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Indoor and Sunless Tanning

DeAnn Lazovich, PhD; Jo Ellen Stryker, PhD; Joni A. Mayer, PhD; Joel Hillhouse, PhD; Leslie K. Dennis, PhD; Latrice Pichon, MPH; Sherry Pagoto, PhD; Carolyn Heckman, PhD; Ardis Olson, MD; Vilma Cokkinides, PhD; Kevin Thompson, PhD

Arch Dermatol. 2008;144(2):225-230.

Objective  To develop items to measure indoor tanning and sunless tanning that can be used to monitor trends in population surveys or to assess changes in behavior in intervention studies.

Design  A group of experts on indoor tanning convened in December 2005, as part of a national workshop to review the state of the evidence, define measurement issues, and develop items for ever tanned indoors, lifetime frequency, and past-year frequency for both indoor tanning and sunless tanning. Each item was subsequently assessed via in-person interviews for clarity, specificity, recall, and appropriateness of wording.

Setting  Universities in Tennessee and Virginia, a medical center in Massachusetts, and a high school in New Hampshire.

Participants  The study population comprised 24 adults and 7 adolescents.

Results  Participants understood indoor tanning to represent tanning from beds, booths, and lamps that emit artificial UV radiation, rather than sunless tanning, even though both can be obtained from a booth. Two items were required to distinguish manually applied from booth-applied sunless tanning products. Frequency of use was easier for participants to recall in the past year than for a lifetime.

Conclusions  While indoor tanning items may be recommended with confidence for clarity, sunless tanning items require additional testing. Memory aids may be necessary to facilitate recall of lifetime use of nonsolar tanning. In addition, studies that assess reliability and validity of these measures are needed. Since study participants were primarily young and female, testing in other populations should also be considered.

Author Affiliations: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (Dr Lazovich); Georgia Cancer Coalition Distinguished Cancer Scholar, Department of Behavioral Sciences & Health Education, Emory University, Atlanta (Dr Stryker); Graduate School of Public Health, San Diego State University, San Diego, California (Dr Mayer); Department of Psychology, East Tennessee State University, Johnson City (Dr Hillhouse); Department of Epidemiology, University of Iowa, Iowa City (Dr Dennis); Joint Doctoral Program in Public Health, San Diego State University/University of California, San Diego (Mr Pichon); Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester (Dr Pagoto); Fox Chase Cancer Center, Philadelphia, Pennsylvania (Dr Heckman); Departments of Pediatrics and Community and Family Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Olson); Risk Factor Surveillance, American Cancer Society, Atlanta (Dr Cokkinides); and Department of Psychology, University of South Florida, Tampa (Dr Thompson).

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