Decrease in Self-Reported Tanning Frequency among Utah Teens following the Passage of Utah Senate Bill 41: An Analysis of the Effects of Youth-Access Restriction Laws on Tanning Behaviors

Introduction. Adolescent use of indoor tanning facilities is associated with an increased risk in later development of melanoma skin cancers. States that have imposed age restrictions on access to indoor tanning generally show lower self-reported rates of indoor tanning than states with no restrictions, but currently no studies have assessed indoor tanning use before and after such restrictions. Methods. In 2013, we compared self-reported indoor tanning data collected in the Prevention Needs Assessment (PNA) survey in 2011 to PNA 2013 data. We also assessed predictors of continued tanning after passage of the bill. Results. Prior to the passage of Senate Bill 41, 12% of students reported at least one incident of indoor tanning in the past 12 months. After passage, only 7% of students reported indoor tanning in the past 12 months (P < 0.0001). Students who continued indoor tanning were more likely to be older and female and to engage in other risk behaviors, including smoking and alcohol use. Lower parental education levels were also associated with continued tanning. Conclusion. Indoor tanning restrictions showed beneficial impact on tanning rates in adolescents in Utah. Stricter restrictions may show even greater impact than restrictions that allow for parental waivers. Stronger enforcement of bans is needed to further reduce youth access. 1. Introduction Unlike many cancers which have seen a decrease in incidence and mortality over the past thirty years, incidence of melanoma skin cancer has been steadily increasing in the United States [1]. Incidence rates of melanoma skin cancer in Utah are 61% higher than the national average, with an incidence rate of 31 per 100,000 people, compared to the national rate of 19.3 per 100,000 people between 2006 and 2010 [2, 3]. Utah’s melanoma mortality is also 30% higher than the national average (3.5 per 100,000 Utahns compared to 2.7 per 100,000 people nationally) [2, 3]. Melanoma is typically diagnosed later in life, but risks to adolescents and young adults have been increasing and melanoma is currently the third most common cause of cancer in individuals aged 15 to 39 years old [4]. Unlike most types of adolescent cancer, which are largely caused by genetic susceptibility, melanoma is associated with both genetic predisposition and behavioral risk factors, including the use of indoor tanning facilities [4, 5]. Indoor tanning before age 35 has been shown to increase the risk of melanoma and other skin cancers, including squamous and basal cell carcinomas [5–7], yet interventions aimed at reducing indoor tanning