Skin cancer researchers and dermatologists say more action may be needed to dissuade young people from using tanning beds, after a survey found that a ban in Ontario made little difference to usage among youth.
The Skin Cancer Prevention Act, enacted in May of 2014, prohibits the sale of ultraviolet services to anyone under 18. Vendors are required to check the identification of people who look younger than 25, provide protective eyewear and display signs about the risks of tanning.
An Ontario group that studies the effects of ultraviolet radiation on human health distributed questionnaires about tanning habits to students in Grades 7 through 12. The first survey was completed in spring 2013 and 2014. The second came a year after the ban had been instated.
Youth ignore tanning ban
The number of youth who said they used a tanning bed at least once within the previous year rose from almost 7 per cent of respondents to nearly 8 per cent after the ban was implemented.
Of those that tanned during the ban, more than three quarters were new users.
“We know that one year out, we’re not seeing any change in tanning bed use, which was a surprise to us,” said John Atkinson, co-author of the report and director of cancer prevention at the Canadian Cancer Society.
All provinces have youth tanning legislation, but Atkinson said that there have not been any critical studies that measure the effectiveness of provincial youth tanning bans, until now.
“The risk for UV radiation just has not been a big priority for the government,” said Atkinson.
And the health risks are greater when tanning starts early. The International Agency for Research on Cancer said that the risk of developing melanoma, the deadliest skin cancer, is more likely if any amount of tanning bed use begins before the age of 35.
“If your mother or father is someone who tans, you are also more likely to start tanning,” said Atkinson, citing a 2011 American Journal of Public Health study that looked at the predictors of youth tanning.
But he said the ban does have the capacity to work, if it’s enforced.
The survey found that 72 per cent of teens who were refused service at least once did not use tanning beds again during the first year of the act.
“This legislation is really positive. But there’s obviously some more work that needs to be done,” said Atkinson.
Public health units are responsible for enforcement of the act, and tanning bed proprietors must register their business under these groups.
More policing needed
Part of the problem for Atkinson and his colleagues is that the current system is complaint-based, meaning that infractions are only found if the public reports illegal practices, which he said is unlikely to happen.
Measures like spot checks and secret shopping should accompany the current system, said Atkinson.
Ottawa Public Health has 64 businesses with tanning beds registered in its database.
Craig Calder, manager of environmental health protection for Ottawa Public Health, said that inspectors were already monitoring tanning businesses before the ban. Annual visits to tanning salons were a part of personal service inspections that review the health standards of businesses that offer aesthetic services, like tattoo parlours and hair salons.
Since the ban, these scheduled visits now include checks to ensure that employees are knowledgeable, signs are up and goggles are on-site.
Calder said no one has ever contacted Ottawa Public Health to complain about infractions.
“We haven’t had to lay any tickets or take anybody to court,” said Calder.
If fines were laid in Ottawa or any other health unit, it would be like getting a speeding ticket.
Infractions of signage, protective eyewear and tanning under 18 range between $100 to $300. If the health unit sees the number of violations pile-up, cases may be taken to court. Individuals can face fines of up to $5,000 while for corporations they can be up to $25,000.
Without complaints though, Calder said that the annual inspections are all they have to measure obedience.
But he believes that tanning services have been responsible and compliant, and as a result there has not been a need for a heavier enforcement approach in Ottawa.
Business on board
Jovani Farah, a tanning salon owner in Ottawa, supports the ban and said she always asks for identification if customers look young.
“Some people don’t even know there is a tanning bed ban,” said Farah.
There have been times when people aren’t aware of the ban until they see signs or speak with Farah. She said that many opt for a spray tan instead.
The Ontario Sun Safety Working Group, the group that did the survey, also recommends that the provincial government starts social marketing and health campaigns to prevent people from feeling the urge to use tanning beds in the first place.
“Some young people and some adults feel that tanning makes them look more sexually appealing or more attractive,” said Atkinson.
Many people also tan indoors to prevent burns on vacations, but Atkinson said there is no evidence that suggests tanning beds are safer than laying out in the sun.
While health campaigns can prevent behaviour through the use of testimonials and knowledge of risks, an “overall comprehensive strategy” is the best approach, according to Jim Mintz, managing partner at the Centre of Excellence for Public Sector Marketing.
Laws are useless unless there are incentives for businesses to follow the law, said Mintz.
“We could learn from other programs,” he added.
Anti-tobacco and alcohol public projects used secret shopping and social marketing in order to curb youth consumption.
Mintz said that the solutions are very simple for addressing youth tanning: they shouldn’t break the bank or take long to implement.
The Ontario Sun Safety Working Group presented its findings to the provincial government earlier this year, before releasing them to the public. The Ministry of Health and Long-Term Care said it would take them into consideration.
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