Sunbed use among Swedish adolescents in the 1990s:: a decline with an unchanged relationship to health risk behaviors

Aims: Sunbed use is common among adolescents, and may give an increment to UV exposure and an overall skin cancer risk comparable to that of the sun. Sunbed use was studied among 15- to 19-year-old adolescents in Stockholm County. Methods: Data from two questionnaire surveys (1,252 respondents in 1993, and 2,950 respondents in 1999, survey tool partly revised) were analysed. By stepwise binary logistic regression the occurrence of sunbed use was assessed and analysed versus sunbed erythema, skin type, outdoor tanning, sunscreen use and smoking. Results: Sunbed use declined between the surveys. In 1993, 70% of females, and 44% of mates used sunbeds; in 1999, these were 45% and 19% respectively. Sunbeds were used against user recommendations. Of the sunbed users in 1993, 45% and 43% reported sunbed erythema; in 1999, 29% and 19% did so. Sunbed erythema, though related to sun sensitivity, occurred in all skin types. In both surveys, sunbed use was positively related to moderately sensitive skin type (females), outdoor tanning, and smoking (females). Smoking was a strong predictor for sunbed use among females in both surveys. Conclusions: Even though different survey tools were used, and in spite of a decline in sunbed use, sunbed erythema was still common, and the relation to other health risk behaviour remained. Further research on sunbed use and its role in the aggregation of health risk behaviours in vulnerable ages is warranted, particularly its relation to outdoor tanning and smoking. A national and international harmonization of survey tools is also recommended for improved comparability.