA
| | - M Allison Ford
- Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, Jackson, MS, USA
| | - Vinayak K Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street - L216, Jackson, MS, 39216, USA. .,Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
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3
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Stapleton JL, Ray AE, Glenn SD, McLouth LE, Parmar V, Manne SL. A randomized controlled trial of a web-based personalized feedback intervention targeting frequent indoor tanning bed users: Engagement, acceptability, and preliminary behavioral outcomes. J Health Psychol 2020; 27:923-935. [PMID: 33353412 DOI: 10.1177/1359105320982038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Frequent indoor tanning bed use is an established public health concern, yet research on tanning cessation interventions for frequent tanners is lacking. We describe the protocol for a brief, web-based tanning behavior change intervention and present evidence that it is acceptable and engaging to frequent indoor tanners. Lower tanning rates were not observed among participants receiving the intervention in a randomized controlled trial but participants' interest in changing tanning increased. This intervention could be a useful approach to increasing frequent tanners' interest in behavior change and openness to engaging within a more intensive, multi-component tanning cessation program.Trial Registration: NCT03448224 Clinical Trials.gov (https://clinicaltrials.gov/ct2/show/NCT03448224?cond=NCT03448224&draw=2&rank=1).
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Affiliation(s)
| | - Anne E Ray
- University of Kentucky College of Public Health, USA
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Bowers JM, Geller AC, Schofield E, Li Y, Hay JL. Indoor Tanning Trends Among US Adults, 2007-2018. Am J Public Health 2020; 110:823-828. [PMID: 32298165 DOI: 10.2105/ajph.2020.305605] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine indoor tanning trends among US adults, and the relation to indoor tanning youth access legislation.Methods. This study analyzed the Health Information National Trends Survey (HINTS), a mailed survey, from the years 2007, 2011, 2013, 2014, 2017, and 2018 (combined n = 20 2019).Results. Indoor tanning prevalence decreased significantly over time among all US adults from 2007 (10%) to 2018 (4%; P < .001), among young adults aged 18 to 34 years (14% to 4%; P < .001), and among both women (14% to 4%; P < .001) and men (5% to 4%; P < .05). Indoor tanning significantly decreased in states that enacted youth access legislation by 2018, but did not significantly decrease for other states. Frequent indoor tanning was common in 2018; about one quarter of respondents who reported any indoor tanning did so 25 times or more in the past year.Conclusions. This study identifies several challenges in continuing to reduce indoor tanning in the United States. Youth access legislation may be effective for reducing tanning among the broader population of tanners; however, there remains a need for focus on highly frequent tanners, as well as men.
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Affiliation(s)
- Jennifer M Bowers
- Jennifer M. Bowers, Elizabeth Schofield, Yuelin Li, and Jennifer L. Hay are with the Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY. Jennifer M. Bowers is also with the Department of Psychology, Stony Brook University, Stony Brook, NY. Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Alan C Geller
- Jennifer M. Bowers, Elizabeth Schofield, Yuelin Li, and Jennifer L. Hay are with the Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY. Jennifer M. Bowers is also with the Department of Psychology, Stony Brook University, Stony Brook, NY. Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Elizabeth Schofield
- Jennifer M. Bowers, Elizabeth Schofield, Yuelin Li, and Jennifer L. Hay are with the Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY. Jennifer M. Bowers is also with the Department of Psychology, Stony Brook University, Stony Brook, NY. Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Yuelin Li
- Jennifer M. Bowers, Elizabeth Schofield, Yuelin Li, and Jennifer L. Hay are with the Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY. Jennifer M. Bowers is also with the Department of Psychology, Stony Brook University, Stony Brook, NY. Alan C. Geller is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Jennifer L Hay
- Jennifer M. Bowers, Elizabeth Schofield, Yuelin Li, and Jennifer L. Hay are with the Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY. Jennifer M. Bowers is also with the Department of Psychology, Stony Brook University, Stony Brook, NY. 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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5
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Sypes EE, McWhirter JE. Content Analysis of Health Warning Labels for Indoor Tanning in the United States. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1571965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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6
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Bowers JM, Moyer A. 'I am happier with my fairer complexion': factors associated with former indoor tanning and reasons for quitting in college women. PSYCHOL HEALTH MED 2018; 24:344-354. [PMID: 30354529 DOI: 10.1080/13548506.2018.1537497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study of 312 female undergraduates investigated the association of recently, formerly, or never indoor tanning with self-perceptions and social influence, and examined reasons to tan and not to tan. Previous research on indoor tanning has focused on recent or current tanners, and few studies have examined former indoor tanners. By examining self-perceptions and social influence, this study aimed to understand how these common tanning correlates, measured in former indoor tanners, compared to those who have never tanned indoors (i.e., never tanners) and those who have recently tanned indoors. Appearance and global self-perceptions were more positive in former indoor tanners compared to never tanners and recent tanners. Recent indoor tanning was positively associated with both higher outdoor tanning frequency and having a higher number of friends performing skin cancer risk behaviors, and formerly indoor tanning was also associated with both, but to a lesser extent. Appearance and social influence were commonly described as reasons for indoor tanning, and perceived health risk, appearance, and social influence were described as prominent reasons for tanning cessation. This study improves what is known about former indoor tanners, which may be useful for behavior change maintenance efforts and developing approaches for skin cancer screening interventions.
