Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates
Abstract
:1. Introduction
2. Methods
2.1. Study Setting
2.2. Instruments and Measures
2.2.1. Outcome Variables
2.2.2. Covariates
2.3. Statistical Analysis
3. Results
3.1. Intentional Outdoor Tanning
3.2. Tanning Bed Use
3.3. Combination of Outdoor and Indoor Tanning
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Current Tanning Bed Use | (Very) Frequent Intentional Outdoor Tanning | ||||
---|---|---|---|---|---|
% | % | p-Value | % | p-Value | |
Total | 7.5 | 13.8 | |||
Sociodemographic characteristics | |||||
Sex | 0.693 | <0.001 | |||
Female | 49.2 | 7.7 | 11.2 | ||
Male | 50.8 | 7.4 | 16.3 | ||
Age group | <0.001 | <0.001 | |||
16–25 years | 16.0 | 6.4 | 17.1 | ||
26–35 years | 19.7 | 7.8 | 23.4 | ||
36–45 years | 19.4 | 7.7 | 21.3 | ||
46–55 years | 22.5 | 11.2 | 6.7 | ||
56–65 years | 22.3 | 4.3 | 3.5 | ||
Immigrant background | 0.009 | 0.961 | |||
No | 85.8 | 7.1 | 13.9 | ||
Yes | 14.2 | 10.3 | 13.8 | ||
School education | <0.001 | 0.081 | |||
Low | 20.0 | 5.0 | 13.7 | ||
Medium | 37.4 | 5.6 | 11.9 | ||
High | 42.6 | 9.2 | 14.8 | ||
Partnership | 0.010 | 0.120 | |||
Yes | 67.8 | 6.9 | 13.3 | ||
No | 32.2 | 9.2 | 15.1 | ||
Employment | <0.001 | <0.001 | |||
None | 24.0 | 3.6 | 9.7 | ||
Part-time | 19.9 | 8.7 | 10.8 | ||
Full-time | 56.1 | 9.3 | 16.4 | ||
Lifestyle characteristics | |||||
Smoking | <0.001 | 0.001 | |||
Current | 25.2 | 9.2 | 15.9 | ||
Past | 24.9 | 9.9 | 15.9 | ||
Never | 49.9 | 5.5 | 11.6 | ||
E-cigarette use | <0.001 | 0.001 | |||
Current | 7.1 | 12.3 | 15.2 | ||
Past | 15.3 | 11.8 | 18.5 | ||
Never | 77.6 | 6.3 | 12.8 | ||
Paying attention to a healthy diet | 0.716 | 0.561 | |||
(Very) much | 60.6 | 7.4 | 13.5 | ||
Partly/not much/not at all | 39.4 | 7.8 | 14.2 | ||
Paying attention to sufficient physical activity | 0.481 | 0.152 | |||
(Very) much | 59.3 | 7.8 | 14.4 | ||
Partly/not much/not at all | 40.7 | 7.2 | 12.8 | ||
Skin-related risk factors | |||||
Skin type | 0.721 | 0.011 | |||
I–II | 40.7 | 7.2 | 13.9 | ||
III | 31.6 | 7.6 | 11.8 | ||
IV–VI | 27.7 | 8.0 | 16.1 | ||
Often sunburn before age of 15 | 0.391 | 0.951 | |||
Yes | 7.4 | 8.8 | 13.9 | ||
No/don’t know | 92.6 | 7.4 | 13.8 | ||
More than 40 naevi | <0.001 | 0.031 | |||
Yes | 32.6 | 9.8 | 15.5 | ||
No | 67.4 | 6.5 | 13.0 | ||
Family history of malignant melanoma | <0.001 | 0.005 | |||
Yes | 11.6 | 12.6 | 18.0 | ||
No/don’t know | 88.4 | 6.9 | 13.2 | ||
History of malignant melanoma | <0.001 | 0.873 | |||
Yes | 4.0 | 14.8 | 14.2 | ||
No | 96.0 | 7.2 | 13.8 | ||
UV-related risk awareness | |||||
“Each sunburn leaves a permanent damage in the skin” | <0.001 | <0.001 | |||
Rather agree | 77.1 | 6.5 | 12.4 | ||
Rather disagree | 19.3 | 11.9 | 18.3 | ||
Don’t know | 3.6 | 7.7 | 19.6 | ||
“Regular use of tanning beds causes premature skin aging” | <0.001 | <0.001 | |||
