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By Anne Harding

MONDAY, April 19, 2010 (Health.com) — Alcoholics, drug addicts, smokers, and gamblers have their 12-step programs—could Tanners Anonymous be next? A new study suggests that 1 in 5 people who use tanning beds exhibit signs of clinical addiction, including feeling guilty about their artificial sun sessions and tanning more than they intended.

“People have shown indirectly, in various ways, that tanning tends to be addictive,” says Darrell Rigel, MD, a clinical professor of dermatology at New York University who wasn’t involved in the research. “This is the first time it’s been done on this large a scale, using strict psychiatric criteria.”

What's more, these tanning addicts appear to be more likely to drink, smoke marijuana, and experience anxiety than non-tanners or tanning-bed users who aren’t addicted, according to the study, which appears in the Archives of Dermatology.

In the study, Catherine Mosher, PhD, of Memorial Sloan-Kettering Cancer Center, in New York City, and Sharon Danoff-Burg, PhD, of the State University of New York at Albany, used two separate questionnaires to survey more than 400 college students in the northeastern United States about their tanning habits.

One questionnaire was adapted from a test used to screen for alcoholism, and included questions such as “Do you ever feel guilty that you are using tanning beds or booths too much?” The other used criteria for substance abuse and dependence from the Diagnostic and Statistical Manual of Mental Disorders (DSM)—sometimes known as the "psychiatrist’s bible"—and included questions such as, “When you go to tanning salons, do you usually spend more time in the tanning bed or booth than you had planned?”

A little more than half of the students said they'd used tanning beds in the past. Of those students, 50 (or 22%) met the criteria for addiction. Another 60 students had what the researchers called "addictive tendencies."

The findings bolster other studies that have shown that frequent tanning bed users can become dependent on catching fake rays. The findings also suggest that efforts to discourage people from overusing tanning beds may need to take ultraviolet (UV) light's addictive potential into account, the researchers say.

UV light triggers the production of endorphins—the same feel-good, opiate-like chemicals responsible for runner’s high, says Carolyn J. Heckman, PhD, an assistant professor at the Fox Chase Cancer Center, in Cheltenham, Penn.

“Some people really like that feeling,” adds Heckman, who studies skin cancer prevention but wasn’t involved in the current research. “If they do it repeatedly over a period of time, it may be difficult for them to stop and they may actually feel sick stopping.”

Next page: Sunbathing may not be as addictive


Sunbathing makes people feel good too, Heckman says, but outdoor tanning often involves socializing or other activities. “With indoor tanning, it’s just pretty much the UV,” she says, which makes it easier for an addictive relationship to develop.

Helping people who are dependent on indoor tanning to give it up may require treating it like an addiction, and also treating any accompanying anxiety and depression, according to Heckman. “Generally there is a trend for those things to go together,” she says. “It’s not really clear which comes first. If people have both, it's important to treat both.”

Indoor tanning, drug and alcohol use, and anxiety do appear to go hand-in-hand, the study shows. Compared to the tanners who were not considered addicted, the tanning addicts were four times more likely to have smoked pot, six times more likely to have drunk alcohol, and four times more likely to have had symptoms of anxiety during the previous month.

Forty-two percent reported using two or more substances other than alcohol during the previous month, compared to 17% of the non-addicted tanners and 16% of the study participants who’d never tanned indoors.

Joni Mayer, PhD, a professor of health promotion and behavioral sciences at San Diego State University, cautions that the study has some limitations. First, she says, it included only college students, and the findings therefore can't be generalized to all tanners—or even to all young tanners.

In addition, Mayer says, it’s easy to answer “yes” to any of the questions in the two questionnaires used in the study without having a clinical addiction.

“Even though there may be a few people who truly have an addiction to indoor or outdoor tanning, I feel these data greatly distort the true picture,” Mayer says. Many people eat fast food often and feel guilty about it, she adds, and "the same can be said for indoor tanning. Does this make these behaviors addictions? I think not!”

John Overstreet, the executive director of the Indoor Tanning Association, a Washington, D.C.-based lobbying organization that represents the tanning industry, says that the current study ignores the health benefits of ultraviolet light, and doesn’t make a “scientifically sound” case for indoor tanning being addictive.

But according to Dr. Rigel, there’s no reason for anyone to make even a single visit to a tanning booth, especially for his or her health. He notes that the ultraviolet light produced by tanning beds is 10 to 15 times more intense than natural sunlight. “There’s no question that it’s bad, and there’s no question that it’s worse than natural sunlight,” he says.

Certain skin conditions—such as psoriasis—are treated with light therapy, Heckman notes, but this is done under a doctor’s care. “Other than that, there’s no reason for people to indoor tan,” she says.