Brief 6: Sun Safety: Perceptions and awareness

In this HINTS Brief, we examine sun-safety practices in the U.S. population and explore differences by sociodemographic characteristics according to HINTS 2005 data.

Only a Minority of Americans Regularly Practice Sun Safety

Skin cancer is the most common type of cancer in the United States, developing in approximately one million Americans each year. Nonmelanoma skin cancers (basal cell cancer and squamous cell cancer) are much more common than melanoma; however, melanoma is the most serious type of skin cancer. Exposure to ultraviolet (UV) rays (both A and B rays) appears to be the most important environmental risk factor for the development of skin cancer. The most effective way to lower the risk of skin cancer is to engage in sun-safety practices, such as wearing sunscreen and protective clothing, seeking shade, and avoiding artificial sources of UV rays (tanning booths and sunlamps).

Respondents to the 2005 Health Information National Trends Survey (HINTS 2005) were asked a series of questions about the frequency with which they engage in sun-safety practices. Only a minority of Americans reported "always or often" engaging in protective behavior when outside for an hour or more on a warm, sunny day. Although 43.4% of respondents reported "always or often" seeking shade, half said they "rarely or never" used sunscreen. Other protective strategies were also used more commonly than sunscreen: 45.4% "always or often" wore long pants and 34.7% "always or often" wore a hat. Only 16.1% "always or often" wore a long-sleeved shirt. Data from the National Health Interview Survey (NHIS) confirm relatively low prevalence of sun-safety behaviors, with estimates of use of sunscreen, protective clothing, or seeking shade hovering around 30% since the early 1990s. In HINTS 2005, 91.7% of American adults reported that they had not used indoor tanning devices during the previous 12 months.

Sun-Safety Practices in the U.S. Population

d

How Can This Inform Your Work?

• There is a need for improved sun-safety behavior among Americans, most notably, the use of sunscreen and protective clothing.
• According to HINTS, sun-safety practice varies by sociodemographic characteristics, including age, race/ethnicity, and gender.
  • Because women tend to use sunscreen more often than men, efforts to encourage use of sunscreen among men are needed.
  • The harm of indoor tanning devices should be emphasized for women, as they use these devices more often than men.
  • Seeking shade is infrequently practiced by younger adults, and the importance of this behavior should be emphasized to this population.
  • Although men report wearing hats more often than women, these may not be the wide-brimmed hats that offer adequate sun protection. Both men and women should be encouraged to wear wide-brimmed hats that protect their faces and necks from UV rays.

Sun Safety: Differences by Age, Race, and Gender

Age
The use of sunscreen was highest among respondents 35 to 49 years old (31.1%).The prevalence of other sun-safety behaviors increased with age. The frequency of seeking shade was lowest among respondents 18-34 years old (37.8%) and highest among those 75 years or older (54.9%), with increasing frequencies in the age groups between. Similar increasing trends with age were observed for wearing a hat, long-sleeved shirts, and long pants.

Race/Ethnicity
Compared with other racial/ethnic groups, non-Hispanic whites reported more frequent use of sunscreen (33.0%). Seeking shade was reported most frequently by non-Hispanic blacks (54.2%), whereas wearing long-sleeved shirts and long pants were most frequently reported by Hispanics (24.8% and 64.2%, respectively). Use of indoor tanning devices and sunless tanning products was most frequent among non-Hispanic white respondents.

Gender
More women than men reported "always or often" using sunscreen (37.4% and 18.7%, respectively) and "always or often" seeking shade (47.9% and 38.6%, respectively). Compared to women, men more often wear hats (24.2% and 45.9%, respectively) and long pants (38.9% and 52.4%, respectively). Indoor tanning over the past 12 months was higher among women (11.2%) than men (5.1%). Use of sunless tanning products was also more frequent among women (17.1%) than men (4.7%).

Spotlight on Research

Emerging Issues in Sun Safety

Sunless tanning products, also called self-tanners, can give skin a tanned look without exposure to harmful UV. Sunless tanning products are generally considered a safe alternative to sunbathing. The American Academy of Dermatology (AAD) recommends the use of sunless tanning products as a substitute for harmful UV-induced tans. In an analysis of HINTS 2005 data, published in 2007, investigators described the use of sunless tanning products and related sun-safety practices of adults in the United States. Frequent use of sunless tanning products was uncommon, with only 11% of respondents reporting use in the past year. Investigators compared sun-safety behavior among four groups of respondents: exclusively sunless tanners, exclusively indoor tanners, both indoor and sunless tanners, and nontanners. Some sun-safety practices during outdoor activities differed significantly by group. Individuals who were exclusively sunless tanners were significantly more likely to use sunscreen and significantly less likely to seek shade than nontanners. However, there were no significant differences between the groups with respect to the use of protective clothing (hat, long-sleeved shirts, or long pants).

Exclusively sunless tanners were significantly more likely than exclusively indoor tanners to practice all five sun-safety practices. Indoor tanners were significantly less likely than nontanners to practice all of the sunsafety behaviors except use of sunscreen. These findings add to our understanding of population practices with regard to sun safety and reveal interesting differences in sun-safety practices among subgroups.

d

References Used in This HINTS Brief

American Cancer Society. Cancer Facts and Figures 2007. Atlanta, Ga: American Cancer Society; 2007.

National Institutes of Health. PDQ Skin Cancer Prevention. Available at www.cancer.gov/cancertopics/pdq/prevention/skin/patient/page2

Stryker JE, Yaroch AL, Moser RP, Atienza A, Glanz K. Prevalence of sunless tanning product use and related behaviors among adults in the United States: Results from a national survey. J Am Acad Dermatol 2007; 56:387-90.

For More Information on Cancer

• Call the NCI Cancer Information Service at 1-800-4-CANCER (1-800-422-6237)



• Visit http://cancer.gov



• Order NCI publications at http://www.cancer.gov/publications

May 2007