Sunbed use in Germany: Trends, user histories and factors associated with cessation and readiness to change
Bock C, Diehl K, Litaker D, Breitbart EW, Greinert R, Schneider S (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 169
Pages Range: 441-449
Journal Issue: 2
DOI: 10.1111/bjd.12390
Abstract
Background Sunbed use is considered carcinogenic in humans. Studies that examine behavioural patterns related to sunbed use over time are needed for developing skin cancer prevention strategies. Objectives To explore age-related trends in the initiation age, to investigate individual histories of sunbed use and to identify characteristics associated with cessation. Methods We analysed cross-sectional data of 4851 sunbed users and nonusers from a representative sample of Germans, aged 14-45 years, interviewed in 2011/2012. Biographical data were reconstructed based on reported tanning frequency/duration and changes in sunbed use over time. We used survival analysis to model the initiation age and created birth cohorts to assess age-related trends. Characteristics associated with sunbed use cessation were identified using logistic regression. Results Among sunbed users, median sunbed exposure was 180 min per year. Annual exposure remained constant in 85·6% of this subgroup with no changes over time during periods of sunbed use. Age at initiation decreased significantly across birth cohorts from 25 to 19 years (25th percentile; cohorts 1966-75 to 1986-93). Characteristics associated with sunbed use cessation included educational level [odds ratios (OR) 1·53 and 1·71 for medium and high education, respectively], greater awareness of skin cancer risk (OR 2·41) and immigrant background (OR 0·54; all P < 0·01). Conclusions Initiation of sunbed use at an increasingly younger age suggests the need for interventions targeted at young adults. Approaches that increase general skin cancer risk awareness and that are sensitive to participants' educational level and immigrant background may also be helpful. What's already known about this topic? Exposure to artificial sources of ultraviolet radiation (UVR) through sunbed use has contributed significantly to rising melanoma rates. The International Agency for Research on Cancer has classified UVR from sunbed use as carcinogenic in humans. The use of sunbeds is widespread in developed countries with prevalence estimates for ever having used sunbeds ranging from 11% to 61%. What does this study add? This is the first study to apply event history analysis to quasilongitudinal data on lifetime sunbed use. Among sunbed users, median sunbed exposure was 180 min per year. The initiation age of sunbed use in Germany has decreased over the past several decades. These findings are significant as they highlight the importance of early intervention. © 2013 British Association of Dermatologists.
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APA:
Bock, C., Diehl, K., Litaker, D., Breitbart, E.W., Greinert, R., & Schneider, S. (2013). Sunbed use in Germany: Trends, user histories and factors associated with cessation and readiness to change. British Journal of Dermatology, 169(2), 441-449. https://doi.org/10.1111/bjd.12390
MLA:
Bock, C., et al. "Sunbed use in Germany: Trends, user histories and factors associated with cessation and readiness to change." British Journal of Dermatology 169.2 (2013): 441-449.
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