CA Cancer J Clin 2002; 52:249
doi: 10.3322/canjclin.52.5.249
© 2002 American Cancer Society
STUDIES DOCUMENT NEED TO IMPROVE TEENS’ SUN PROTECTION ATTITUDES AND BEHAVIOR
It appears that many children and young adults are unaware of recommendations for sun protection or they are ignoring them, according to three articles in the June and July issues of Pediatrics (2002;109:1009–1014, 1124–1130 and 2002;110:27-35).
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First Study Looks for Modifiable Sunburn Risk Factors
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Teens’ sun protection attitudes and behavior are in need of improvement.
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In the first article, Kourtney J. Davis, PhD, of GlaxoSmithKline, Inc. in Research Triangle Park, NC, a former American Cancer Society (ACS) epidemiologist, and colleagues from the Centers for Disease Control and Prevention, the ACS, and Brown University reported that 72 percent of children aged 11 to 18 surveyed in 1998 had at least one summer sunburn. And many of those children had several sunburns during the summer of that same year (30 percent reported at least three sunburns and 12 percent reported at least five).
Forty percent of the children said they had used sunscreen when they developed their most serious sunburn of the summer. And only five percent of the children had used "sun-sensible ways" of protecting themselves before they had gotten their most serious sunburn (i.e., by wearing protective clothing or a wide brimmed hat, or by staying in the shade).
"The high frequency of sunscreen use during the sunburning episodes suggests the need to educate youth and parents better about proper use of these agents, as well as the importance of practicing other sun-protection behaviors such as wearing hats and protective clothing, and avoiding the sun during peak exposure times," the authors said. They concluded that "there is a real need for better education and awareness of proper use of these lotions to be accomplished through media/ education-based programs as well as through the American Cancer Society ‘Slip! Slop! Slap!’ message: (SLIP! on a shirt, SLOP! on sunscreen, and SLAP! on a hat)."
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Second Study Focuses on Use of Tanning Lamps
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In a second article, Vilma Cokkinides, PhD, and colleagues from the American Cancer Society (ACS) and Brown University in Providence, RI, looked at the prevalence of tanning sunlamp use by young people aged 11 to 18 in the United States. Researchers also surveyed the tanning behavior of the teens’ parents or adult caregivers.
Looking at the entire group, more than ten percent of youth surveyed had used indoor tanning sunlamps in the previous year. More disturbing, they said, was the finding that four out of ten young women aged 17 to 18 had used a tanning sunlamp over the previous year. Researchers found that if a parent or caregiver used a sunlamp in the previous year, then 30 percent of their children did the same. Other factors associated with the use of tanning lamps aside from age and parental influence included a desire to have a tanned look, and not using a sunscreen with sun protection factor (SPF) of 15 or greater when at the beach or outdoor pool.
"A single 15- to 30-minute salon session exposes the body to the same amount of harmful UV sunlight as a day at the beach," the authors wrote. The result is that children are putting themselves "at greater [and unneces-sary] risk of experiencing the short- and long-term health impact of UV exposure."
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Third Study Documents Deficits in Sun Protection Knowledge, Attitudes, Behavior
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The third study, by Alan Geller, RN, MPH, and associates from Boston University and Harvard Medical School, both in Boston, and the Memorial Sloan-Kettering Cancer Center in New York City surveyed the prevalence of sunscreen use, sunburning, and tanning bed use among 10,079 boys and girls aged 12 to 18 from all 50 states. The study, conducted in 1999, was limited to white youth, since non-whites have a far lower risk of developing skin cancer.
The findings are disappointing, but not surprising. Only 40 percent of the girls and 26 percent of boys surveyed used sunscreens. About one-third of the girls and almost 25 percent of the boys thought it was a good idea to burn when trying to get a good tan. Fourteen percent of girls and two percent of boys had used a tanning bed during the past year. Girls’ use of tanning beds increased substantially with age (seven percent of 14-year-olds and 35 percent of 17-year-olds). Eighty-three percent of the young people had a sunburn during the previous year, and 36 percent had three or more sunburns during that period.
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Advice From the Authors
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The problem needs to be attacked from several angles, according to Geller and col-leagues. A change in attitudes and behaviors is key, along with long-term public health approaches such as putting age limits on who may use a tanning bed. We need to teach students about these dangers in school, and make people, both young and old, aware of how much UV exposure they are likely to get by encouraging them to listen to "UV index reports" on weather, news, and other broadcasts, wrote Geller.
Cokkinides and colleagues also suggested requiring parental consent where possible. While "teenagers may be the most vulnerable because of their lack of full awareness of the health risks involved and their (desire) to intentionally tan," they wrote, "parents are able to directly advocate prevention and incorporate preventive behaviors into family routines."
Davis and colleagues suggested strategies that address the four modifiable factors they found to be independently associated with sunburn prevalence—"higher desirability of a tan, lower perceived benefits of sun protection, deliberate sunbathing, and higher levels of summer-sun exposure during the hours of 10:00 AM and 4:00 PM."
"We need to find new ways to talk with teens about protecting their skin," Davis said. "Teens are different, and nagging them is not effective."
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First Study Looks for...
Second Study Focuses on...
