{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:03:06Z","timestamp":1789574586317,"version":"build-2803163510"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec id=\"ab-doi260028-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Intentional outdoor tanning involves exposing one\u2019s skin to UV radiation from the sun for the purpose of darkening the skin to create a tanned appearance. Although robust surveillance data are available on many skin cancer risk factors, limited data on intentional outdoor tanning prevalence have been reported to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi260028-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the prevalence of intentional outdoor tanning among US adults and the factors associated with this behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi260028-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional study used data from US adults who participated in the 2024 National Health Interview Survey, a nationally representative sample of civilian, noninstitutionalized US adults aged 18 years or older, to assess the prevalence of intentional outdoor tanning and sunburn by asking participants \u201cwhen spending time outdoors, how often do you try to get some sun for the purpose of developing a tan?\u201d (always, most of the time, sometimes, rarely, or never) and \u201cduring the past 12 months, did you have a sunburn even on a small part of your skin?\u201d (yes or no). The individual-level factors analyzed were demographic characteristics and health-related behaviors, including physical activity and alcohol use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi260028-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was prevalence of intentional outdoor tanning. The secondary outcome was prevalence of sunburn.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi260028-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 31 615 US adults (mean [SD] age, 48.3 [18.6] years; 17 111 females [51.4%]) were included in the study. Overall, the unadjusted prevalence of intentional outdoor tanning among adults was 30.2% (35.6% [95% CI, 34.6%-36.7%] in women and 26.6% [95% CI, 25.6%-27.7%] in men). Among women and men, prevalence of intentional outdoor tanning was associated with age, race and ethnicity, sun sensitivity, physical activity, and alcohol use. Among women, prevalence was highest among those aged 18 to 29 years (48.1%; 95% CI, 45.3%-50.9%), non-Hispanic White women (41.3%; 95% CI, 39.9%-42.7%), non\u2013sun-sensitive women (38.3%; 95% CI, 36.6%-40.1%), women who met both aerobic and strength guidelines (39.5%; 95% CI, 37.6%-41.5%), and women who engaged in heavy or binge drinking (47.2%; 95% CI, 44.8%-49.7%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for all &amp;amp;lt; .001). Among men, prevalence was highest among those aged 18 to 29 years (29.9%; 95% CI, 27.4%-32.6%), non-Hispanic White men (30.5%; 95% CI, 29.0%-32.1%), sun-sensitive men (28.7%; 95% CI, 27.2%-30.2%), men who met both aerobic and strength guidelines (32.2%; 95% CI, 30.2%-34.3%), and men who engaged in heavy or binge drinking (31.2%; 95% CI, 29.0%-33.5%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for all &amp;amp;lt; .001). Among women only, prevalence was associated with educational level and body mass index, with a higher prevalence among women with some college (37.5%; 95% CI, 35.8%-39.3%) and those at a healthy weight (38.7%; 95% CI, 37.0%-40.5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      for all &amp;amp;lt; .001). Among men only, prevalence was associated with marital status, with a higher prevalence among married or partnered men (25.8%; 95% CI, 24.5%-27.1%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04). The prevalence of sunburn was significantly higher among adults who reported intentional outdoor tanning (49.9%; 95% CI, 48.5%-51.4%) compared with those who did not (28.3%; 95% CI, 27.4%-29.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi260028-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cross-sectional study found that the highest prevalence of intentional outdoor tanning occurs among US women who are younger, non-Hispanic White, and physically active and report heavy and\/or binge drinking. Those who engage in intentional outdoor tanning are more likely to experience sunburn, increasing their skin cancer risk. These findings can inform future strategies to address intentional outdoor tanning as part of larger efforts to reduce skin cancer risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.2450","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:30:33Z","timestamp":1784734233000},"page":"904","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Associated Factors of Intentional Outdoor Tanning Among US Adults"],"prefix":"10.1001","volume":"162","author":[{"given":"Dawn