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Affiliation(s)
- Jennifer M Bowers
- a Department of Psychology , Stony Brook University , Stony Brook , NY , USA
| | - Anne Moyer
- a Department of Psychology , Stony Brook University , Stony Brook , NY , USA
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Glanz K, Jordan A, Lazovich D, Bleakley A. Frequent Indoor Tanners' Beliefs About Indoor Tanning and Cessation. Am J Health Promot 2018; 33:293-299. [PMID: 29973065 DOI: 10.1177/0890117118784235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Indoor tanning is associated with an increased risk of developing skin cancer. In the United States, nearly 1 in 5 white women aged 18 to 25 are indoor tanners. This study elicited beliefs about tanning indoors and quitting/cutting back on indoor tanning. DESIGN Semi-structured interviews. PARTICIPANTS AND SETTING Forty 18- to 25-year-old white females who engaged in frequent indoor tanning participated in either in-person or telephone interviews. Most were college students from southeastern Pennsylvania and Delaware. METHOD A semi-structured interview was used to elicit beliefs about indoor tanning and quitting or cutting back. Data analyses using NVivo and multiple coders identified key themes about going and quitting/cutting back on indoor tanning. RESULTS Key themes stated as reasons for indoor tanning included improving physical appearance, social acceptance, increased confidence, and happiness. The main themes identified as advantages of quitting/cutting back on indoor tanning were to decrease skin cancer risk and save money. Perceived disadvantages of quitting/cutting back included themes of concerns about being pale and a decline in self-confidence. The prospect of saving money and warm weather were seen as facilitating quitting/cutting back. CONCLUSION Findings suggest the necessity of addressing appearance concerns, psychological benefits associated with feeling more attractive, and short-term gains such as saving money. These findings provide a foundation for developing effective anti-indoor tanning communication.
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Affiliation(s)
- Karen Glanz
- 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 2 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Jordan
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - DeAnn Lazovich
- 4 School of Public Health, University of Minnesota, MN, USA
| | - Amy Bleakley
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
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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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9
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Stapleton JL, Hillhouse J, Levonyan-Radloff K, Manne SL. Review of interventions to reduce ultraviolet tanning: Need for treatments targeting excessive tanning, an emerging addictive behavior. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017. [PMID: 28639816 DOI: 10.1037/adb0000289] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Millions of Americans engage in tanning each year, defined as intentional ultraviolet radiation (UVR) exposure in the form of sunbathing or the use of indoor tanning beds. An emerging body of research suggests that UVR has addictive properties and some tanners engage in excessive tanning. This article provides an overview of the evidence of tanning addiction and a systematic review of existing tanning interventions with the goal of evaluating their potential to impact addicted tanners. Our search identified 24 intervention studies that were summarized and discussed according to 3 primary themes. First, there is a dearth of tanning interventions that target excessive tanning or are designed as treatments for tanning addiction. Second, tanning interventions are primarily educational interventions designed to increase knowledge of the risks of tanning. Third, there are notable aspects of existing tanning interventions that are relevant to addiction science, including the use of brief motivational and cognitive-behavioral-based interventions. Future directions are considered including recommendations for utilizing the existing evidence base to formulate interventions targeting excessive tanners. (PsycINFO Database Record
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Affiliation(s)
- Jerod L Stapleton
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey
| | - Joel Hillhouse
- Department of Community and Behavioral Health, East Tennessee State University College of Public Health
| | | | - Sharon L Manne
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey
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10
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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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12
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Myrick JG, Noar SM, Kelley D, Zeitany AE, Morales-Pico BM, Thomas NE. A longitudinal test of the Comprehensive Indoor Tanning Expectations Scale: The importance of affective beliefs in predicting indoor tanning behavior. J Health Psychol 2016; 22:3-15. [DOI: 10.1177/1359105315595116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In order to better understand drivers of dangerous indoor tanning behaviors, researchers developed the Comprehensive Indoor Tanning Expectations scale. To examine the longitudinal effectiveness of Comprehensive Indoor Tanning Expectations, we surveyed young women in the Southeastern United States at two time points ( N = 553). The scale demonstrated strong test–retest reliability. Participants who believed indoor tanning would improve their mood and afford social approval were significantly more likely to tan 6 months later, while participants who believed indoor tanning leads to psychological/physical discomfort were significantly less likely to tan 6 months later. Knowing the psychological bases for indoor tanning can inform intervention and message design.
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Affiliation(s)
| | - Seth M Noar
- The University of North Carolina at Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, USA
| | | | | | | | - Nancy E Thomas
- The University of North Carolina at Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, USA
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Abstract
As of August 2014, 11 states in the USA have passed under-age-18 bans on indoor tanning. The Society of Behavioral Medicine, the American Academy of Dermatology, and the American Academy of Pediatrics have all issued statements in support of an under-age-18 ban. The World Health Organization and the Food and Drug Administration have both declared indoor tanning devices as carcinogenic, and this year, the Surgeon General for the first time issued a warning on the dangers of UV radiation and indoor tanning. This essay highlights how the awareness of the risks of indoor tanning, effective policies, and a conducive political atmosphere have aligned to create a window of opportunity for further under-age-18 indoor tanning legislation. The rising number of preventable skin cancers and mortalities is an issue that transcends political party lines, and now, there is a need for support from health professionals and advocates to motivate legislators to push new under-age-18 bills past their sticking points.
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