Indoor Tanning May Be Addicting for Some Young Adults
Findings may have implications for interventions aimed at reducing skin cancer risk, researchers say.
April 28, 2010 — Indoor tanning may be an addictive behavior for certain young adults, according to a study published in the April issue of Archives of Dermatology.
This study "extends prior work by relating indoor tanning addiction to substance use and affective disturbance," Catherine E. Mosher, PhD, from the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, and colleagues note in their article.
Between September and December 2006, a total of 421 college students from the northeastern United States anonymously completed questionnaires regarding indoor tanning habits, substance use, anxiety and depression symptoms, and demographics.
To assess potential dependence on indoor tanning, the researchers used modified versions of the Cut down, Annoyed, Guilty, Eye-opener (mCAGE) Questionnaire used to screen for alcoholism and the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (mDSM-IV-TR) criteria used to screen for substance-related disorders.
Versions of these measures were used in prior research to assess addiction to UV light tanning, the investigators note. Participants also completed the Beck Anxiety Inventory and the Beck Depression Inventory.
When asked if they had ever tanned indoors, 237 (56.3%) of the 421 student participants answered yes. Eight of these individuals were omitted from further analyses because of missing data on the mCAGE and mDSM-IV-TR measures, leaving a total of 229 students who had used indoor tanning facilities. Ninety (39.3%) of them met mDSM-IV-TR criteria and 70 (30.6%) met mCAGE criteria for addiction to indoor tanning, the study team found.
The students reported a mean of 23 indoor tanning sessions in the past year. Those who met criteria for addiction to tanning reported tanning more often than those with addictive tendencies, and both groups reported more tanning than those who did not meet criteria for addiction to indoor tanning.
Link to Substance Use, Anxiety
With regards to the relation between substance use and indoor tanning, "a major difference" emerged, Dr. Mosher told Medscape Psychiatry.
Forty-two percent of students who met criteria for indoor tanning addiction (21 of 50) reported using 2 or more substances (excluding alcohol) in the past month. In contrast, only 16.0% of students (29 of 181) who had never tanned indoors and 16.8% of students (20 of 119) who were not addicted to tanning affirmed this degree of substance use. Students who met study criteria for addiction to indoor tanning also reported greater alcohol and marijuana use.
"Overall, findings suggest that individuals who use drugs may be more likely to develop dependence on indoor tanning because of a similar addictive process," Dr. Mosher and colleagues write. "In addition, tanning and drug user may be reinforced by peer group norms."
Depressive symptoms did not vary significantly by indoor tanning addiction status; however, "the rate of moderate-to-severe anxiety was almost double" among those addicted to indoor tanning, Dr. Mosher said.
Specifically, 14 (28.0%) of the 50 students who met criteria for indoor tanning addiction had moderate-to-severe anxiety on the Beck Anxiety Inventory, compared with 21 (11.6%) of 181 students who did not use indoor tanning, 18 (15.1%) of 119 not addicted to tanning and 12 (20.0%) of 60 with addictive tendencies toward indoor tanning.
If the association between anxiety and indoor tanning is replicated, "referral to mental health services might be in order for a patient who is excessively engaging in tanning and appears to be anxious or depressed," said Dr. Mosher.
More Women Than Men
There was no association between skin type and addiction to indoor tanning, although the researchers say this may be due to underrepresentation of students with darker skin tones.
In addition, sex was not associated with addiction to indoor tanning, although women were overrepresented in the study. "Further studies with sex-balanced samples are needed," the study authors note.
Limitations of the study include its cross-sectional design and reliance on self-report measures. The study population — undergraduates from the northeastern United States — means the findings may not be generalizable across individuals of different age group, socioeconomic levels, and geographic areas.
On the basis of these findings, Dr. Mosher and colleagues say it would be "interesting to explore the physiologic and psychological mechanisms underlying the relations among addiction to indoor tanning, other addictive behaviors, and affective disturbance."
"Such research would inform biopsychological conceptualizations of tanning behavior and tailored interventions that address individuals' motivations for tanning and the relation of those motivations to psychopathological conditions," they write.
Arch Dermatol. 2010;146:412-417.
News Author: Megan Brooks
CME Author: Laurie Barclay, MD
Source: Medscape: http://cme.medscape.com/viewarticle/720920?src=cmemp&uac=105105SV