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Original Investigation
March 3, 2017

Prevalence of Indoor Tanning and Association With Sunburn Among Youth in the United States

Author Affiliations
  • 1Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
  • 2Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
JAMA Dermatol. Published online March 3, 2017. doi:10.1001/jamadermatol.2016.6273
Key Points

Question  What are the trends in the prevalence of indoor tanning and the association between indoor tanning and sunburn among US high school students?

Findings  This analysis of cross-sectional, nationally representative data from US high school students found a substantial reduction in indoor tanning among US high school students from 2009 to 2015. Indoor tanning was associated with sunburn, with three-quarters of indoor tanners experiencing at least 1 sunburn.

Meaning  Public health and medical community efforts are needed to further reduce the prevalence of indoor tanning and sunburn and thus prevent future cases of skin cancer.

Abstract

Importance  Indoor tanning and sunburns, particularly during adolescence and young adulthood, increase the risk of developing skin cancer.

Objective  To examine the trends in the prevalence of indoor tanning and the association between indoor tanning and sunburn among US high school students.

Design, Setting, and Participants  This study pooled and examined cross-sectional data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Survey. During 2009, 2011, 2013, and 2015, the overall response rates were 71%, 71%, 68%, and 60%, respectively, and unweighted sample sizes were 16 410, 15 425, 13 538, and 15 624, respectively. It included nationally representative samples of US high school students. Data were collected during the spring semester (January to June) in each survey cycle beginning February 9, 2009, through June 18, 2015.

Main Outcomes and Measures  Prevalence of indoor tanning in the past year from 2009 to 2015 and its association with sunburn in 2015.

Results  Among high school students in the United States, the prevalence of indoor tanning decreased from 15.6% (95% CI, 13.7%-17.6%) in 2009 to 7.3% (95% CI, 6.0%-8.9%) in 2015. Decreases in indoor tanning were found among male (from 6.7% in 2009 to 4.0% in 2015) and female (from 25.4 % in 2009 to 10.6 % in 2015) students overall, non-Hispanic white (from 21.1 % in 2009 to 9.4% in 2015) and Hispanic (from 8.2% in 2009 to 4.7% in 2015) students overall, and all age groups. Among non-Hispanic white female students, the prevalence decreased from 37.4% (95% CI, 33.6%-41.4%) in 2009 to 15.2% (95% CI, 11.7%-19.5%) in 2015. In 2015, indoor tanning was associated with sunburn in the adjusted model: 82.3% (95% CI, 77.9%-86.0%) of indoor tanners had at least 1 sunburn during the preceding year compared with 53.7% (95% CI, 48.9%-58.4%) of those who did not engage in indoor tanning (P < .001).

Conclusions and Relevance  Despite declines in the prevalence of indoor tanning from 2009 to 2015 among high school students nationwide, indoor tanning remains commonplace among certain subgroups, especially non-Hispanic white female students. Three-quarters of those who engaged in indoor tanning had experienced at least 1 sunburn. Efforts by the public health and medical communities are needed to further reduce the prevalence of indoor tanning and sunburn and thus prevent future cases of skin cancer.

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