Indoor Tanning and Youth - Compliance, Inspection, and Enforcement of Legislation
Indoor tanning is a common health risk behaviour that exposes users to artificial ultraviolet radiation, which can lead to skin cancer. Evidence of the dangers of indoor tanning and its popularity, including among youth, has led jurisdictions around the world to implement indoor tanning legislations. The objective of this research was to determine compliance, implementation, impact, and enforcement of indoor tanning legislations, as well as access to indoor tanning facilities, and to provide suggestions for legislative amendments and improvements, with a focus on youth access and use. The findings of two systematic reviews indicate that while compliance with most aspects of indoor tanning legislation varies widely, including the all-important age restrictions (range=0–100%; mean=65%; SD=25), the prevalence of youth indoor tanning is significantly lower in jurisdictions with indoor tanning legislation compared to those without (n=4, mean=5% lower, range=1%–18% lower). Variability in compliance suggests indoor tanning legislations may not be as impactful as their fully intended protective purpose. In Ontario, survey research demonstrates that most indoor tanning legislation infractions were uncovered during non-mandatory routine inspections (n=234, 97%) rather than mandatory complaints-driven inspections (n=8, 3%) and have largely been related to a lack of required warning signs (n=201, 83%), with only one infraction related to youth access (n=1, 0.4%). Furthermore, geospatial analysis reveals 95% (n=655) of indoor tanning facilities in Ontario are located within 3 km of a high school, and 44% (n=300) are located within 3 km of a college or university. In Toronto specifically, the locations of indoor tanning facilities and schools cluster (p=0.004). Together, this suggests youth and young adults have relatively easy access to indoor tanning given the low compliance with indoor tanning legislation restricting youth access, small impact of indoor tanning legislation on youth indoor tanning use, lack of infractions related to youth access in Ontario, and close geographic distances between indoor tanning facilities and schools. Findings highlight the public health importance of indoor tanning legislation and the need for enhanced resource allocation to support inspection and enforcement, policy amendments, and new policy initiatives, including zoning by-laws, especially addressing youth access to indoor tanning facilities.