Rather agree | 78.8 | 5.7 | 12.5 | ||
Rather disagree | 17.4 | 15.6 | 19.7 | ||
Don’t know | 3.8 | 9.2 | 13.8 | ||
“Regular tanning bed use increases the skin cancer risk” | <0.001 | <0.001 | |||
Rather agree | 74.6 | 4.8 | 11.6 | ||
Rather disagree | 20.5 | 18.0 | 22.2 | ||
Don’t know | 4.9 | 6.2 | 12.3 |
Model I | Model II | Model III | Model IV | Model V | |
---|---|---|---|---|---|
OR [95% CI] | OR [95% CI] | OR [95% CI] | OR [95% CI] | OR [95% CI] | |
Sociodemographic characteristics | |||||
Sex | |||||
Female | 0.68 [0.55–0.83] | 0.68 [0.56–0.82] | |||
Male | Ref. | Ref. | |||
Age group | |||||
16–25 years | Ref. | Ref. | |||
26–35 years | 1.41 [1.04–1.89] | 1.39 [1.06–1.82] | |||
36–45 years | 1.27 [0.94–1.71] | 1.27 [0.97–1.68] | |||
46–55 years | 0.32 [0.22–0.46] | 0.33 [0.23–0.46] | |||
56–65 years | 0.17 [0.11–0.27] | 0.17 [0.11–0.26] | |||
Employment | |||||
None | Ref. | ||||
Part-time | 0.92 [0.66–1.28] | ||||
Full-time | 1.26 [0.97–1.64] | ||||
Lifestyle characteristics | |||||
Smoking | |||||
Current | 1.34 [1.05–1.71] | 1.21 [0.94–1.57] | |||
Past | 1.29 [1.02–1.64] | 1.37 [1.07–1.76] | |||
Never | Ref. | Ref. | |||
E-cigarette use | |||||
Current | 1.02 [0.70–1.48] | 0.89 [0.60–1.31] | |||
Past | 1.35 [1.05–1.74] | 1.12 [0.85–1.47] | |||
Never | Ref. | Ref. | |||
Skin-related risk factors | |||||
Skin type | |||||
I–II | Ref. | ||||
III | 0.83 [0.66–1.04] | ||||
IV–VI | 1.23 [0.99–1.53] | ||||
More than 40 naevi | |||||
Yes | 1.20 [0.90–1.46] | ||||
No | Ref. | ||||
Family history of malignant melanoma | |||||
Yes | 1.38 [1.06–1.80] | 1.14 [0.86–1.51] | |||
No/don’t know | Ref. | Ref. | |||
UV-related risk awareness | |||||
“Each sunburn leaves a permanent damage in the skin” | |||||
Rather agree | Ref. | Ref. | |||
Rather disagree | 1.13 [0.88–1.44] | 1.05 [0.82–1.34] | |||
Don’t know | 1.89 [1.16–3.10] | 1.67 [1.02–2.74] | |||
“Regular use of tanning beds causes premature skin aging” | |||||
Rather agree | Ref. | ||||
Rather disagree | 1.07 [0.81–1.40] | ||||
Don’t know | 0.87 [0.49–1.55] | ||||
“Regular tanning bed use increases the skin cancer risk” | |||||
Rather agree | Ref. | Ref. | |||
Rather disagree | 1.99 [1.55–2.56] | 1.84 [1.46–2.32] | |||
Don’t know | 0.90 [0.53–1.53] | 0.84 [0.51–1.38] | |||
Nagelkerke’s r2 | 0.127 | 0.010 | 0.009 | 0.028 | 0.140 |
n | 3801 | 3979 | 3947 | 3974 | 3959 |
Model I | Model II | Model III | Model IV | Model V | |
---|---|---|---|---|---|
OR [95% CI] | OR [95% CI] | OR [95% CI] | OR [95% CI] | OR [95% CI] | |
Sociodemographic characteristics | |||||
Age group | |||||
16–25 years | Ref. | ||||
26–35 years | 0.91 [0.56–1.48] | ||||
36–45 years | 1.06 [0.66–1.71] | ||||
46–55 years | 1.44 [0.92–2.27] | ||||
56–65 years | 0.65 [0.39–1.11] | ||||
Immigrant background | |||||
No | Ref. | Ref. | |||
Yes | 1.53 [1.07–2.17] | 1.06 [0.76–1.48] | |||
School education | |||||
