Interventions on Reducing Exposure to Tanning Beds among High School Age Students - Research Paper

There has been an unprecedented increase in cases of skin cancer, especially in the United States due to increased indoor tanning through use of indoor tanning devices such as tanning beds (Rogers et al., 2010). This is due to increased long-term exposure to harmful ultraviolet (UV) radiation emanating from both tanning beds and natural sunlight hence posing the risk of malignant melanoma to the users of the tanning devices, which is a potentially fatal form of skin cancer (Diepgen & Mahler, 2002). Annually, diagnosis of over 60 000 cases of melanomas takes place with approximately 3.5 million cases of non-melanoma being treated.

The rate at which melanoma causes the death of the infected people is not only high but also alarming such that in the year 2009, this deadly typical form of skin cancer claimed the lives of over 9000 people in the US. A Recent study by the world health organization indicated that the individuals who started using tanning beds in their teens and teens have a high risk of developing melanoma cancer (Torre et al., 2015).

Despite most of the cancer cases declining over the past decades, there has been an increase in melanoma cancer attributable largely to indoor tanning, particularly among the young mature women (Ferrucci et al., 2012). Indoor tanning increases the risks of cancer across different age groups in that 59% increment of melanoma cancer occurs to individuals before the age of 35, basal cell carcinoma increases by 40% in indoor tanning before the age of 25 and by 102% in squamous cell carcinoma (Guy et al., 2015). In addition to the health risks that skin cancer poses, it causes a significant economic burden such that it was noted that in 2004 approximately $1.7 billion in annual direct medical costs of treatment. In the US alone, tanning beds can increase the bill to a tune of $343 million yearly on medication costs. Unnecessary mortality, morbidity, and medical expenses continue to rise in the US due to increased rates of skin cancer.

Despite the apparent health risks posed by indoor tanning, there has been an unprecedented increase in exposure to tanning beds among the high school age students (Tuong et al., 2012). In 2011, 6.2% of male and 20.9% female students in high school engaged in indoor tanning. This has raised concerns among the world nations to develop sustainable intervention measures to curb this menace before the situation gets out of hand.

POLICY AND REGULATIONS

In the recent years, more than half of the world states have enacted laws and regulations prohibiting minors below a certain age from using tanning beds while six states have a total ban. In addition, others requirements that go along with these enacted laws such as provisions for permission of the parents and accompaniment of the minors by the parents or guardians vary by state. The aim of these legislations is to restrict the use of tanning devices by the minors as they run the risk of developing melanoma cancer due to high exposure to harmful ultraviolet rays from indoor tanning. Evidence shows that at least 32 states in the US have enacted laws restricting minors in using tanning facilities with seven of these states have enacted total bans prohibiting minors under a certain age from accessing and using the tanning facilities.

States such as California, Maine, Illinois, New York and New Jersey have enacted laws prohibiting individuals under the age of 14 from using the tanning devices while Wisconsin and Texas prohibiting minors under the age of 16 and 16.5 respectively from using tanning facilities. Additionally, along with the prohibition of minors under a certain age from using tanning facilities, some states have gone an extra mile and enacted stringent regulations on other requirements for tanning bed such as North Carolina law that provides that a minor below the age of 13 be prohibited from using tanning facilities. The Carolina law further requires that a written prescription from a physician indicating the nature of the condition of treatment in case a minor below the age of 13 require treatment. In other states such as Delaware, New Hampshire, and North Dakota allows minors age of 14 to use a tanning bed in case they have a medical order or parental consent or accompaniment. Moreover, 21 states have also enacted laws for addressing penalties for tanning facilities that do not comply with the regulations while 11 of these states having provisions for addressing the licensing of the tanning facilities.

