New Study Indicates Tanning May Be Addictive

Despite repeated health
warnings about the dangers of tanning from sunlight and artificial light
sources, there are still those whose mantra "bronzed is beautiful" remains
unshaken. Dermatologists have long suspected that some people may be
addicted to tanning -- similar to addictions to drugs or alcohol -- and
refuse to alter their behaviors, even knowing they have an increased risk
of developing skin cancer. Now, a new study of college co-eds indicates
that some people may be addicted to ultraviolet (UV) light.


In the report entitled, "UV light abuse and high-risk tanning behavior
among undergraduate college students," published in the March 2007 issue of
the Journal of the American Academy of Dermatology, dermatologist Robin L.
Hornung, MD, MPH, FAAD, Division of Dermatology at the University of
Washington and the Children's Hospital and Regional Medical Center in
Seattle, Wash., used a standardized testing tool to gauge the presence of a
substance-related disorder (SRD) as a means to determine whether some
college students could be hooked on tanning.



"Numerous studies have shown that increased knowledge of the dangers of
overexposure to UV light often fails to change tanning behavior and
attitudes, especially among high-risk age groups such as adolescents and
young adults," explained Dr. Hornung. "We also know from previous
experiments that UV light causes endorphin release, similar to the euphoric
sensation associated with intense exercise commonly referred to as
'runner's high' or other pleasure-seeking behavior. Our study set out to
find whether certain individuals, particularly those who classify
themselves as frequent tanners, exhibit addictive behaviors toward
tanning."



Dr. Hornung and her collaborator, Solmaz Poorsattar, asked a total of
385 male and female college students at the University of Washington in
Seattle to complete a multiple-choice questionnaire that included questions
about their personal tanning practices and those of their family and
friends. In addition, four questions in the survey also comprised a
modified version of the cut down, annoyed, guilty, eye-opener (CAGE)
questionnaire tool. CAGE, which is a proven testing tool most often used to
identify SRD with regard to alcohol, was used to determine whether
participants showed symptoms of an SRD to UV light. Only students who
reported ever purposely tanning were asked to complete this portion of the
questionnaire. The four modified CAGE questions that were measured
included:


-- "Have you ever felt you ought to cut down on your tanning?"


-- "Have people annoyed you by criticizing your tanning?"


-- "Have you ever felt bad or guilty about your tanning?"


-- "Have you ever thought about tanning first thing in the morning?"



Of the 385 students who participated in the study, 76 percent of female
students reported purposely tanning their skin vs. 59 percent of male
students. In addition, 42 percent of the female students reported using
indoor tanning devices compared to only 17 percent of the male students.
















When the responses to the CAGE questions were examined, 12 percent of
the total sample of students, 18 percent of the students who reported
regularly tanning in outdoor sunlight and 28 percent of indoor tanners
scored positively on the CAGE questions -- indicating SRD with regard to UV
light. Of the students who reported purposely tanning their skin, 22
percent of female outdoor tanners had positive CAGE results, compared with
only 8 percent of male outdoor tanners. Interestingly, students who
reported using indoor tanning devices were much more likely to be
identified as potentially having a UV light disorder than nonusers -- 28
percent vs. 12 percent, respectively.



"Our finding that 18 percent of the students who admitted to purposely
tanning their skin scored positively on the CAGE questionnaire is
significant, not only because it indicates the probable existence of SRD
with respect to UV light but because this percentage is comparable with
findings of other addiction studies," said Dr. Hornung. "For example, a
Midwest study found that 18 percent of college students who admitted to
drinking alcohol also scored positively on the CAGE questionnaire with
respect to alcohol, as well as the 16 percent of college students who
reported smoking cigarettes daily in a 2002 National Institutes of Health
study. If tanning is addictive as our study suggests, it helps explain why
education alone will probably not stop high-risk tanning behavior --
similar to how the 'don't drink' and 'don't smoke' messages often fail to
change behaviors."



While a known family history of skin cancer is a risk factor for
developing future skin cancers, the students in the study who reported a
family history of skin cancer were significantly more likely to engage in
tanning than those students without a known family history of skin cancer.
Of the students with a positive family history of skin cancer, 77 percent
purposely tanned their skin outdoors and 45 percent used indoor tanning
devices. "This finding infers that even a personal experience with skin
cancer failed to alter tanning behavior in this population, despite an
increased health risk," said Dr. Hornung.



Dr. Hornung added that almost half (41 percent) of the students who tan
reported doing so to relax, which is a strong motivating factor that has
been noted by numerous studies examining tanning behaviors and also is
consistent with other addictive practices.



"The fact that tanning may be addictive for some individuals should
strengthen the argument for stricter regulations on the indoor tanning
industry," said Dr. Hornung. "Education alone is not enough to stop
high-risk tanning behavior, and skin cancer rates will continue to increase
markedly without proper intervention."



Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more
than 15,000 physicians worldwide, the Academy is committed to: advancing
the diagnosis and medical, surgical and cosmetic treatment of the skin,
hair and nails; advocating high standards in clinical practice, education,
and research in dermatology; and supporting and enhancing patient care for
a lifetime of healthier skin, hair and nails.


American Academy of Dermatology

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