M.","family":"Holman","sequence":"first","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Boring","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K.","family":"Julian","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Moser","sequence":"additional","affiliation":[{"name":"Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank M.","family":"Perna","sequence":"additional","affiliation":[{"name":"Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"doi260028r1","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s10552-022-01644-0","article-title":"Economic burden of skin cancer treatment in the USA: an analysis of the Medical Expenditure Panel Survey Data, 2012-2018.","volume":"34","author":"Kao","year":"2023","journal-title":"Cancer Causes Control"},{"key":"doi260028r8","doi-asserted-by":"crossref","DOI":"10.5888\/pcd11.140329","article-title":"Prevalence of alcohol dependence among US adult drinkers, 2009-2011.","volume":"11","author":"Esser","year":"2014","journal-title":"Prev Chronic Dis"},{"key":"doi260028r9","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.ypmed.2017.06.003","article-title":"Intentional outdoor tanning in the United States: results from the 2015 Summer ConsumerStyles survey.","volume":"101","author":"Shoemaker","year":"2017","journal-title":"Prev Med"},{"issue":"6","key":"doi260028r11","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.jaad.2017.01.022","article-title":"Trends in indoor tanning and its association with sunburn among US adults.","volume":"76","author":"Guy","year":"2017","journal-title":"J Am Acad Dermatol"},{"issue":"10","key":"doi260028r13","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1080\/13548506.2017.1330544","article-title":"Beauty and the burn: tanning and other appearance-altering attitudes and behaviors.","volume":"22","author":"Gillen","year":"2017","journal-title":"Psychol Health Med"},{"issue":"10","key":"doi260028r14","doi-asserted-by":"publisher","first-page":"5770","DOI":"10.3390\/ijerph20105770","article-title":"Gender and media representations: a review of the literature on gender stereotypes, objectification and sexualization.","volume":"20","author":"Santoniccolo","year":"2023","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"doi260028r16","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1177\/00332941211000659","article-title":"Role of sociocultural pressures and internalization of appearance ideals in the motivation for exercise.","volume":"125","author":"Anic","year":"2022","journal-title":"Psychol Rep"},{"issue":"8","key":"doi260028r17","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afad145","article-title":"Factors that influence older adults\u2019 participation in physical activity: a systematic review of qualitative studies.","volume":"52","author":"Meredith","year":"2023","journal-title":"Age Ageing"},{"issue":"3","key":"doi260028r18","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1123\/jpah.2017-0292","article-title":"A systematic scoping review of engagement in physical activity among LGBTQ+ adults.","volume":"15","author":"Herrick","year":"2018","journal-title":"J Phys Act Health"},{"key":"doi260028r19","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.psychsport.2018.12.010","article-title":"Body image, physical activity, and sport: a scoping review.","volume":"42","author":"Sabiston","year":"2019","journal-title":"Psychol Sport Exerc"},{"key":"doi260028r20","doi-asserted-by":"publisher","DOI":"10.2196\/54489","article-title":"Analysis of Reddit discussions on motivational factors for physical activity: cross-sectional study.","volume":"27","author":"Shmueli-Scheuer","year":"2025","journal-title":"J Med Internet Res"},{"key":"doi260028r22","doi-asserted-by":"publisher","DOI":"10.1155\/jskc\/5592331","article-title":"Reasons for outdoor tanning in adults: Q methodology identifies three types of tanners.","volume":"2025","author":"Bergmann","year":"2025","journal-title":"J Skin Cancer"},{"issue":"4","key":"doi260028r23","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1177\/003335491112600409","article-title":"Sun-seeking behavior to increase cutaneous vitamin D synthesis: when prevention messages conflict.","volume":"126","author":"Clipp","year":"2011","journal-title":"Public Health Rep"},{"issue":"8","key":"doi260028r24","doi-asserted-by":"publisher","first-page":"1963","DOI":"10.1002\/ijc.24154","article-title":"Vitamin D and sun protection: the impact of mixed public health messages in Australia.","volume":"124","author":"Youl","year":"2009","journal-title":"Int J Cancer"},{"issue":"4","key":"doi260028r25","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s10865-018-9911-1","article-title":"Time spent outdoors, activity levels, and chronic disease among American adults.","volume":"41","author":"Beyer","year":"2018","journal-title":"J Behav Med"},{"issue":"12","key":"doi260028r26","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.18058","article-title":"Assessment of tanning beds in 3 popular gym