To: Tommy Brown
From: Kliti Shentolli
Date: January 18, 2019
Impose federal restrictions on the use of tanning beds.
Problem Statement:
Should the federal government impose stricter regulations on the use of tanning beds? Should the government increase awareness of possible risks associated with frequent use of tanning beds?
Background:
Regardless of whether you tan at the beach or tan indoors, the results are the same. In both situations, you are exposing yourself to harmful UV radiations (a proven human carcinogen) that can lead to premature skin damage, skin aging (brown spots, wrinkles and more) and as well as skin cancer. According to AADA, more than 9.7 million people in the United States use indoor tanning beds. 17% of that number are teenagers, ages 18 and younger. AADA also states that 82% of teenagers who frequently use tanning beds have experienced sunburns in the past year. Just from one blistering sunburn, the chances for a teenager to develop melanoma is nearly doubled. In fact, people who frequently use tanning beds before the age of 35 are at 75% increased risk for developing melanoma when compared to someone who has never used a tanning bed. Each year, more than 419,000 cases of skin cancer are directly related to indoor tanning and is costing the U.S government about $343.1 million annually to provide medical care for these patients. When looking at current regulations and restrictions on tanning beds, as of January 1st, 2017, only nineteen states (including New York) ban anyone under the age of 18 from using any tanning devices, while the rest of the states have implemented a combination of restrictions, but not fully banned minors from using tanning devices. Stricter regulations and increased education on skin cancer and indoor tanning all over U.S should be implemented, especially on those states that still have not banned minors from using tanning devices. We need to act now to reduce the number of skin cancer cases related to tanning beds and by doing so, we would also decrease national spending on skin cancer treatment as well.
Landscape:
- Political factor– Just like many other regulations, tanning bed regulations has been left on the hands of state and local governments to decide. However, multiple attemtps have been made to ban minors from using tanning beds on a federal level. The first attempt was in 2010, when Affordable Care Act (ACA), implemented a 10% “tanning tax” on indoor tanning service across the nation. From 2010 to 2015, the number of high school student using tanning beds decreased by 50%. The Skin Cancer Foundation and many other health organizations fully support that the “tanning tax” should remain in power. Another attempt was made in 2015 by the Food and Drug Administration (FDA), but the proposed rule has not yet been finalized. Many activists, politicians and the general public (especially parents) are in support for such restrictions and still continue to push for further restrictions. Some advocate, politicians and health organizations that have spoken for further restriction on indoor tanning are: Governor Andrew Cuomo, California State Senator Ted Lieu, advocate from Delaware Samantha Jenkins, American Academy of Pediatrics, The Skin Cancer Foundation, Gov. Arnold Schwarzenegger, FDA and more.
- Economic factor– As mentioned above, U.S spends approximately $343.1 million every year to provide medical care to patients diagnosed with skin cancer due to use of tanning beds. U.V radiation is one of the most preventable carcinogenic factors for skin cancer. The Journal of the American Academy of Dermatology, estimated that a total ban on indoor tanning for all minors across the U.S would prevent 203,000 cases of melanoma and save up to $1.1 billion in melanoma treatment cost. Such numbers should motivate local and state policymakers and the federal government to impose such restrictions as soon as possible. FDA should look at these numbers too and impose more restrictions on a federal level.
- Practical factor– When people think of skin cancer, they usually associate harmful UV radiations coming from the sun, and think that indoor UV radiations are “safer” because they’re not coming directly from the sun, but from some lamps. As more research is coming out, the direct association and relationship between frequent use of tanning beds and skin cancer is becoming more obvious. Currently, there are more than 19,000 indoor tanning in U.S and that number is growing. Other countries like Brazil and Australia have already shown that nationwide tanning restriction can occur so its our time to do so. The key stakeholders in this category would be the tanning services themselves and their customers. Imposing restrictions would directly affect both the tanning business and the customers, especially young adults since that’s the majority that uses tanning services across the nation.
- Social factor– 59% of people who use tanning beds in America are college students (ages 18-25), 17% teenagers (ages 18 and younger) and the rest are adults. By increasing age restriction and education on risks associated with tanning beds, all these groups will be affected, especially college students and teenagers. In today’s society, being tan signifies a healthier look. This is promoted all over social media, models, celebrities, and this propaganda is mostly effecting teenagers and college students. In fact, according to JAMA Dermatology, about 48% of all U.S college campuses have at least one indoor tanning facility, increasing access for college student to use tanning beds and other tanning devices.
Options Analysis:
- Increase the legal age for having access to indoor tanning salons/facilities/ beds or any other tanning devices that releases harmful UV radiation, to 21-years-old in all states and increase educational efforts in U.S college campuses and U.S high schools to promote skin cancer prevention.
