Jerod L. Stapleton, a behavioral scientist at Rutgers Cancer Institute of New Jersey and an assistant professor of medicine at Robert Wood Johnson Medical School, is seeking to answer these questions with support from a career development grant from the National Cancer Institute. Stapleton and his team will conduct a study of interviews over the next two years that are designed to better understand the views and motivations of tanners. The researchers will then use their findings to develop a behavioral intervention program tailored to encourage young women tanners to consider monitoring or changing their behavior.
Studies have long shown an association between the use of ultraviolet indoor tanning beds and melanoma risk, with frequent tanners the highest risk group. But indoor tanning remains widespread among young adults, according to a recent study published in JAMA Dermatology. Nationwide, 35 percent of adults and 55 percent of college students report having tanned indoors. TheJAMA study reported that 419,254 cases of skin cancer in the U.S. could be attributed to indoor tanning. Of these cases, 6,199 are melanomas, the deadliest kind of skin cancer.
Stapleton spoke with Rutgers Today about the behavioral patterns of frequent, long-term indoor tanners and the challenges in communicating the health risks to them.
Rutgers Today: How do you define a "frequent" indoor tanner?
Stapleton: This is someone who engages in indoor tanning 10 or more times a year. The majority of indoor tanners are Caucasian women. The behavior is seen in men, of course, but it's not as prevalent. There is some evidence that people who are frequent tanners may be prone to other risky behaviors like alcohol use or smoking and report body image concerns. The problem of frequent indoor tanning is clear when considering the recent trends of increasing melanoma rates among young women compared to other groups.
Stapleton: Tanning is seen as attractive and desirable among many young women, and having a tan can increase their self-esteem. They seem to discount the long-term risks in favor of the immediate benefits: an appearance they desire, a mood boost, stress relief and peer reinforcement. In my recent studies of young women tanners, I have been surprised to learn how much indoor tanning can become a part of their social life. Tanning can become part of a personal routine, like going to the gym. Many women go on "tanning dates" with their friends to the tanning salons and other places. And with frequent users, indoor tanning is likely to take on an even more significant importance at personal, social and emotional levels.
Rutgers Today: Is there something physiological that compels people to tan?
Stapleton: Some people can become "tanning dependent." Exposure to UV radiation causes a physiological response that can mirror a pleasure response in certain individuals. For these people, tanning is a reinforcing activity. One of the hallmarks of dependency is that a person starts increasing the "dosage" to get the sensation he or she has come to expect. Since indoor tanning can be done year-round and emits a greater concentration of UV rays than sunlight, it may lend itself to more dependency than outdoor tanning.
Rutgers Today: How does your study differ from previous research on indoor tanning?
Stapleton: A lot of research focuses on trying to describe who is likely to use indoor tanning and many prevention efforts highlight the appearance and health-damaging effects of tanning beds. Frequent tanners, whom I plan to study, may have heard the message about health and appearance risks and are already starting to ignore it. My previous work has shown that tanners are less likely to respond to an intervention with these messages if they are aware of the risks prior to the intervention. I plan to deeply explore how frequent indoor tanners view this behavior as meaningful, socially important and useful for their perspective. We want to understand their world, their culture, to comprehend why tanning is so important to them. Frequent tanners need to be reached with a message specific to them, in a language they understand. Knowing what drives them to continue their behavior will help us create an intervention that may be more likely to resonate personally. We hope it will encourage them to consider the reasons behind their use of tanning beds, reshape their view of the benefits and costs of their tanning, and promote alternatives to this practice.
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