chains.","volume":"2","author":"Pagoto","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"7","key":"doi260028r29","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1038\/s41380-023-02074-3","article-title":"Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment.","volume":"28","author":"M\u00fcller","year":"2023","journal-title":"Mol Psychiatry"},{"issue":"2","key":"doi260028r30","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/pcmr.12726","article-title":"MITF and UV responses in skin: from pigmentation to addiction.","volume":"32","author":"Nguyen","year":"2019","journal-title":"Pigment Cell Melanoma Res"},{"issue":"8","key":"doi260028r32","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.annepidem.2008.04.006","article-title":"Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis.","volume":"18","author":"Dennis","year":"2008","journal-title":"Ann Epidemiol"},{"issue":"11","key":"doi260028r33","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1001\/jamadermatol.2025.3473","article-title":"Sunburn and cutaneous squamous cell carcinoma: a meta-analysis.","volume":"161","author":"Weber","year":"2025","journal-title":"JAMA Dermatol"},{"key":"doi260028r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2023.102379","article-title":"A meta-analysis of sunburn and basal cell carcinoma risk.","volume":"85","author":"Lashway","year":"2023","journal-title":"Cancer Epidemiol"},{"issue":"4","key":"doi260028r35","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1080\/19325037.2018.1473181","article-title":"Understanding misinformation in the pro-tanning communication environment: a content analysis.","volume":"49","author":"Kelly","year":"2018","journal-title":"Am J Health Educ"},{"issue":"4","key":"doi260028r36","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1111\/j.1751-1097.1998.tb02518.x","article-title":"Tanning in human skin types II and III offers modest photoprotection against erythema.","volume":"68","author":"Sheehan","year":"1998","journal-title":"Photochem Photobiol"},{"key":"doi260028r2"},{"key":"doi260028r21","volume-title":"Shedding Light on Indoor Tanning","author":"Hunt","year":"2012"},{"key":"doi260028r31","volume-title":"Shedding Light on Indoor Tanning","year":"2012"},{"key":"doi260028r3","unstructured":"Centers for Disease Control and Prevention. About NHIS. November 20, 2024. Accessed July 15, 2025. https:\/\/www.cdc.gov\/nchs\/nhis\/about\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/nchs\/nhis\/about_nhis.htm?"},{"key":"doi260028r4","unstructured":"Centers for Disease Control and Prevention. 2024 NHIS questionnaires, datasets, and documentation. Accessed July 15, 2025. https:\/\/www.cdc.gov\/nchs\/nhis\/documentation\/2024-nhis.html"},{"key":"doi260028r5","unstructured":"Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans. US Department of Health and Human Services. Updated November 19, 2025. Accessed June 15, 2026. https:\/\/odphp.health.gov\/our-work\/nutrition-physical-activity\/physical-activity-guidelines\/current-guidelines"},{"key":"doi260028r6","unstructured":"Centers for Disease Control and Prevention. Alcohol use and your health. Accessed August 27, 2025. https:\/\/www.cdc.gov\/alcohol\/about-alcohol-use\/index.html"},{"key":"doi260028r7","unstructured":"Centers for Disease Control and Prevention. Glossary\u2014Alcohol. Accessed August 27, 2025. https:\/\/archive.cdc.gov\/www_cdc_gov\/nchs\/nhis\/alcohol\/alcohol_glossary"},{"key":"doi260028r10","unstructured":"National Cancer Institute. Cancer Trends Progress Report 2025: indoor and outdoor tanning. April 2025. Accessed July 15, 2025. https:\/\/progressreport.cancer.gov\/prevention\/sun\/tanning"},{"key":"doi260028r12","unstructured":"IMPACT Melanoma. Be Skin Smart. 2026. Accessed June 5, 2026. https:\/\/impactmelanoma.org\/be-skin-smart\/"},{"key":"doi260028r15","unstructured":"Centers for Disease Control and Prevention. Cancer statistics: incidence melanoma of the skin. June 2025. Accessed December 11, 2025. https:\/\/gis.cdc.gov\/Cancer\/USCS\/#\/explore\/incidence?cancer=58&datatype=1&dataset=standard&indicator=value&area=1&timeperiod=1&sexes=1&races=8_11_12_13_6&ages=23&tab=2&view=chart&xaxis=races&shownational=1"},{"key":"doi260028r27","unstructured":"National Institutes of Health. Vitamin D. June 27, 2025. Accessed December 11, 2025. https:\/\/ods.od.nih.gov\/factsheets\/VitaminD-HealthProfessional\/."},{"key":"doi260028r28","unstructured":"National Cancer Institute. Alcohol and cancer risk. May 2, 2025. Accessed September 30, 2025. https:\/\/www.cancer.gov\/about-cancer\/causes-prevention\/risk\/alcohol\/alcohol-fact-sheet."}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2851879\/jamadermatology_holman_2026_oi_260028_1788201945.58159.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:04:31Z","timestamp":1789571071000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2851879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":36,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2026.2450","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}