This shows that there are commitments by the states through policies and regulations to curb the menace of the increasing rates of skin cancer. These laws have an effect of restricting the youths in accessing indoor tanning facilities and targeting on the reduction of consumer risk while including the operators and facility responsibilities (Nikolaou & Stratigos, 2014). Additionally, these policies and regulations seek to enhance safety and equipment standards and enforcing authority and penalties to the manufactures who do not comply. Studies indicate increased compliance rates among the tanning facilities for parental permission laws and hence a progress in the efforts by the states in reducing the increasing rates of skin cancer. This, therefore, indicates that these laws are effective in reducing the use of tanning beds among adolescents especially those laws providing for age restrictions.

Awareness creation campaigns

Awareness creation through mass media is critical in enhancing the fight against cancer and is highly recommended in conjunction with other interventions. These campaigns raise awareness of the harmful threats posed by indoor tanning through exposure of harmful ultraviolet rays (UV rays) and have an effect of changing the behavior of individuals especially the adolescents and changing their social norms over time (Autier, 2004). However, in their recently updated literature, Task Force indicated that there is no sufficient evidence to determine the efficiency of this strategy alone of raising awareness through mass media in reducing the exposure of individuals to ultraviolet radiation.

In other countries, mass media campaign's in raising awareness against cancer have been successful especially the overall sun-safety campaign in Denmark that included an initiative that targeted indoor tanning youths aged between 12 and 25 years and urged them to desist from using the sunbed. Widespread proactive campaigns' and youth surveillance efforts have indicated a decrease in the use of indoor tanning devices in public buildings since these campaigns' started. These efforts have succeeded due to a comprehensive social marketing approach and extensive efforts that have been put in the social media.

The media can help change the social norms of individuals by encouraging people to accept their untanned skin and shun the use of tanning beds. These can be done through publishing articles, magazines, newspapers including other media platforms that encourage users of tanning devices to stop using them. This would be effective if the media promoters and campaigners would give detailed information of the harmful ultraviolet rays from the tanning beds leads to the deterioration of the skin including the financial implications ion bid to raise the medical expenses.

Programs and shows through the media that show life experiences of individuals who are living with cancer that developed because of using the tanning beds can send a strong message to the minors who are adamant in using the devices. The media should also educate the audience on the laws and policies in place in various states and penalties that one risk in case of non-compliance. This creates a healthy society that would promote consumer security and encourage manufacturers of products to follow strict standards when manufacturing their products. The Cosmopolitan magazine is an example of an educative media campaign that covered a number of celebrities that have spoken about the dangers of indoor tanning and hence enhancing the "Practice Safe Sun" campaign.

There need to be concerted efforts by the public health experts to raise awareness on the effects of tanning beds and encourage by the involvement of all stakeholders from all disciplines in the campaign.

References

Rogers, H. W., Weinstock, M. A., Harris, A. R., Hinckley, M. R., Feldman, S. R., Fleischer, A. B., & Coldiron, B. M. (2010). Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Archives of dermatology, 146(3), 283-287.

Diepgen, T. L., & Mahler, V. (2002). The epidemiology of skin cancer. British Journal of Dermatology, 146(s61), 1-6.

Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., LortetTieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA: a cancer journal for clinicians, 65(2), 87-108.

Ferrucci, L. M., Cartmel, B., Molinaro, A. M., Leffell, D. J., Bale, A. E., & Mayne, S. T. (2012). Indoor tanning and risk of early-onset basal cell carcinoma. Journal of the American Academy of Dermatology, 67(4), 552-562.

Tuong, W., Cheng, L. S., & Armstrong, A. W. (2012). Melanoma: epidemiology, diagnosis, treatment, and outcomes. Dermatologic clinics, 30(1), 113-124.

Nikolaou, V., & Stratigos, A. J. (2014). Emerging trends in the epidemiology of melanoma. British journal of dermatology, 170(1), 11-19.

Guy, G. P., Berkowitz, Z., Jones, S. E., Holman, D. M., Garnett, E., & Watson, M. (2015). Trends in indoor tanning among US high school students, 2009-2013. JAMA dermatology, 151(4), 448-450.

Autier, P. (2004). Perspectives in melanoma prevention: the case of sunbeds. European Journal of cancer, 40(16), 2367-2376.