Tanning can be addictive
A study from the USA has provided further evidence that some people who tan excessively are tanning dependent.
The study recruited 400 volunteers from an American university, who were asked to complete an online questionnaire that had been modified to identify tanning dependence (modified CAGE and DSM-IV-TR scales). The mean age of participants was 21 years, 75% were women and 66% were white.
More than 25% of participants were defined as tanning dependent, with a high level of concordance between the two scales used. The most commonly endorsed questionnaire items in those identified as tanning dependent were ‘annoyance with people's advice against tanning' (modified CAGE) and ‘tanning despite cancer risk' (modified DSM-IV-TR).
Tanning dependence was associated with longer hours spent sunbathing, higher frequency of sunburn and lower levels of sun protection. It was also linked with increased use of indoor tanning booths in warm weather but not chemical sunless tanners. Those who were tanning dependent were significantly more likely to be smokers and to have a low BMI.
Despite extensive public health education about the risks of excessive exposure to ultraviolet radiation, some people continue to tan excessively. Similarities between excessive tanning and substance use disorders are increasingly being discussed. Both are particularly common in the young, associated with pleasurable reinforcing experiences such as relaxation and socialisation and represent health risk behaviours that continue despite health warnings. A possible mechanism, linking tanning to endogenous opioid release during ultraviolet radiation exposure, has been mooted.
The concept of tanning dependence may be new to many GPs and may help them provide health education for those who continue to tan excessively.
Heckman CJ, Egleston BL, Wilson DB et al. A Preliminary Investigation of the Predictors of Tanning Dependence. Am J Health Behav 2008;32:451-64Reviewer
Dr Jez Thompson
Former GP, Clinical Director, Leeds Community Drug Services