Low | Ref. | ||||
Medium | 0.95 [0.61–1.49] | ||||
High | 1.52 [1.00–2.31] | ||||
Partnership | |||||
No | Ref. | Ref. | |||
Yes | 0.68 [0.51–0.91] | 0.80 [0.61–1.04] | |||
Employment | |||||
None | Ref. | Ref. | |||
Part-time | 2.38 [1.54–3.67] | 2.45 [1.66–3.60] | |||
Full-time | 2.40 [1.48–3.88] | 2.08 [1.33–3.25] | |||
Lifestyle characteristics | |||||
Smoking | |||||
Current | 1.39 [1.01–1.93] | 1.16 [0.82–1.63] | |||
Past | 1.57 [1.15–2.14] | 1.46 [1.05–2.02] | |||
Never | Ref. | Ref. | |||
E-cigarette use | |||||
Current | 1.76 [1.15–2.69] | 1.73 [1.11–2.70] | |||
Past | 1.64 [1.20–2.24] | 1.30 [0.92–1.83] | |||
Never | Ref. | Ref. | |||
Skin-related risk factors | |||||
More than 40 naevi | |||||
Yes | 1.43 [1.12–1.83] | 1.32 [1.02–1.71] | |||
No | Ref. | Ref. | |||
Family history of malignant melanoma | |||||
Yes | 1.61 [1.15–2.26] | 1.16 [0.81–1.66] | |||
No/don’t know | Ref. | Ref. | |||
History of malignant melanoma | |||||
Yes | 1.55 [0.94–2.54] | ||||
No | Ref. | ||||
UV-related risk awareness | |||||
“Each sunburn leaves a permanent damage in the skin” | |||||
Rather agree | Ref. | ||||
Rather disagree | 0.906 [0.66–1.23] | ||||
Don’t know | 0.95 [0.45–2.00] | ||||
“Regular use of tanning beds causes premature skin aging” | |||||
Rather agree | Ref. | Ref. | |||
Rather disagree | 1.42 [1.02–1.97] | 1.41 [1.02–1.96] | |||
Don’t know | 1.64 [0.82–3.28] | 1.97 [1.01–3.87] | |||
“Regular tanning bed use increases the skin cancer risk” | |||||
Rather agree | Ref. | Ref. | |||
Rather disagree | 3.71 [2.72–5.05] | 3.20 [2.34–4.36] | |||
Don’t know | 0.98 [0.47–2.04] | 0.96 [0.46–2.01] | |||
Nagelkerke’s r2 | 0.050 | 0.023 | 0.017 | 0.081 | 0.123 |
n | 3317 | 3993 | 3993 | 3988 | 3749 |
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Diehl, K.; Breitbart, E.W.; Greinert, R.; Hillhouse, J.; Stapleton, J.L.; Görig, T. Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates. Int. J. Environ. Res. Public Health 2022, 19, 12309. https://doi.org/10.3390/ijerph191912309
Diehl K, Breitbart EW, Greinert R, Hillhouse J, Stapleton JL, Görig T. Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates. International Journal of Environmental Research and Public Health. 2022; 19(19):12309. https://doi.org/10.3390/ijerph191912309
Chicago/Turabian StyleDiehl, Katharina, Eckhard W. Breitbart, Rüdiger Greinert, Joel Hillhouse, Jerod L. Stapleton, and Tatiana Görig. 2022. "Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates" International Journal of Environmental Research and Public Health 19, no. 19: 12309. https://doi.org/10.3390/ijerph191912309
APA StyleDiehl, K., Breitbart, E. W., Greinert, R., Hillhouse, J., Stapleton, J. L., & Görig, T. (2022). Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates. International Journal of Environmental Research and Public Health, 19(19), 12309. https://doi.org/10.3390/ijerph191912309