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In 2017, 7.5% of female adolescents used an indoor tanning device within the past year.
Introduction
Exposure to artificial ultraviolet radiation (UVR) from indoor tanning beds and sun lamps increases the risk of skin cancer. In July 2014, a Surgeon General’s Call To Action to Prevent Skin Cancer Report was released. One of the goals of this report was to reduce the harms from indoor tanning. In the same year, the U.S. Food and Drug Administration (FDA) increased the stringency of regulations related to indoor tanning equipment and facilities that provide indoor tanning services, recommended that persons repeatedly exposed to UVR should be regularly evaluated for skin cancer, and changed the classification of such devices to a Class II from a Class I designation. Guy et al. 2017 estimated that restricting indoor tanning among minors under 18 years old may prevent melanoma incidence and mortality and save millions of dollars in treatment costs in the United States. Reports indicate that age restriction laws have been associated with less indoor tanning. Several states have adopted laws restricting youth access to tanning beds, and the FDA has proposed a nationwide restriction for minors’ (under 18 years) access to tanning beds.
Measure
The percentage of high school students (grades 9-12) who reported use of an indoor tanning device such as a sunlamp, sunbed, or tanning booth (not counting receipt of a spray-on tan) one or more times during the 12 months before the survey.
The percentage of adults aged 18 years and older who have used an indoor tanning device one or more times during the past 12 months. Although NHIS-CCS also collected this data for adults in 2005 and 2008, the methodology used likely resulted in overestimates, and these data are not included in the report.
Healthy People 2020 Target
- Reduce to 14 percent the proportion of adolescents in grades 9 through 12 who report using artificial sources of ultraviolet light for tanning.
- Reduce to 3.6 percent the proportion of adults aged 18 years and older who report using artificial sources of ultraviolet light for tanning.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Adolescents: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System (YRBSS), 2009–2017.
Adults: Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey NCI and CDC co-sponsored Cancer Control Supplement, 2010-2015.
Trends and Most Recent Estimates
Adolescents
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
Both Sexes
|
5.6 | 4.7 - 6.6 |
Male
|
3.5 | 2.9 - 4.3 | |
|
Female
|
7.5 | 5.8 - 9.5 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
All Races
|
5.6 | 4.7 - 6.6 |
Non-Hispanic White
|
6.6 | 5.3 - 8.3 | |
Non-Hispanic Black
|
5.5 | 4.1 - 7.3 | |
Hispanic
|
3.2 | 2.7 - 3.9 | |
Females by Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of female adolescents | 95% Confidence Interval | ||
|
All Races
|
7.5 | 5.8 - 9.5 |
Non-Hispanic White
|
10.1 | 7.5 - 13.4 | |
Non-Hispanic Black
|
3.8 | 2.5 - 5.8 | |
Hispanic
|
3.0 | 2.3 - 4.0 | |
By High School Grade
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
Grade 9
|
3.7 | 2.7 - 4.9 |
Grade 10
|
4.3 | 3.3 - 5.7 | |
Grade 11
|
5.6 | 4.3 - 7.2 | |
Grade 12
|
8.9 | 7.2 - 11.0 | |
Females by High School Grade
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of female adolescents | 95% Confidence Interval | ||
|
Grade 9
|
5.0 | 3.5 - 7.3 |
Grade 10
|
4.2 | 2.7 - 6.5 | |
Grade 11
|
8.1 | 5.7 - 11.4 | |
Grade 12
|
13.0 | 9.8 - 17.0 | |
Non-Hispanic White Female by High School Grade
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of female Non-Hispanic White adolescents | 95% Confidence Interval | ||
|
Grade 9
|
6.0 | 3.8 - 9.3 |
Grade 10
|
5.6 | 3.3 - 9.1 | |
Grade 11
|
12.2 | 8.4 - 17.3 | |
Grade 12
|
17.3 | 12.2 - 23.9 | |
Adults
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
3.6 | 3.3 - 4.0 |
Male
|
1.7 | 1.4 - 2.0 | |
Female
|
5.6 | 5.1 - 6.2 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
3.6 | 3.3 - 4.0 |
Non-Hispanic White
|
5.5 | 5.0 - 6.1 | |
Non-Hispanic Black
|
0.2 | 0.1 - 0.4 | |
Hispanic
|
1.0 | 0.8 - 1.4 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
6.2 | 5.1 - 7.5 |
Ages 25+
|
3.3 | 2.9 - 3.6 | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males, Ages 18-24
|
1.5 | 0.9 - 2.5 |
Males, Ages 25+
|
1.7 | 1.4 - 2.0 | |
Females, Ages 18-24
|
11.0 | 9.0 - 13.4 | |
Females, Ages 25+
|
4.8 | 4.3 - 5.4 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
2.6 | 2.2 - 3.0 |
>=200% of federal poverty level
|
4.2 | 3.7 - 4.6 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
1.6 | 1.1 - 2.2 |
High School
|
3.8 | 3.1 - 4.6 | |
Greater than High School
|
3.4 | 3.0 - 3.8 | |
By Sun Sensitivity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Sun-Sensitive
|
4.5 | 4.0 - 5.0 |
Not Sun-Sensitive
|
3.0 | 2.6 - 3.5 | |
| Sun sensitivity reflects a person's biological response (e.g., a burn, a burn and then tan, etc.) after prolonged sun exposure or after a long period or season of being relatively unexposed. Although race is related to sun sensitivity, race and ethnicity are not adequate proxies for sun sensitivity. | |||
Evidence-based Resources
Resources are available on sun-protective behaviors that are effective at lowering risk of skin cancer. Visit the sun safety on Cancer Control P.L.A.N.E.T. web portal
Multicomponent community-wide interventions are recommended to prevent skin cancer as well as education and policy approaches.
