Indoor tanning facility density in eighty U.S. cities

How Do Perceived Descriptive Norms Influence Indoor Tanning Intentions? An Application of the Theory of Normative Social Behavior

Indoor tanning bed use is highly influenced by perceived norms about a tanned appearance. The theory of normative social behavior (TNSB) details the many ways in which norms can impact intentions and behavior, but has never been assessed in the context of indoor tanning. Considering this, we conducted a survey among female university students (N = 274) to determine the extent to which the TNSB predicted intentions to use indoor tanning beds. Overall, the path model predicted about 46% of the variance in intentions, and the majority of significant indirect effects were witnessed through the outcome expectation variables included in the TNSB, suggesting that these may be the most salient mechanisms-as predicted by the TNSB-through which norms can impact tanning intentions. In light of these results, theoretical and practical implications are discussed, and specific recommendations are given to extend the predictive utility of the TNSB in the context of indoor tanning.

More skin, more sun, more tan, more melanoma

Although personal melanoma risk factors are well established, the contribution of socioeconomic factors, including clothing styles, social norms, medical paradigms, perceptions of tanned skin, economic trends, and travel patterns, to melanoma incidence has not been fully explored. We analyzed artwork, advertisements, fashion trends, and data regarding leisure-time activities to estimate historical changes in UV skin exposure. We used data from national cancer registries to compare melanoma incidence rates with estimated skin exposure and found that they rose in parallel. Although firm conclusions about melanoma causation cannot be made in an analysis such as this, we provide a cross-disciplinary, historical framework in which to consider public health and educational measures that may ultimately help reverse melanoma incidence trends.

Community variation in adolescent access to indoor tanning facilities

Melanoma rates among younger women in New Hampshire (NH) are rising. In urban studies, youth proximity to tanning facilities has been linked to indoor tanning, a proven cause of melanoma. Youth access has not been examined in rural settings. To determine on a statewide basis the influence of rurality and community income level on female students' ease of access to tanning facilities, all NH tanning facilities (N = 261) and high schools (N = 77) in 2011 were spatially and statistically analyzed to determine schools with more facilities within 2 miles of the school and greater capacity (fewer female students per facility), for indoor tanning. Schools above the state-wide average for both measures were classified as "Easy Access" to indoor tanning. Among NH high schools, 74 % have 1 or more tanning facility within two miles and 22 % have "Easy Access" to tanning facilities. Ease of access did not differ by rurality. Lower-income school status was an independent predictor of both greater capacity and "Easy Access". While urban and rural teens have similar access to indoor tanning, female students in lower-income communities have easier access. Variations in access by community size and income must be considered in planning interventions to address youth indoor tanning.

Adolescents' use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy-level correlates

OBJECTIVES

We evaluated psychosocial, built-environmental, and policy-related correlates of adolescents' indoor tanning use.

METHODS

We developed 5 discrete data sets in the 100 most populous US cities, based on interviews of 6125 adolescents (aged 14-17 years) and their parents, analysis of state indoor tanning laws, interviews with enforcement experts, computed density of tanning facilities, and evaluations of these 3399 facilities' practices regarding access by youths. After univariate analyses, we constructed multilevel models with generalized linear mixed models (GLMMs).

RESULTS

In the past year, 17.1% of girls and 3.2% of boys had used indoor tanning. The GLMMs indicated that several psychosocial or demographic variables significantly predicted use, including being female, older, and White; having a larger allowance and a parent who used indoor tanning and allowed their adolescent to use it; and holding certain beliefs about indoor tanning's consequences. Living within 2 miles of a tanning facility also was a significant predictor. Residing in a state with youth-access legislation was not significantly associated with use.

CONCLUSIONS

Current laws appear ineffective in reducing indoor tanning; bans likely are needed. Parents have an important role in prevention efforts.

Density of indoor tanning facilities in 116 large U.S. cities

BACKGROUND

U.S. adolescents and young adults are using indoor tanning at high rates, even though it has been linked to both melanoma and squamous cell cancer. Because the availability of commercial indoor tanning facilities may influence use, data are needed on the number and density of such facilities.

METHODS

In March 2006, commercial indoor tanning facilities in 116 large U.S. cities were identified, and the number and density (per 100,000 population) were computed for each city. Bivariate and multivariate analyses conducted in 2008 tested the association between tanning-facility density and selected geographic, climatologic, demographic, and legislative variables.

RESULTS

Mean facility number and density across cities were 41.8 (SD=30.8) and 11.8 (SD=6.0), respectively. In multivariate analysis, cities with higher percentages of whites and lower ultraviolet (UV)index scores had significantly higher facility densities than those with lower percentages of whites and higher UV index scores.

CONCLUSIONS

These data indicate that commercial indoor tanning is widely available in the urban U.S., and this availability may help explain the high usage of indoor tanning.

Measuring the stringency of states' indoor tanning regulations: instrument development and outcomes

OBJECTIVES

We sought to describe the development of an instrument to quantify the stringency of state indoor tanning legislation in the United States, and the instrument's psychometric properties. The instrument was then used to rate the stringency of state laws.

METHODS

A 35-item instrument was developed. An overall stringency measure and 9 stringency subscales were developed, including one measuring minors' access to indoor tanning. Stringency measures showed good internal consistency and interrater reliability.

RESULTS

In all, 55% of the 50 states and the District of Columbia had any indoor tanning law, and 41% had any law addressing minors' access. Oregon, Illinois, South Carolina, Florida, Indiana, Iowa, and Rhode Island had high overall stringency scores, and Texas and New Hampshire were the most restrictive with regard to minors' access.

LIMITATIONS

Measurement of actual enforcement of the laws was not included in this study.

CONCLUSIONS

The instrument appears to be an easy-to-use, reliable, and valid methodology. Application of the instrument to actual laws showed that, in general, state laws are relatively weak, although there was considerable variability by state.