Our results indicate that indoor tanning device use is widespread among US high school students, and the use of indoor tanning devices multiple times is common. This study is consistent with previous reports showing widespread use of indoor tanning devices among adolescents and a higher prevalence among older adolescents, females, and whites (6
Given the known health risks associated with indoor tanning device use, many health-related organizations recommend regulations limiting minors' access to these devices (8
). In the United States, 26 states have laws restricting minors' access to tanning facilities; statutory requirements include parental consent or accompaniment, physician authorization, and bans on tanning device use (10
). However, the presence of state legislation restricting minors' access to indoor tanning devices has limited effectiveness (7
). Our results suggest that additional strategies for reducing indoor tanning device use among US high school students need to be examined. Such efforts could include public education about the risks of indoor tanning device use, efforts aimed at changing the social norms regarding skin tanning, better enforcement of current restrictions, and more stringent legislative measures prohibiting the use of indoor tanning devices among minors.
This study is subject to certain limitations. The results from this study are generalizable only to youths who attend high school and may not be representative of the entire youth population. Additionally, the use of an indoor tanning device was self-reported, and the degree of misreporting cannot be determined. Although reliability data are not available for the question about indoor tanning device use, a previous reliability study of the YRBS questionnaire demonstrated most items had good test-retest reliability (11
). An important strength of this study is that it provides a nationally representative estimate of indoor tanning device use among US high school students.
The Patient Protection and Affordable Care Act includes a 10% excise tax on indoor tanning device use. This newly enacted tax may reduce the use of indoor tanning devices, especially among adolescents. A 10% increase in the price of tobacco led to an approximate 4% reduction in tobacco use prevalence among adolescents (12
); thus, the newly imposed tax may reduce indoor tanning device use and UV radiation exposure, a documented risk factor for melanoma. Because this study provides nationally representative estimates, it can serve as a baseline for continued monitoring of indoor tanning device use and evaluating the effect of the new excise tax and other interventions on reducing indoor tanning device use among US high school students.