slides trouble with tanning beds

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with Dr. Mike Magee

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Hooked on Tanning? Big business, but bad for your health

• Our culture places a premium on youth, good looks, glamour• Many believe a deep tan is “glamorous”  - Recent surge in tanning salons• Young people, in particular, are customers, despite dangers: 

• Our culture places a premium on youth, good looks, glamour • Many believe a deep tan is “glamorous” - Recent surge in tanning salons • Young people, in particular, are customers, despite dangers The Big Business of Tanning “If I have a big event to go to, like my sorority formal or a wedding, I’ll go to a tanning salon three times the week before. But then I’ll cut back for the rest of the month. I try not to go too often. I am nervous that this could cause cancer and wrinkles. But, then again, I don’t want to be pale.” -- Casey Brooks U.S. college student Quoted in The New York Times Sources: Singer N. “Seeking ‘Healthy’ Look, Tanners Ignore Risks.” The New York Times. May 18, 2006.

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Business Snapshot United States • 25,000+ tanning outlets • 160,000 employees • 30 million customers • $20 - $50 dollars per session • $2 billion+ in spending per year Great Britain • 3 million+ indoor tanners • 1 in 5 customers pays for 100+ tanning sessions a year Sources: Singer N. “Seeking ‘Healthy’ Look, Tanners Ignore Risks.” The New York Times. May 18, 2006. Indoor Tanning Association. “Frequently Asked Questions.” Available at http://www.theita.com/indoor/faq.cfm. Times Online. “Are You Tanorexic?” November 14, 2004. Available at http://www.timesonline.co.uk/article/0,,2104-1344980,00.html.

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Skin Cancer Rates Have Soared 50% of new cancers are skin cancers • 3 forms, arising from different cells in skin’s outer layer • 2006: 1.3 million Americans will be diagnosed Sources: American Cancer Society. “Overview: Skin Cancer - Nonmelanoma.” American Medical Association House of Delegates. May 30, 2006. Resolution: 428 (A-06). American Cancer Society. “Overview: Skin Cancer - Melanoma.” American Academy of Dermatology. “Indoor Tanning: All the Dangers of the Outdoors Including Skin Cancer.” April 24, 2002. Barrett J. “Health: Your Tan Could Kill You.” Newsweek. June 5, 2006. Available at http://www.msnbc.msn.com/id/13007383/site/newsweek/. Types of skin cancer • 70%: basal cell carcinomas (arising from bottom basal cells) • 23%: squamous cell carcinomas (from surface thin squamous cells) • 7%: melanomas (arising from pigment-producing melanocytes) Each tumor behaves differently • Melanoma is most likely to metastasize and cause death • 2006: 7,500 Americans will die from skin cancer • All skin cancers are on the rise: rates 3X – 4X higher than 1976

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Primary Culprit: Exposure to Ultraviolet Rays UV Rays from Sun/Tanning Beds • UVA: damages surface epidermis, connective tissues, vessels below • UVB: associated with quick surface burns Sources: Feldman SR, et al. 2004. Ultraviolet exposure is a reinforcing stimulus in frequent indoor tanners. J Am Acad Dermatol. 2004;51:45-51. World Health Organization. “The known health effects of UV.” Available at http://www.who.int/uv/faq/uvhealtfac/en/index.html. Can cause cancer in 3 ways: 1) Disrupts DNA • Resulting in mutations, causing cells to grow out of control 2) Disorders cell oxygen metabolism • Damaging molecule function 3) Locally interferes with skin’s immune defense system • More likely cancer will arise unchecked

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What Keeps Tanning Customers Going Back? “Fake tan is fine, but after a sunbed treatment I’m on a mini-high ... I always feel in a good mood after a session. So much so that, when I come out, the first thing I do is book the next one.” Sources: Times Online. “Are You Tanorexic?” November 14, 2004. Levins PC., Carr DB, Fisher JE, Momtaz K, Parrish JA. Plasma beta-endorphin and beta-lipoprotein response to ultraviolet radiation. Lancet. 2003;2:166. Garssen J, Buckley TL, Van Loveren H. A role for neuropeptides in UVB-induced systemic immunosuppression. Photochemistry and Photobiology. 1998;68:205-10. “Fake tan” products dye skin to make it darker • Gives “the look,” which is harmless, but not “the feeling” -- Lynne McFadden U.K. law student Quoted in The Sunday Times Where does “the feeling” come from? • UV rays cause release of endorphins, neuropeptides from skin • Mood elevation is distinct

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Unconcerned Industry Myth: Tanning treatments are needed to activate vitamin D Reality: We get plenty of vitamin D from normal sources • 5 - 15 minutes of casual sun exposure to hands/face/arms several times a week during summer months is efficient Sources: World Health Organization. “The known health effects of UV.” Available at http://www.who.int/uv/faq/uvhealtfac/en/index.html. Skin Cancer Foundation. “The Case Against Indoor Tanning.” Available at: http://www.skincancer.org/artificial/index.php. The experience is “more than just a good tan; [customers] also enjoy the positive psychological and physiological effects of regular exposure to ultraviolet light.” -- Indoor Tanning Association “Moderate tanning has never been linked to skin cancer. In fact, by helping people tan with a reduced incidence of sunburn, indoor tanning may reduce your risk of ever contracting skin cancer.” -- Tanning Trends magazine

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Time to Take Action So far, we have been either unwilling or unable to regulate an industry whose profits come only with rising disease burdens and health costs. Sources: Singer N. “Seeking ‘Healthy’ Look, Tanners Ignore Risks.” The New York Times. May 18, 2006. American Medical Association House of Delegates. May 30, 2006. Resolution: 428 (A-06). Skin Cancer Foundation. “As Sun Safety Grows, So Do the Benefits of Sunless Tanning.” AMA has called for 3 steps to bring about change 1) Tanning booths should be off-limits to those 18 or younger 2) FDA should conduct hearings to weigh in on risk and need for increased regulation 3) Booths should come with a surgeon general’s warning “New cigarette packs say smoking causes cancer. We don’t want to wait another 50 years to have labels that adequately warn people that tanning beds cause cancer.” -- Rep. Carolyn Maloney (D - NY)

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Release Date: 8/16/2006 www.HealthPolitics.org Hooked on Tanning? Big business, but bad for your health