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Choy CC, Cartmel B, Clare RA, Ferrucci LM. Compliance with indoor tanning bans for minors among businesses in the USA. Transl Behav Med 2018; 7:637-644. [PMID: 28593496 DOI: 10.1007/s13142-017-0510-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Indoor tanning is a known risk factor for skin cancer and is especially dangerous for adolescents. Some states have passed indoor tanning bans for minors, but business compliance with the bans is not well understood. Thus far, studies have assessed ban compliance in one or two states at a time. This study aimed to assess compliance with indoor tanning bans for minors and knowledge of dangers and benefits of tanning among indoor tanning businesses. Female research assistants posing as minors telephoned a convenience sample of 412 businesses in 14 states with tanning bans for minors under age 17 or 18. We evaluated differences in compliance by census region and years since ban was implemented and differences in reported dangers and benefits by compliance. Most (80.1%) businesses told the "minor" caller she could not use the tanning facilities. Businesses in the south and in states with more recent bans were less compliant. Among those (n = 368) that completed the full interview, 52.2% identified burning and 20.1% mentioned skin cancer as potential dangers. However, 21.7% said dangers were no worse than the sun and 10.3% denied any dangers. Stated benefits included vitamin D (27.7%), social/cosmetic (27.2%), and treats skin diseases (26.4%), with only 4.9% reporting no benefits. While most businesses followed the indoor tanning ban when a minor called, one-fifth did not. Many stated inaccurate health claims. Additional enforcement or education might increase compliance with indoor tanning bans and action is needed to prevent businesses from stating false health information.
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Affiliation(s)
- Courtney C Choy
- Yale School of Public Health, 55 Church Street, Suite 801, New Haven, CT, 06510, USA
| | - Brenda Cartmel
- Yale School of Public Health, 55 Church Street, Suite 801, New Haven, CT, 06510, USA.,Yale Cancer Center, New Haven, CT, 06520, USA
| | - Rachel A Clare
- Yale School of Public Health, 55 Church Street, Suite 801, New Haven, CT, 06510, USA
| | - Leah M Ferrucci
- Yale School of Public Health, 55 Church Street, Suite 801, New Haven, CT, 06510, USA. .,Yale Cancer Center, New Haven, CT, 06520, USA.
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Sample A, He YY. Mechanisms and prevention of UV-induced melanoma. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 34:13-24. [PMID: 28703311 PMCID: PMC5760354 DOI: 10.1111/phpp.12329] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 02/06/2023]
Abstract
Melanoma is the deadliest form of skin cancer and its incidence is rising, creating a costly and significant clinical problem. Exposure to ultraviolet (UV) radiation, namely UVA (315-400 nm) and UVB (280-315 nm), is a major risk factor for melanoma development. Cumulative UV radiation exposure from sunlight or tanning beds contributes to UV-induced DNA damage, oxidative stress, and inflammation in the skin. A number of factors, including hair color, skin type, genetic background, location, and history of tanning, determine the skin's response to UV radiation. In melanocytes, dysregulation of this UV radiation response can lead to melanoma. Given the complex origins of melanoma, it is difficult to develop curative therapies and universally effective preventative strategies. Here, we describe and discuss the mechanisms of UV-induced skin damage responsible for inducing melanomagenesis, and explore options for therapeutic and preventative interventions.
