International perspectives on indoor tanning

Abstract

This chapter reviews the English language literature regarding the prevalence, frequency, and predictors of sunbed use outside of the United States. The literature examining sunbed use across European and non-European countries indicates prevalent use, especially in young women. In Sweden an extensive body of literature indicates that over 50% of females in their teens and twenties have used sunbeds at least once. In other European countries, the literature is less extensive but shows that rates of sunbed use are consistent with those reported in Sweden, at least in Northern Europe. There is evidence of a North-South gradient with lower prevalence of use in Southern Europe. The United Kingdom, Canada, and Australia document more modest rates of sunbed use. Of concern is the relatively high rate of heavy sunbed use in many countries. While measurement strategies differ, 20-25% of sunbed users indicate very frequent sunbed use recently, or over their lifetime. The predictors of sunbed use are consistent across studies and include female gender, younger age, higher socioeconomic status and urban locale, beliefs that a tan will improve appearance and that a base tan is needed before going on vacation, lower skin sensitivity to sunburn, heightened tobacco use and outdoor tanning behavior. The belief that tanned skin is attractive is a motivation for tanning, especially in young women, and needs to be confronted as new mass media and individual-level interventions are developed.