Additional Information on Indoor Tanning
For the public
- Skin Cancer (including Melanoma)—Patient Version. National Cancer Institute.
- Skin Cancer. American Cancer Society.
- Indoor Tanning Restrictions for Minors – A State-by-State Comparison (April 2018). National Conference of State Legislatures.
- National Council on Skin Cancer Prevention.
- Code of Federal Regulations Title 21, Volume 76, Number 117, Part 352: Sunscreen Drug Products for Over-the-Counter Human Use (April 2019). U.S. Food and Drug Administration.
- Code of Federal Regulations Title 21, Volume 76, Number 117, Part 201: Labeling (July 2018). U.S. Food and Drug Administration.
- Sunburn Protection Factor (SPF). U.S. Food and Drug Administration.
For health professionals
- Melanoma Treatment (PDQ®)—Health Professional Version. National Cancer Institute.
- Skin Cancer Treatment (PDQ®)—Health Professional Version. National Cancer Institute.
- 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.
- Counseling on Sun Protection and Indoor Tanning. Balk SJ, Gottschlich EA, Holman DM, Watson M. Pediatrics. 2017;140(6): e20171680.
- Skin cancer: multicomponent community-wide interventions. Community Preventive Services Task Force.
- Indoor Tanning Association settles FTC charge that it deceived customers about skin cancer risks from tanning. Federal Trade Commission.
- Dietary Reference Intakes for Calcium and Vitamin D (2010). Institute of Medicine.
- Stratosphere: UV index. National Weather Service: Climate Prediction Center.
- Sun Safety. U.S. Environmental Protection Agency.
- Sunscreen: How to Help Protect Your Skin From the Sun. U.S. Food and Drug Administration.
- 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.
- Radiation-Emitting Products: Sunlamps and Sunlamp Products (Tanning Beds/Booths). 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 recommendation statement. U.S. Preventive Services Task Force. JAMA 2018;319(11):1134–1142.
Scientific reports
- Reducing environmental cancer risk: what we can do now. National Cancer Institute. 2008–2009 Annual Report of the President’s Cancer Panel.
- Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomized trials. Autier P, Mullie P, Macacu A et al. Lancet Diabetes Endocrinol. 2017;5(12):986-1004.
- 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.
- Interdisciplinary Perspectives on Sun Safety. Geller AC, Jablonski NG, Pagoto SL et al. JAMA Detmatol. 2018:154(1):88-92.
- 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.
- Trends in indoor tanning and its association with sunburn among US adults. Guy GP, Watson M, Seidenberg AB et al. J Am Acad Dermatol. 2017;76(6):1191-1193 .
- The potential impact of reducing indoor tanning on melanoma prevention and treatment costs in the U.S.: An economic analysis. Guy GP, Zhang Y, Ekwueme DU et al. J Am Acad Dermatol. 2017;76(2):226-233.
- 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.
- Prevalence and predictors of total-body skin examination among US adults: 2005 National Health Interview Survey. Lakhani NA, Shaw KM, Thompson T, et al. J Am Acad Dermatol. 2011: 65(3): 645-648.
- 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.
- 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. U.S. Preventive Services Task Force. JAMA 2018;319(11):1134–1142.
- 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.
- Age-Specific Incidence of Melanoma in the United States. Paulson KG, Gupta D, Kim TS, et al. JAMA Dermatol. 2019. doi: 10.1001/jamadermatol.2019.3353. [Epub ahead of print]
- Research on Skin Cancer-Related Behaviors and Outcomes in the NIH Grant Portfolio, 2000-2014: Skin Cancer Intervention Across the Cancer Control Continuum (SCI-3C). Perna FM, Dwyer LA, Tesauro G et al. JAMA Dermatol. 2017;153(5): 398-405.
- State Indoor Tanning Laws and Prevalence of Indoor Tanning Among US High School Students, 2009-2015. Qin J, Holman DM, Jones SE et al. Am J Public Health. 2018;108(7):951-956.
- 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.
- Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017. Tabbakh T, Volkov A, Wakefield M, Dobbinson S. PLoS Med. 2019;16(10):e1002932.
- Surgeon General Call to Action to Prevent Skin Cancer, 2014. U.S. Department of Health and Human Services.
- Indoor tanning: The risks of ultraviolet rays. U.S. Food and Drug Administration.
- Tanning Salon Compliance Rates in States with Legislation to Protect Youth Access to UV Tanning. Williams MS, Buhalog B, Blumenthal L, Stratman EJ. JAMA Dermatol 2018;154(1):67-72.
Statistics
- SEER Cancer Statistics Review. National Cancer Institute.
- Cancer Statistics Center, 2018 Estimates. American Cancer Society.
- National Health Interview Survey. Centers for Disease Control and Prevention, National Center for Health Statistics.
Year Range
2009-2017
Recent Summary Trend Year Range
2013-2017
Summary Tables
Sun Protection
Recent Summary Trend
Falling
Desired Direction
Falling