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In 2015, 70.8% of adults said they usually or always protect themselves from the sun by practicing at least one of three sun protection behaviors.
Introduction
Avoiding sunburns and intermittent high-intensity sun exposure (especially in children, teens, and young adults) reduces the chances of getting melanoma skin cancer. Engaging in sun protective behaviors when outside can reduce one’s exposure to UV radiation and sunburn. For example, broad spectrum sunscreen (protects against UVA and UVB) should be used and applied appropriately (e.g., proper amount applied, sunscreens should be applied prior to exposure, and sunscreen should be reapplied for prolonged UV exposure). In recent years, the Food and Drug Administration has improved standards for sunscreen content and labeling. Seeking shade can also reduce the risk of sunburn and one of the goals of the Surgeon General’s Call To Action to Prevent Skin Cancer is to increase the availability of shade in outdoor recreation, education, and workplace environments.
Addition behaviors such as wearing sunglasses and sun protective clothing (e.g., long sleeve shirt, long pants, and wide brim hat) can help prevent excessive exposure to UV. Sun protective behaviors are most needed when UV intensity is greatest, which occurs during the summer time and between 10 am and 4 pm. However, for some regions of the US, such as the southeast and southwest, UV intensity is high year round. To help maximize one’s protection, multiple sun protective behaviors should be practiced.
Measure
The percentage of adults aged 18 years and older who reported that they usually or always practice at least one of three sun-protective behaviors - using sunscreen, wearing protective clothing (a long-sleeve shirt, and/or wide brimmed hat shading the face, ears, and neck, and/or long pants/long skirt), or seeking shade when going outside on a sunny day for more than an hour.
Beginning in 2005, the question on hat use (as part of protective clothing) was modified to more accurately distinguish baseball caps (which do not fully protect the face, neck, and ears) from other types of fully protective hats. Graphic illustrations of different hats were used, and respondents were asked a separate question about baseball cap and sun visor use. Also, long pants/long skirt was an item added in 2005.
In certain sections of this report, the protective clothing and sunscreen measures were defined according to the Healthy People 2020 (HP2020) objectives with data available since 2005, allowing for only short-term trends. HP2020 defines use of protective clothing as wearing one or more of the following -- a wide-brimmed hat that shades the face, ears, and neck, long sleeves, and long pants or long skirt. HP2020 guidelines for sunscreen use refer to sunscreens with a sun protective factor (SPF) of 15 or higher.
Healthy People 2020 Target
- Increase to 11.2 percent the proportion of adolescents in grades 9 through 12 who follow protective measures that may reduce the risk of skin cancer.
- Increase to 73.7 percent the proportion of adults aged 18 years and older who follow protective measures that may reduce the risk of skin cancer.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey NCI and CDC co-sponsored Cancer Control Supplement, 1992-2010, 2005–2015.
Trends and Most Recent Estimates
Sun Protection Methods
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Total
|
70.8 | (69.9 - 71.6) |
Sunscreen (SPF 15+)
|
33.7 | (32.8 - 34.5) | |
Protective clothing
|
38.4 | (37.6 - 39.2) | |
Seek Shade
|
39.1 | (38.3 - 40.0) | |
Use Some Type of Protection
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Both Sexes
|
70.8 | (69.9 - 71.6) |
Male
|
66.7 | (65.6 - 67.8) | |
Female
|
74.8 | (73.8 - 75.7) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
All Races
|
70.8 | (69.9 - 71.6) |
Non-Hispanic White
|
69.6 | (68.6 - 70.7) | |
Non-Hispanic Black
|
67.7 | (65.5 - 69.9) | |
Hispanic
|
75.7 | (74.0 - 77.3) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Ages 18-24
|
60.6 | (57.8 - 63.5) |
Ages 25+
|
72.3 | (71.4 - 73.1) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Males, Ages 18-24
|
55.4 | (51.6 - 59.2) |
Males, Ages 25+
|
68.3 | (67.2 - 69.5) | |
Females, Ages 18-24
|
66.2 | (62.6 - 69.7) | |
Females, Ages 25+
|
76.0 | (75.1 - 77.0) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
<200% of federal poverty level
|
71.5 | (70.3 - 72.7) |
>=200% of federal poverty level
|
70.5 | (69.4 - 71.5) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Less than High School
|
73.6 | (71.6 - 75.6) |
High School
|
69.3 | (67.8 - 70.9) | |
Greater than High School
|
72.9 | (71.9 - 73.9) | |
Use Sunscreen
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Both Sexes
|
33.7 | (32.8 - 34.5) |
Male
|
23.4 | (22.4 - 24.4) | |
Female
|
