Journal Article

Indoor tanning is associated with substance use behaviors among adolescents

Fastner, Suzanne L., Brintz, Ben J., Schlechter, Chelsey R., Shen, Nathan, Wang, Xuechen, Wu, Yelena P.

2025

Overview

Introduction Adolescents increase their skin cancer risk through exposure to ultraviolet radiation, tanning, and poor use of sun-safety practices. Past studies documented that adolescent indoor tanning is associated with substance use. However, these did not examine e-cigarette use as many were conducted prior to their widespread popularity nor were most studies focused on areas with high environmental risk for skin cancer. The present study examined the current relationship between indoor tanning and substance use, including e-cigarettes, in an area with high skin cancer burden. Methods Data for the current study stem from a statewide survey of middle and high school students in a high melanoma burden state of the United States ( N  = 22,141). The survey assessed student’s reported indoor tanning, alcohol use, cigarette smoking, and e-cigarette and marijuana usage. Results Across all student participants, 3.5% reported indoor tanning one or more times in the past 12 months. Weighted chi-square tests revealed statistically significant associations between indoor tanning and other health risk behaviors ( p  < 0.001). Specifically, higher alcohol consumption, e-cigarette use, marijuana use, and cigarette use were all significantly associated with more frequent indoor tanning. Female and older adolescents were more likely to report indoor tanning. Conclusions Indoor tanning among adolescents is associated with increased odds of engaging in substance use behaviors, including e-cigarette use. Health interventions for adolescents may benefit from addressing multiple health risk behaviors concurrently and targeting adolescents most in need for health interventions. Future work to better understand the common mechanisms underlying co-occurring health risk behaviors could inform development of such interventions.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adolescent Behavior - psychology / Adolescents / Alcohol Drinking - epidemiology / Alcoholic beverages / Behavior / Biostatistics / Cancer / Cannabis / Chi-square test / Cigarette smoking / Cigarettes / Drugs and youth / Electronic cigarettes / Environmental Health / Environmental risk / Epidemiology / Female / Health aspects / Health promotion / Health risk behaviors / Health risks / High school students / Humans / Indoor environments / Indoor tanning / Junior high school students / Male / Marijuana / Medicine / Medicine & Public Health / Melanoma / Public Health / Risk factors / Risk taking / Risk-taking (Psychology) / Skin cancer / Skin Neoplasms / Smoking and youth / Statistical analysis / Students / Students - psychology / Students - statistics & numerical data / Substance use / Substance-Related Disorders - epidemiology / Sunbathing - psychology / Sunbathing - statistics & numerical data / Sunburn & sun tanning / Sunless tanning products / Surveys / Surveys and Questionnaires / Tanning / Teenagers / Ultraviolet radiation / United States - epidemiology / Vaccine