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Brief Report
September 2, 2020

Prevalence and Location of Indoor Tanning Among High School Students in New Jersey 5 Years After the Enactment of Youth Access Restrictions

Author Affiliations
  • 1Markey Cancer Center, University of Kentucky, Lexington
  • 2Department of Health, Behavior & Society, University of Kentucky College of Public Health, Lexington
  • 3Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, New Jersey
  • 4Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey
  • 5Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick
  • 6now at Medical Data Analytics, Parsippany, New Jersey
JAMA Dermatol. Published online September 2, 2020. doi:10.1001/jamadermatol.2020.2935
Key Points

Question  Are state restrictions that ban minors from using indoor tanning beds effective in reducing the prevalence of indoor tanning among high school students?

Finding  Data from cross-sectional surveys conducted between 2012, the year prior to indoor tanning restrictions, and 2018 showed that the prevalence of tanning decreased among all minors younger than the legal tanning age and among female students older than the legal tanning age. The prevalence among minors of tanning in salons and nonsalon unregulated locations was similar.

Meaning  This study provides unique evidence supporting the benefit of enacting new regulatory efforts that restrict indoor tanning access among minors and extending existing restrictions to address unsupervised nonsalon tanning.


Importance  Several state governments have enacted bans on the use of indoor tanning beds at tanning salons among minors, but studies of the association of such restrictions with tanning behavior have produced mixed results. Little is known about the prevalence of tanning in nonsalon locations that are typically not covered by restrictions. Evidence that age bans are associated with a reduction in tanning bed use is needed to support policy makers’ efforts to expand tanning regulations.

Objective  To determine the prevalence and location of indoor tanning among New Jersey youths after a 2013 statewide indoor tanning ban for minors younger than 17 years.

Design, Setting, and Participants  This survey study comprised 4 biennial (2012-2018) and representative cross-sectional surveys conducted among 12 659 high school students (grades 9-12) in New Jersey.

Main Outcomes and Measures  The main outcome was the frequency of indoor tanning in the past year. Location of tanning bed use (ie, tanning salons or nonsalon locations, such as private residences or gyms) was also assessed.

Results  Survey responses from a total of 12 659 high school students (6499 female [51%]; mean [SD] age, 15.8 [1.3] years) were analyzed across the 4 survey waves. Tanning prevalence among students younger than 17 years (ie, younger than the legal tanning age) was 48% lower in 2018 compared with 2012 (adjusted odds ratio, 0.52; 95% CI, 0.33-0.81; P = .002). Tanning prevalence was 72% lower among female students 17 years or older (adjusted odds ratio, 0.28; 95% CI, 0.18-0.44; P < .001). Prevalence rates were not significantly different for male students 17 years or older and for racial/ethnic minority students. The prevalence of tanning in salons and private residences was similar among students younger than 17 years.

Conclusions and Relevance  This study suggests that the prevalence of tanning in New Jersey has begun to decrease among all youths younger than the legal tanning age and among female students of legal age in the 5 years after a statewide tanning ban. These findings provide valuable evidence to policy makers to support ongoing state-level efforts to enact age-specific bans on indoor tanning. The unique assessment of tanning location demonstrates the need for both greater enforcement of existing tanning salon regulations to ensure compliance and broadening restrictions to cover nonsalon tanning locations.

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