43.6 | (42.4 - 44.8) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
All Races
|
33.7 | (32.8 - 34.5) |
Non-Hispanic White
|
40.4 | (39.3 - 41.5) | |
Non-Hispanic Black
|
10.9 | (9.7 - 12.2) | |
Hispanic
|
24.7 | (23.1 - 26.3) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Ages 18-24
|
25.9 | (23.1 - 28.7) |
Ages 25+
|
34.8 | (33.9 - 35.7) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Males, Ages 18-24
|
17.0 | (13.8 - 20.1) |
Males, Ages 25+
|
24.3 | (23.2 - 25.5) | |
Females, Ages 18-24
|
35.3 | (31.3 - 39.2) | |
Females, Ages 25+
|
44.8 | (43.6 - 46.0) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
<200% of federal poverty level
|
21.4 | (20.3 - 22.6) |
>=200% of federal poverty level
|
38.7 | (37.6 - 39.7) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Less than High School
|
16.0 | (14.2 - 17.9) |
High School
|
24.9 | (23.3 - 26.5) | |
Greater than High School
|
41.8 | (40.7 - 42.9) | |
Wear Protective Clothing
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Both Sexes
|
38.4 | (37.6 - 39.2) |
Male
|
43.6 | (42.4 - 44.8) | |
Female
|
33.4 | (32.4 - 34.4) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
All Races
|
38.4 | (37.6 - 39.2) |
Non-Hispanic White
|
34.7 | (33.6 - 35.7) | |
Non-Hispanic Black
|
39.6 | (37.4 - 41.7) | |
Hispanic
|
49.0 | (47.2 - 50.9) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Ages 18-24
|
27.1 | (24.5 - 29.6) |
Ages 25+
|
40.1 | (39.2 - 41.0) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Males, Ages 18-24
|
31.8 | (28.0 - 35.6) |
Males, Ages 25+
|
45.3 | (44.0 - 46.6) | |
Females, Ages 18-24
|
22.1 | (18.9 - 25.3) | |
Females, Ages 25+
|
35.0 | (34.0 - 36.1) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
<200% of federal poverty level
|
43.4 | (42.0 - 44.8) |
>=200% of federal poverty level
|
36.2 | (35.2 - 37.2) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Less than High School
|
51.7 | (49.3 - 54.1) |
High School
|
40.8 | (39.1 - 42.5) | |
Greater than High School
|
37.7 | (36.6 - 38.8) | |
Seek Shade
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Both Sexes
|
39.1 | (38.3 - 40.0) |
Male
|
31.9 | (30.8 - 33.1) | |
Female
|
46.0 | (45.0 - 47.1) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
All Races
|
39.1 | (38.3 - 40.0) |
Non-Hispanic White
|
34.1 | (33.1 - 35.1) | |
Non-Hispanic Black
|
48.7 | (46.5 - 50.9) | |
Hispanic
|
49.1 | (47.2 - 50.9) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Ages 18-24
|
32.0 | (29.5 - 34.5) |
Ages 25+
|
40.2 | (39.3 - 41.1) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Males, Ages 18-24
|
25.5 | (22.3 - 28.7) |
Males, Ages 25+
|
32.9 | (31.6 - 34.2) | |
Females, Ages 18-24
|
38.8 | (35.2 - 42.3) | |
Females, Ages 25+
|
47.1 | (46.1 - 48.1) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
<200% of federal poverty level
|
45.6 | (44.3 - 47.0) |
>=200% of federal poverty level
|
36.3 | (35.3 - 37.4) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Less than High School
|
46.0 | (43.6 - 48.4) |
High School
|
39.9 | (38.0 - 41.7) | |
Greater than High School
|
39.0 | (37.9 - 40.1) | |
Additional Information on UV Exposure and Sun Protective Practices
For the public
- Skin Cancer. American Cancer Society.
- Skin Cancer. National Cancer Institute.
- Indoor Tanning Restrictions for Minors – A State-by-State Comparison (April 2014). National Conference of State Legislatures.
- National Council on Skin Cancer Prevention.
- Sunscreen drug products for over-the-counter human use, 2011. U.S. Food and Drug Administration, U.S. Department of Health and Human Services.
- Code of Federal Regulations Title 21, Volume 76, Number 117, Parts 201, 310, and 352. (June 17, 2011). Fed Regist. 2011.
- Sunburn protection factor (SPF). U.S. Food and Drug Administration.
For health professionals
- Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update). AHRQ Publication No. 14-E004-EF September 2014. Evidence Report/Technology Assessment Number 217.
- The Community Guide: what works to promote health. Community Preventive Services Task Force.
- Preventing skin cancer: multicomponent community-wide interventions (abbreviated). Community Preventive Services Task Force.
- Indoor Tanning Association settles FTC charge that it deceived customers about skin cancer risks from tanning. Federal Trade Commission.
- Melanoma Treatment (PDQ®). National Cancer Institute.
- Skin Cancer Treatment (PDQ®). National Cancer Institute.
- Stratosphere: UV index. National Weather Service: Climate Prediction Center.
- The Surgeon General’s Call to Action to Prevent Skin Cancer. U.S. Department of Health and Human Services. Washington, DC: U.S. Dept of Health and Human Services, Office of the Surgeon General; 2014.
- UV index. U.S. Environmental Protection Agency, SunWise Program.
- Sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Title 21. Food and drugs. CFR 1040.20. Fed Regist. 2013.
