Tanning Salon Compliance Rates in States With Legislation to Protect Youth Access to UV Tanning | Adolescent Medicine | JAMA Dermatology | JAMA Network
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Original Investigation
January 2018

Tanning Salon Compliance Rates in States With Legislation to Protect Youth Access to UV Tanning

Author Affiliations
  • 1Department of Dermatology, Marshfield Clinic, Marshfield, Wisconsin
  • 2Department of Dermatology, University of Wisconsin–Madison
  • 3Department of Internal Medicine, Loyola University Medical Center, Maywood, Illinois
JAMA Dermatol. 2018;154(1):67-72. doi:10.1001/jamadermatol.2017.3736
Key Points

Question  How compliant are the tanning salons in 42 states and the District of Columbia with current indoor tanning legislation?

Findings  In this cross-sectional telephone survey of 427 tanning salons in 42 states and the District of Columbia, 159 tanning salons were out of compliance with state legislation. Statistically significant decreases in compliance were found for rural, independently owned, and southern US tanning salons.

Meaning  Tanning salon compliance with state laws restricting access to minors is unsatisfactory, and monitoring and enforcement efforts are needed to ensure compliance with these laws that are intended to minimize the harmful effects of UV tanning in minors.


Importance  The US Food and Drug Administration has classified tanning beds as carcinogenic. Most states have enacted legislation to prevent or create barriers for minors accessing tanning establishments. Determining tanning salon compliance with legislation would provide an indication of the influence of legislation at preventing exposure to the carcinogen in minors.

Objectives  To investigate compliance rates in the 42 states and the District of Columbia with legislation restricting tanning bed use in minors and to identify differences in compliance based on population, regional location, salon ownership, age group being regulated, and time since the law was enacted.

Design, Setting, and Participants  This investigation was a cross-sectional telephone survey conducted between February 1, 2015, and April 30, 2016, by callers posing as minors attempting to schedule a tanning appointment. The setting was tanning salons in the 42 states and the District of Columbia that currently have legislation restricting tanning bed use in minors. Included in the study were 427 tanning salons, 10 randomly selected from each state or territory with tanning legislation.

Main Outcomes and Measures  Overall compliance of tanning salons with state tanning legislation and differences in compliance based on community population, regional location, independent vs chain tanning salon, age group being regulated, and time since the law was enacted.

Results  Of the 427 tanning salons surveyed, overall noncompliance with state legislation was 37.2% (n = 159). There were more noncompliant tanning salons in rural locations (45.5%; 95% CI, 37.5%-53.7%; P = .009), southern regions of the United States (49.4%; 95% CI, 41.4%-57.4%; P = .001), independently owned salons (43.9%; 95% CI, 37.3%-50.6%; P = .003), states with younger age groups being regulated (53.5%; 95% CI, 45.7%-61.2%; P < .001), and states with more than one tanning regulation (50.0%; 95% CI, 42.0%-58.0%; P < .001). No difference was found based on time since the law was enacted.

Conclusions and Relevance  Compliance with state legislation aimed at limiting tanning bed use among US minors is unsatisfactory, indicating that additional efforts to enforce the laws and education of the harmful effects of UV tanning are necessary, especially in rural, independently owned, and tanning salons in southern regions, which have decreased compliance rates.