The case against indoor tanning is a strong one: According to the American Academy of Dermatology, indoor tanning before the age of 35 is linked to a 75 percent increase in the risk of developing melanoma, the deadliest form of skin cancer. But the cancer risk hasn't been bad for business — on an average day, more than 1 million people visit indoor tanning salons, and research conducted in 2008 found an average of 42 tanning salons per city in the United States.
Tanning aside, there are more than 1 million new cases of skin cancer diagnosed every year, and an estimated $300 million is spent annually treating melanoma.
If indoor tanning poses such a substantial health risk, why do people — especially teens — keep doing it?
A recently published report by Catherine E. Mosher of Memorial Sloan-Kettering Cancer Center in New York and Sharon Danoff-Burg of the University of Albany, State University of New York, offers one explanation for the rampant use of tanning beds by people who should know better: For some, indoor tanning could be addictive.
The researchers gave 421 study participants two questionnaires traditionally used to test for alcohol and substance abuse that had been modified to measure tanning addiction. They also assessed participants' anxiety, depression and substance use.
For the 229 participants guilty of "fake-baking," the average number of visits made to a tanning salon in the past year was 23. But the scientists found that 90 of these participants met the criteria for tanning addiction on one measure used, and 70 did on another. These "tanaholics" were also more likely to report anxiety and substance use than other study participants.
Meanwhile, in a study released today in the Archives of Dermatology, for at least some tanning addicts, clearly pointing out the leathery skin that frequent tanning is likely to produce may be sufficient to cut down on their visits.
There may be a (non-UV) light at the end of the tunnel: A little-known provision in the United States' divisive new health care reform package might be effective in reducing tanning bed use. The legislation imposes a 10 percent tax on indoor tanning to help pay for health care reform. The bill originally taxed cosmetic surgery at 5 percent — a so-called "Bo-tax" — but opposition from medical and dermatological circles led Congress to a tanning tax instead.
The tanning tax has faced opposition from the industry and tanning aficionados alike. Research suggests that if it resembles other so-called "sin taxes," it just might reduce the use of tanning beds.
Taxes on environmental and social ills, from plastic bag use to obesity, do reduce consumption; one study found that taxing junk food was more effective at improving diet quality than subsidizing fruits and veggies.
And there's plenty of research to support the contention that sin taxes reduce substance use, even for addicts.
One study in the February 2009 issue of Addiction found that the more alcoholic beverages cost, the less likely people are to drink. Researchers analyzed 112 studies spanning nearly 40 years and found a concrete relationship between the cost of alcohol and how much of it people consume. Tax or price increases on alcohol reduced use for heavy and light drinkers, young and old, which suggests that a tanning tax might reduce use for casual tanners and tanaholics alike.
Another paper published this year reviewed 72 studies to determine whether making it more expensive to drink might reduce the bad effects of drinking. The researchers found that as the tax or price on alcohol increased, both excessive drinking and poor health due to drinking decreased.
Raising taxes on tobacco also appears to curb use. A fact sheet from the Campaign for Tobacco-Free Kids quotes a 1985 Philip Morris document, "Of all the concerns, there is one — taxation — that alarms us the most. While marketing restrictions and passive smoking [restrictions] do depress volume, in our experience taxation depresses it much more severely."
The same fact sheet suggests that every 10 percent increase in the real price of cigarettes reduces consumption by 3 to 5 percent. However, research from Columbia University suggests that while cigarette taxes do reduce smoking, they also grow the black market for cigarettes in poor neighborhoods. (Imagine a back-alley black market for indoor tanning: suburban housewives sneaking their friends into their garages for tax-free tanning somehow doesn't seem likely.)
Whether or not the tanning tax reduces indoor tanning, it might make tanners feel better about their habit. The National Bureau of Economic Research found that smokers are actually happier when cigarette taxes are higher. James Sadowsky, professor of philosophy at Fordham University, writes, some smokers and moderate drinkers like sin taxes because they make them feel less guilty for their actions.
Still, while it appears that a tax on tanning may be just what the dermatologist ordered, it's important to remember the irony inherent in taxing sin: If the taxes actually discourage "sinful" behavior, they stop being lucrative. In other words, if the tanning tax actually helps addicts kick the habit, it probably won't succeed in raising the $2.7 billion it's supposed to generate.