- FDA news release: FDA to require warnings on sunlamp products. U.S. Food and Drug Administration.
- General and plastic surgery devices: reclassification of ultraviolet lamps for tanning, henceforth to be known as sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Rule. Fed Regist. 2014;79:31205-31214.
- Behavioral counseling to prevent skin cancer. U.S. Preventive Services Task Force.
- Sun Protection in Schools: an Educational Package to Protect Children from Ultraviolet Radiation. World Health Organization. Geneva, Switzerland: World Health Organization; 2003.
Scientific reports
- Surgeon General Call to Action to Prevent Skin Cancer, 2014.
- FDA Indoor tanning: The risks of ultraviolet rays.
- Buying indoor tanning with university debit cards. Boyers L, Karimkhani C, Crane LA, Asdigian N, Hollonds A, Dellavalle RP. J Am Acad Dermatol. 2014;71(1):199-201.
- VITamin D and OmegA-3 TriaL (VITAL Study). Brigham and Women’s Hospital.
- Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. Buller DB, Cokkinides V, Hall HI, et al. J Am Acad Dermatol. 2011;65(5):S114–S123.
- User-centered development of a smart phone mobile application delivering personalized real-time advice on sun protection. Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK. Transl Behav Med. 2013;3(3):326-334.
- Sunburn and sun protective behaviors among adults aged 18–29 Years – United States, 2000–2010. Centers for Disease Control and Prevention. MMWR 2012;61(18);317–322.
- Use of indoor tanning devices by adults – United States, 2010. Centers for Disease Control and Prevention. MMWR 2012;61(18);323–326.
- Reduced melanoma after regular sunscreen use: randomized trial follow-up. Green A, Williams GM, Logan V, and Strutton GM. J Clin Oncol. 2011;29(3):257–263.
- State indoor tanning laws and adolescent indoor tanning. Guy GP, Berkowitz Z, Jones SE, et al. Am J Public Health. 2014;104(4):e69-e74.
- The association between demographic and behavioral characteristics and sunburn among U.S. Adults – National Health Interview Survey, 2010. Holman DM, Berkowitz Z, Guy GP, Hartman AM, Perna FM. Prev Med. 2014;63:6-12.
- Correlates of intentional tanning among adolescents in the United States: a systematic review of the literature. Holman DM, Watson M. J Adolesc Health. 2013;52(5 suppl):S52-S59.
- History and culture of tanning in the United States. Hunt Y, Auguston E, Rutten L, Moser R. In: Heckman CJ, Manne EL, eds. Shedding Light on Indoor Tanning. New York, NY: Springer; 2012:5-30.
- Solar and ultraviolet radiation. International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 2012;100D:36–102.
- Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Lazovich D, Vogel R, Berwick M, et al. Cancer Epidemiol Biomarkers Prev 2010;19(6):1557–68.
- Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. Lim HW, James WD, Rigel DS, et al. J Am Acad Dermatol. 2011;64(4):e51–60.
- Behavioral counseling to prevent skin cancer: a systematic review for the U.S. Preventive Service Task Force. Lin JS, Eder M, Weinmann S. Ann Intern Med. 2011;154:190–201.
- Changes in solarium numbers in Australia following negative media and legislation. Makin JK, Dobbinson SJ. Aust N Z J Public Health 2009;33:491–494.
- Adolescents’ use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy- level correlates. Mayer JA, Woodruff SI, Slymen DJ, et al. Am J Public Health. 2011;101(5):930-938.
- Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force recommendation statement. Moyer VA, U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(1):59-65.
- Reducing environmental cancer risk: what we can do now. National Cancer Institute. 2008–2009 Annual Report of the President’s Cancer Panel.
- Subsequent primary malignancies in patients with nonmelanoma skin cancer in England: a national record-linkage study. Ong EL, Goldacre R, Hoang U, Sinclair R, Goldacre M. Cancer Epidemiol Biomarkers Prev. 2014;23(3):490-498.
- Youth access to artificial UV radiation exposure: practices of 3647 US indoor tanning facilities. Pichon L, Mayer J, Hoerster K, Woodruff S, et al. Arch Dermatol. 2009;145(9):997–1,002.
- Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Reed KB, Brewer JD, Lohse CM, et al. Mayo Clin Proc. 2012;87(4):328–334.
- Implications of lessons learned from tobacco control for tanning bed reform. Sinclair C, Makin JK. Prev Chronic Dis. 2013;10:e28.
- Vitamin D and Cancer. World Health Organization, International Agency for Research on Cancer. IARC Working Group Reports 2008;5.
Statistics
- National Health Interview Survey. Centers for Disease Control and Prevention, National Center for Health Statistics.
- Healthy People 2020, 2020 Topics & Objectives – Cancer.
- SEER Cancer Statistics Review, 1975–2009, National Cancer Institute.
Year Range
2005-2015
Recent Summary Trend Year Range
2010-2015
Summary Tables
Sun Protection
Recent Summary Trend
Stable
Desired Direction
Rising