- Advantage: By promoting prevention and educating the most effected groups on skin cancer and risks associated with indoor tanning, we can reduce the number of people diagnosed with melanoma and other skin cancers each year. Not only it would reduce the number of deaths but also decrease national expenses each year on managing and treating melanoma and other skin cancers. According to AADA, 33% of adults in the U.S stated they started tanning at the age of 18. By increasing the legal age to 21, we could eliminate or at least reduce that percentage. By that age people are also more mature and able to make more thought-out decisions.
- Disadvantage: In 47 states, the age when a person has the legal rights and responsibilities of that of an adult is 18. It took years of efforts and campaigning for the 19 states to set the legal age of tanning beds at 18 years old. It would take so much more effort and time to change the age to 21 and it would be a bigger struggle to have every state to pass this regulation. Increasing efforts to promote skin cancer prevention and expand education in all states can be expensive and not a single organization has yet to come forward to fund such activities.
- Increase the “tanning tax” percentage to 15% to both privately and publicly owned indoor tanning services.
- Advantage: As already mentioned above, when ACA increased the “tanning tax” to 10%, the number of high school students visiting these tanning services decreased by 53%. By increasing this “tanning tax” even higher, to every tanning service even on college campuses, we can definitely expect the number of both high school kids and college students visiting tanning services to decrease. Access to tanning services would be limited and more expensive. The owners of such facilities would have to raise the prices due to high taxes, resulting in less customers.
- Disadvantage: A few of these tanning services are privately owned and are small businesses that an increase of 15% on the “tanning tax” would most likely put them out of business. This goes against Small Business Administration, whose function is to protect, aid, and assist the interests of small businesses across the nation. Closing of these small businesses can also have a negative impact on the U.S economy.
- Mandate each tanning facility to implement restrictions on the number of tanning sessions a person is allowed to get per week. Have tanning facilities to limit the number of tanning sessions to 3 times a week for a maximum of 50 minutes per session. Facilities that do not comply can be subject to fines and penalties.
- Advantage: American Academy of Dermatology recommends the usage of tanning beds 3 times a week, with a break of 48 hrs between each session. They also recommend a maximum of 20 to 25 minutes of UV radiation exposure to the back of the body and another 20-25 minutes of exposure to UV radiation to the front of the body. These recommendations are rarely followed and often ignored, that’s why reinforcing these recommendations can decrease the number of cases of melanoma associated with indoor tanning.
- Disadvantaged: Implementing such regulations and reinforcing fines and penalties for each tanning facility across the nation can be expensive, requires lots of resources and may not be a priority for the government right now as oppose in focusing more on smoking and lung cancer or promoting healthy diet and fight against obesity. Again, lots of regulation and restrictions would limit customers and force some of these businesses to close down.
Recommendation:
Out of the three options proposed above, increasing the “tanning tax” to 15% is the most ideal policy that could be implemented right now. We saw how successful the 2010 “tanning tax” was in reducing the number of cases of melanoma due to tanning beds. Most of the tanning services today are owned or co-owned by big fitness centers, hotels, resorts, beauty salons, colleges/universities, and more. The point is that businesses that rely only on tanning services as their main source of profit are dying out, instead big companies and businesses are incorporating tanning services under their roof. A 15% “tanning tax” would not put these large companies out of business but instead would hopefully discourage them from putting more emphasis in promoting their tanning services to the public. Compare to the other two options, a 15% tax is the most realistic and easiest to implement through the nation. The 10% “tanning tax” is already implemented, the bases for it are already in place and is supported by many, so raising the tax to 15% would require less effort and resources than trying to campaign for more direct governmental involvement into the matter or trying to raise the legal age of tanning beds to 21 years old. The major con of this policy it’s the devastating effect on small tanning service businesses. One possible way to overcome such issue is to implement this 15% “tanning tax” to only large companies and businesses and give small businesses a break.
Source: https://www.skincancer.org/prevention/tanning
https://www.skincancer.org/skin-cancer-information/skin-cancer-facts
http://www.ncsl.org/research/health/indoor-tanning-restrictions.aspx
https://www.aad.org/media/stats/prevention-and-care
https://blog.skincancer.org/2018/07/17/indoor-tanning-legislation-heres-stand/
https://www.thecut.com/2016/12/economic-impact-of-banning-minors-from-using-tanning-beds.html
https://www.usatoday.com/story/news/nation/2014/01/29/indoor-tanning-increase/5028431/
https://www.skincancer.org/news/tanning/college
https://www.sba.gov/about-sba/what-we-do/authority
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