Prevalence of Indoor Tanning Among Young White Women

August 23, 2013

Prevalence of Indoor Tanning Among Young White Women

  1. Mary Wu Chang, MD and
  2. Craig A. Elmets, MD

Physician counseling, legislation limiting commercial use by minors, and FDA warnings about the adverse effects of tanning beds are needed to stem use by an alarming percentage of young tanners.

  1. Mary Wu Chang, MD and
  2. Craig A. Elmets, MD

Indoor tanning before age 35 increases melanoma risk by up to 75%, and melanoma risk increases by 1.8% with each additional tanning session per year. Use before age 25 increases nonmelanoma skin cancer risk by up to 102%. Melanoma incidence is increasing, especially among young, non-Hispanic white women. Indoor tanning may be a causative factor, but prevalence data are limited.

Investigators used the 2011 Youth Risk Behavior Survey (YRBS) of high school students and the 2010 National Health Interview Survey (NHIS) of adults aged 18 to 34 years to study indoor tanning prevalence among non-Hispanic white women. Both surveys are conducted by the CDC. Indoor tanning was defined as use of a tanning device at least once in the prior 12-month period, and 10 or more times in that period constituted “frequent” use.

Of 2527 non-Hispanic white female high school student respondents (grades 9-11; age range, 14-18 years) to the YRBS, 29% had engaged in indoor tanning; 17% of all responders and 57% of ever-tanners tanned frequently. The prevalence and frequency of indoor tanning increased with age. Of 1857 non-Hispanic white female respondents to the NHIS (age range, 18-34 years), 25% engaged in indoor tanning, 15% frequently in the previous year. In these respondents, prevalence and frequency of indoor tanning decreased with age. In both surveys, the prevalence was highest in the South and Midwest.


These data show that indoor tanning is rampant among non-Hispanic white women, especially older high school girls. Although WHO has classified ultraviolet radiation as a class I carcinogen, the tanning industry is a thriving, largely unregulated $2 billion industry. In my office, an American Academy of Dermatology poster describing the dangers of indoor tanning has triggered many comments from parents and teens, with many saying they thought tanning was safe. Appearance-focused interventions and education are helpful for teenagers, but eliminating deceptive advertising claims and preventing access by minors are also crucial.

Editor Disclosures at Time of Publication

  • Disclosures for Mary Wu Chang, MD at time of publication Consultant / Advisory board Valeant Speaker’s bureau Galderma

  • Disclosures for Craig A. Elmets, MD at time of publication Consultant / Advisory board Astellas Pharmaceuticals Grant / research support NIH; NIH/NCI; Veteran’s Administration; Abbott Laboratories; Biogen; Clinuvel; Covan Basilea Pharmaceutica; Genentech; TenX Biopharma; University of California Editorial boards Cancer Prevention Research; Journal of the American Academy of Dermatology; Photodermatology, Photoimmunology, & Photomedicine; UpToDate Leadership positions in professional societies American Academy of Dermatology (Psoriasis Guidelines Subcommittee and Chair Designate, Clinical Guidelines and Research Committee); Photomedicine Society (Board of Directors)


Reader Comments (2)


educate, educate, educate and hope for the best.

R Bryan Other, Other

Was data on session duration gathered? If so, what was the average duration and standard deviation.

Is there data on the devices used? Are most equivalent to solar radiation in terms of UVA and UVB? What about the strength of radiation compared to solar radiation?

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