Researchers posing as minors called 427 tanning salons in 42 states
and the District of Columbia and said they wanted to tan before an
upcoming family vacation. Tanning facility employees were asked
about session costs and whether a parent needed to be present to
consent to the tanning session.
Overall, 159 salons, or 37%, failed to follow state laws restricting
access for minors, the study found. The most common lapse was
allowing teens to book appointments without permission from a parent
in states that required parental consent.
Complicated laws were linked to higher rates of noncompliance.
“States that have multiple components to their tanning laws based on
age of the minors or parental consent ability had worse compliance
than states with simple bans for all minors, similar to bans on
cigarettes or alcohol,” said senior study author Dr. Erik Stratman,
a dermatologist at the Marshfield Clinic and the University of
Wisconsin School of Medicine and Public Health in Madison.
“We believe that straightforward banning for all minors would
improve compliance with the law,” Stratman said by email.
Most states have enacted laws to prevent or create barriers to
tanning establishments for minors, researchers note in JAMA
Dermatology online October 25. Still, nearly 2 million high school
students in the U.S. use these facilities.
Banning indoor tanning for anyone under 18 could prevent thousands
of melanoma diagnoses and deaths, as well as millions of dollars in
treatment costs, researchers point out.
“Because the damaging effects of UV are cumulative over a lifetime,
when intense UV exposure occurs during childhood, there is greater
chance in that person's life that enough damage to the skin cells
will trigger cancer,” Stratman said.
Tanning salons were less likely to follow state laws in rural areas,
the South, and in states where laws applied only to younger minors
aged 15 or less, the study found.
Independently owned salons were also less likely to comply with
state laws than chain establishments.
One limitation of the study is that the phone encounters might not
reflect what would happen if young people came to tanning salons in
person to book appointments.
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Even if salons are following the law, parents should still refuse to
give teens permission to use these facilities, said Dr. Elizabeth
Martin, president of Pure Dermatology and Aesthetics in Hoover,
“The American Academy of Dermatology’s position is that no minor
under 18 should be permitted to use sunlamp products, and this is a
position I strongly support,” Martin, who wasn’t involved in the
study, said by email. “But in those states in which indoor tanning
is currently permitted at a younger age with parental consent, I
would impress upon parents that if they allow their teen to
patronize indoor tanning facilities, they are increasing their
child’s risk of developing cancer.”
Part of the problem with giving parents a choice about teen tanning
is that many people don’t realize the risk involved, said Dr.
Kathleen Cook Suozzi, a researcher at Yale School of Medicine in New
Haven, Connecticut, who wasn’t involved in the study.
“Cigarette smoke is readily accepted as a cause of lung cancer;
however, the number of skin cancer cases due to tanning is higher
than the number of lung cancer cases due to smoking,” Suozzi said by
While tanning is also a cancer risk for adults, teens may not have
the same ability to make an informed decision about the health
effects of tanning when they go to a salon, said Dr. Henry Lim,
president of the American Academy of Dermatology.
“The major risk for young people is that their judgment is not yet
fully formed, therefore, they are much more easily misled by false
or inaccurate statements from tanning booth operators on the lack of
side effects of tanning booth exposure,” Lim, who wasn’t involved in
the study, said by email. “In addition, peer pressure for this group
is also a major factor that leads to overuse of tanning booths.”
JAMA Dermatol 2017.
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