Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 853-864 (doi:10.1542/10.1542/peds.2005-3109)
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ARTICLE

Trends in Sunburns, Sun Protection Practices, and Attitudes Toward Sun Exposure Protection and Tanning Among US Adolescents, 1998–2004

Vilma Cokkinides, PhDa, Martin Weinstock, MD, PhDb,c, Karen Glanz, PhD, MPHd, Jessica Albano, MSPHa, Elizabeth Ward, PhDa and Michael Thun, MD, MSa

a Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia
b DermatoEpidemiology Unit, VA Medical Center Providence, Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island
c Departments of Dermatology and Community Health, Brown University, Providence, Rhode Island
d Rollins School of Public Health, Emory University, Atlanta, Georgia

BACKGROUND. Sun exposure in childhood is an important risk factor for developing skin cancer as an adult. Despite extensive efforts to reduce sun exposure among the young, there are no population-based data on trends in sunburns and sun protection practices in the young. The aim of this study was to describe nationally representative trend data on sunburns, sun protection, and attitudes related to sun exposure among US youth.

METHODS. Cross-sectional telephone surveys of youth aged 11 to 18 years in 1998 (N = 1196) and in 2004 (N = 1613) were conducted using a 2-stage sampling process to draw population-based samples. The surveys asked identical questions about sun protection, number of sunburns experienced, and attitudes toward sun exposure. Time trends were evaluated using pooled logistic regression analysis.

RESULTS. In 2004, 69% of subjects reported having been sunburned during the summer, not significantly less than in 1998 (72%). There was a significant decrease in the percentage of those aged 11 to 15 years who reported sunburns and a nonsignificant increase among the 16- to 18-year-olds. The proportion of youth who reported regular sunscreen use increased significantly from 31% to 39%. Little change occurred in other recommended sun protection practices.

CONCLUSIONS. A small reduction in sunburn frequency and modest increases in sun protection practices were observed among youth between 1998 and 2004, despite widespread sun protection campaigns. Nevertheless, the decrease in sunburns among younger teens may be cause for optimism regarding future trends. Overall, there was rather limited progress in improving sun protection practices and reducing sunburns among US youth between 1998 and 2004.

Key Words: skin cancer • skin neoplasms prevention and control • sun exposure • sun protection • sunburn • sunscreen agents • adolescent • epidemiology • health surveys

Abbreviations: SPF 15+—sun protection factor ≥15 • CI—confidence interval

Accepted Mar 27, 2006.


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