March 14, 2007 -- Despite the dangers and the health warnings, some people feel like they just have to tan.
Now a new survey shows what dermatologists have long suspected -- that tanning can be an addictive behavior, similar to a drug or alcohol addiction.
The finding may shed light on why public health messages about the risks of sun exposure have been ignored by so many people, especially teens and young adults.
"If tanning is addictive, as our study suggests, it helps explain why education alone will probably not stop high-risk tanning behaviors -- similar to how the 'don't drink' and 'don't smoke' messages often fail to change behaviors," researcher Robin L. Hornung, MD, MPH, says in a news release.
A Tanner's High?
Previous research suggests that exposure to ultraviolet (UV) light, either from indoor tanning beds or the sun itself, causes the release of endorphins, which can produce euphoric sensations. The euphoria is the same as the "runner's high" that people often experience with intense exercise.
In the new study, 385 students at the University of Washington at Seattle were surveyed in an effort to find out if tanning rose to the level of an addictive behavior.
Four of the survey questions, designed to determine if exposure to UV light was an addiction, were modified from a screening tool for alcohol abuse, known as the "cut down, annoyed, guilty, eye-opener" (CAGE) questionnaire. Those who reported "yes" to two or more questions were considered to have a positive screening. The questions were:
- Have you ever felt you ought to cut down on tanning?
- Have people annoyed you by criticizing your tanning?
- Have you ever felt bad or guilty about your tanning?
- Have you ever thought about tanning first thing in the morning?
Seventy-six percent of the female study participants and 59% of the males reported tanning their skin on purpose. Forty-two percent of the females and 17% of the males reported tanning indoors at tanning salons.
Women tanners were more likely than men to score positively in their CAGE response, suggesting UV light addiction. Of the respondents who acknowledged purposely tanning, 22% of the women and 8% of the men had positive CAGE results.
'Education Isn't Enough'
Hornung and co-researcher Solmaz Poorsattar also found that:
- Indoor tanners were more likely to report problem tanning behaviors than outdoor tanners -- 28% vs. 18% answered CAGE questions positively.
- Almost one in 10 intentional tanners (9%) reported tanning more than 20 times a month.
- Survey respondents who reported a family history of skin cancer were more likely to engage in tanning than those without such a history.
- Three out of four tanners said they exposed their skin to UV light to look better, while 41% said they tanned to relax and 22% said they tanned to feel healthy.
- One in five tanners believed that they tanned too much. The same percentage reported feeling guilty about tanning, and about one in 10 said they had been annoyed by people's criticism of their tanning.
"The fact that tanning may be addictive for some individuals should strengthen the argument for stricter regulations on the indoor tanning industry," Hornung says. "Education alone is not enough to stop high-risk tanning behavior, and skin cancer rates will continue to increase markedly without proper intervention."
Washington, D.C., dermatologist and American Academy of Dermatology board member Sandra Read, MD, says she is all too familiar with patients who want to stop tanning but can't.
"I hear the language of addiction in their comments," she tells WebMD. "They tell me, 'I know it's not good for me, but I can't stop' and 'I wish I could stop,'" she says. "I liken it to a nicotine addiction. For some people it isn't just a question of choice. It's physical."
When patients tell her they are tanning to look better, she tries to get them to switch to a cosmetic tanner.
"There are very good products out there to help people achieve the look they want without tanning," she says.