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Affiliation(s)
- Ashley Sample
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
- Committee on Cancer Biology, University of Chicago, Chicago, IL
| | - Yu-Ying He
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
- Committee on Cancer Biology, University of Chicago, Chicago, IL
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Seidenberg AB, Noar SM, Sontag JM. Is initiating tanning bed use as a minor associated with increased risky tanning behaviors and burning? An exploratory study. Prev Med 2017; 105:15-18. [PMID: 28757448 PMCID: PMC5998669 DOI: 10.1016/j.ypmed.2017.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/19/2022]
Abstract
Tanning bed use is most common among youth and young adults, and is associated with an increased risk of skin cancer. Recently, numerous states have adopted restrictions on minors' access to tanning beds; however, little has been reported on how such policies may impact tanning behaviors and burning. The purpose of this study was to examine the associations between age of indoor tanning initiation and risky tanning behaviors and burning. Female students (n=567) attending a large southeastern public university completed a questionnaire (spring of 2015) assessing tanning bed use history, including age of initiation. The analytic sample was limited to participants reporting past year indoor tanning (n=134). Multivariable logistic regression was used to compare the odds of risky tanning behaviors and burning among those initiating indoor tanning before and after their 18th birthday. Participants initiating indoor tanning as a minor had significantly (ps<0.05) greater odds of using a tanning bed 10 or more times in the previous year, typically indoor tanning for ≥10min, ever indoor tanning without wearing goggles, and ever fallen asleep inside a tanning bed. Further, those that initiated as a minor had significantly greater odds of ever burning from indoor tanning (p<0.05). Indoor tanning initiation as a minor was associated with several risky tanning behaviors and burning. Youth access restrictions may help reduce the harms caused by tanning beds.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Jennah M Sontag
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Mays D, Atkins MB, Ahn J, Tercyak KP. Indoor Tanning Dependence in Young Adult Women. Cancer Epidemiol Biomarkers Prev 2017; 26:1636-1643. [PMID: 29051341 DOI: 10.1158/1055-9965.epi-17-0403] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/05/2017] [Accepted: 08/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background: There is mounting evidence that young people can develop a dependence on indoor tanning, but research on factors associated with indoor tanning dependence remains limited.Methods: This cross-sectional study investigated factors associated with indoor tanning dependence in a community sample of 389 non-Hispanic white young adult women ages 18 to 30 who had indoor tanned ≥1 time in the past year. Participants completed measures of indoor tanning dependence, including the modified CAGE and modified Diagnostic and Statistical Manual for Mental Disorders-IV psychiatric screening assessments, indoor tanning behavior and beliefs, and behavioral and psychiatric comorbidity.Results: Overall, 22.6% of the sample screened positive for indoor tanning dependence. In multivariable analyses, indoor tanning dependence was associated with younger age of indoor tanning initiation [adjusted odds ratio (aOR) = 0.79; P = 0.017], indoor tanning ≥20 times in the past year (aOR = 3.03; P = 0.015), stronger beliefs about the benefits of tanning (aOR = 2.15; P = 0.004), greater perceived susceptibility to indoor tanning risks (aOR = 2.72; P < 0.001), stronger beliefs about physical appearance (aOR = 1.73; P = 0.037), and depressive symptoms (aOR = 3.79; P < 0.001).Conclusions: Indoor tanning dependence among young, non-Hispanic white women is associated with behaviors that increase the risk of skin cancer, beliefs favoring the perceived benefits of tanning, and comorbid risks such as stronger beliefs about physical appearance and depressed mood.Impact: Comprehensive skin cancer prevention efforts should address indoor tanning dependence among young women and its leading risk factors. Cancer Epidemiol Biomarkers Prev; 26(11); 1636-43. ©2017 AACR.
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Affiliation(s)
- Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
| | - Michael B Atkins
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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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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Mays D, Evans WD. The Effects of Gain-, Loss-, and Balanced-Framed Messages for Preventing Indoor Tanning among Young Adult Women. JOURNAL OF HEALTH COMMUNICATION 2017; 22:604-611. [PMID: 28598730 PMCID: PMC6085748 DOI: 10.1080/10810730.2017.1332119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Indoor tanning (IT) increases the risks of skin cancer, but evidence on how to design health education messaging targeting IT among young adult women remains limited. This study investigated the effects of theory-guided gain-, loss-, and balanced-framed IT prevention messages. Young adult women ages 18-30 who indoor tan (n = 552, mean age = 24.9 years [standard deviation = 3.1]) were recruited online, completed pre-exposure measures, and were randomized to view a gain-, loss-, or balanced-framed message. Participants completed post-exposure measures of message response (emotional response, message receptivity), IT risk (perceived severity, susceptibility), and efficacy (self-efficacy, perceived benefits of avoiding IT) beliefs, and IT behavioral intentions. Loss- and balanced-framed messages promoted significantly greater emotional response and message receptivity and lower IT behavioral intentions than gain-framed messages. The effects of loss- and balanced-framed messages on IT behavioral intentions were mediated by greater emotional response and message receptivity compared with the gain-framed message. These results can inform the development of public health education campaigns to prevent and reduce IT among young adult women. Future research can build from these findings by investigating additional message themes and tailoring strategies to maximize their effects, examining the effects of framed messages prospectively, and investigating ways to enhance message receptivity, such as through novel message delivery channels (e.g., mobile devices).
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Affiliation(s)
- Darren Mays
- Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, 3300 Whitehaven Street NW, Suite 4100, Washington, DC 20007, USA
- Correspondence to: D. Mays.
| | - W. Douglas Evans
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue, NW, 2 floor, Washington, DC 20037, USA
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Evans WD, Mays D. Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study. JMIR Mhealth Uhealth 2016; 4:e137. [PMID: 28007691 PMCID: PMC5216257 DOI: 10.2196/mhealth.6493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 09/19/2016] [Accepted: 12/15/2016] [Indexed: 01/05/2023] Open
Abstract
Background Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=–2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages.
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Affiliation(s)
- William D Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Georgetown University, Washington, DC, United States
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