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For most teens, getting a tan
during spring break or in preparation for the prom is as
common as these rites of passage themselves. Although
teens hear dermatologists’ warnings that tanning is the
most avoidable risk factor in the prevention of skin
cancer, studies find they forgo this advice in favor of
the bronzed look.
Speaking at the American
Academy of Dermatology’s (AAD) Melanoma/Skin Cancer
Detection and Prevention Month news conference,
dermatologist James M. Spencer, M.D., vice chairman,
department of dermatology, Mount Sinai School of Medicine
in New York City, addressed the incidence of teens and
tanning and how the AAD is trying to combat it.
Alarming Trends This year,
more than 1 million new cases of skin cancer will be
diagnosed in the United States – exceeding the incidence
of all other cancers combined. It is estimated that there
will be about 95,880 new cases of melanoma (the deadliest
form of skin cancer) in 2004, which represents a 4 percent
increase in new cases of melanoma from 2003.
“While many health issues
are complex and involve multiple factors, in the case of
skin cancer we know that ultraviolet light is the culprit
and avoiding excessive exposure is the solution,” said
Dr. Spencer. “Yet despite this knowledge, the number of
skin cancers continues to rise each year. Even more
disheartening is the fact that teens continue to tan
despite the known health risks.”
A national study of 6,903
non-Hispanic white adolescents – between the ages of 13
and 19 – found that indoor tanning is not only
prevalent, but influenced by factors such as demographics,
the use of controlled substances (e.g., alcohol, tobacco
and marijuana), appearance-related factors (e.g.,
dieting), and psychosocial factors (e.g., cognitive
ability). The study, “Use of Indoor Tanning Facilities
by White Adolescents in the United States,” was
published in the September 2003 issue of Archives of
Pediatric Adolescent Medicine.
Overall, when taking the
national population into consideration, the number of
young women who reported using a tanning booth at least
once far outweighed the number of young men who engaged in
this activity (36.8 percent vs. 11.2 percent,
respectively). The number of young women who reported
using tanning booths also increased with age. The study
found that 47 percent of young women aged 18 to 19 years
old reported using a tanning booth three or more times,
compared with 11.2 percent of 13- to 14-year-old girls.
Geographic region greatly
influenced the likelihood of using an indoor tanning
facility, with adolescents in the Midwest and South being
two to three times more likely to use tanning booths than
the rest of the country. In addition, teens that attended
a rural high school were more likely to report using an
indoor tanning facility than their counterparts at urban
high schools.
“This study confirms that
despite the risk, indoor tanning seems to be increasingly
popular with young people – and particularly young
women,” said Dr. Spencer. “It’s unfortunate that the
pressure these teens face to conform to cosmetic ideals
presented in popular culture and advertising is so
powerful, even with all we know about the dangers of
tanning.”
Dermatologists Take Action
Indoor tanning is a booming
business in the United States, generating estimated
revenues in excess of $5 billion dollars a year. Most
salons use bulbs in their tanning beds that emit a
significant amount of UVB and UVA radiation – both of
which are associated with the development of skin cancer
and premature aging. In fact, the Department of Health and
Human Services has added UV radiation from the sun or
artificial light sources such as tanning beds and sun
lamps to the government’s list of known carcinogens.
The manufacturers of indoor
tanning equipment are regulated at the federal level. Once
manufacturers sell the equipment to a tanning salon, it is
generally up to the states to regulate their operations.
While 29 states regulate tanning salon operators, the
legislation varies in severity and there is limited
enforcement. While some states go so far as to prohibit
access to tanning booths by minors without parental
consent, some require salon owners to post warning signs
in a visible location in the salon, and others may only
establish educational and training standards for tanning
salon operators.
“Even in those states
that have some elementary safety regulations, it is not
clear who would enforce them,” explained Dr. Spencer.
“That means children and teens have open access to
equipment that appears to be utilized in an often careless
fashion. We applaud states like Texas, California and
Tennessee that have worked feverishly to enact tough
legislation restricting the use of indoor tanning
facilities, especially among minors. But more states need
to take their lead and enforce regulations that limit
access to this dangerous activity.”
The American Academy of
Dermatology Association (AADA) recently issued a new
position statement on indoor tanning, encouraging states
to aggressively pursue legislation that protects children
and urging the Food and Drug Administration (FDA) to take
action that will ban the sale and use of tanning equipment
for non-medical purposes. Specifically, the AADA supports
the following requirements for indoor tanning facilities:
No minor should be
permitted to use tanning devices. A Surgeon General’s
warning should be placed on all tanning devices.
No person or facility
should advertise the use of any Ultraviolet A or
Ultraviolet B tanning device using wording such as
“safe,” “safe tanning,” “no harmful rays,”
“no adverse effect,” or similar wording or concepts.
“Throughout most of the
country, none of the basic safety measures that we are
proposing are required,” explained Dr. Spencer.
“Research has shown that indoor tanning is dangerous,
and there should be laws to protect children from engaging
in this activity as there are from other unhealthy
behaviors such as drinking or smoking. We urge all states
to take immediate action to prohibit indoor tanning for
minors.”
In addition to the AADA’s
call for tighter regulations, the AAD is targeting teens
with print and broadcast public service announcements
(PSAs) on the dangers of tanning that are scheduled to be
released nationwide to the media this summer.
“We conducted focus group
testing with teens across the country and found that while
teens know that overexposure to the sun can cause skin
cancer and premature aging, they are reluctant to change
their behavior because they feel more attractive with a
tan,” said Dr. Spencer. “For our new PSA campaign, we
used this research to develop the messages and images that
almost force teens to stop and re-examine their behavior.
If we’re successful in getting even one teen to change
his or her behavior, that’s one life we eventually might
save.”
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