• Color me appalled

    Let’s start with the basics:

    Indoor tanning is associated with an increased risk of skin cancer, especially among frequent users and those initiating use at a young age. Indoor tanning before age 35 years increases melanoma risk by 59% to 75%, while use before age 25 years increases nonmelanoma skin cancer risk by 40% to 102%. Moreover, melanoma risk increases by 1.8% with each additional tanning session per year. Melanoma incidence rates are steadily increasing, especially among young non-Hispanic white females, which may be due, in part, to indoor tanning.

    So, obviously, don’t do it. Right? Prepare to be appalled. “Indoor Tanning Among Young Non-Hispanic White Females“:

    We used data from the 2011 national Youth Risk Behavior Survey (YRBS) of high school students and the 2010 National Health Interview Survey (NHIS) for adults aged 18 to 34 years. We estimated the prevalence of indoor tanning and frequent indoor tanning, overall and by age and US census region. Indoor tanning was defined as using an indoor tanning device (eg, a sunlamp, sunbed, or tanning booth, not including a spray-on tan) at least 1 time during the 12 months before each survey. Frequent indoor tanning was defined as using an indoor tanning device at least 10 times during the same period. Differences in prevalence between subgroups were assessed with χ2 tests.

    I made a chart of the results:

    Indoor tanningOverall, about 29% of young, non-Hispanic females had tanned indoors the last year. Almost 17% of them had tanned 10 times or more in the last year. The numbers for women 18 and older give me the chills.

    This is so, so, so, so, so, so, so bad for you. Why don’t I see rage against this in my inbox like I do for diet soda? Why can’t people differentiate risk appropriately?

    And who would fight a tax on this?



    • What is the baseline risk? If the answer is one in a billion, then doubling that risk is no big deal.

      The most useful thing I find in the link is this: 3438 additional cases of melanoma attributed to tanning beds in Europe per year. But I’m not sure what is the population of “Europe” as that article defines it. If it is 750 million, then that means, I think, your lifetime chances of getting sunbed-induced melanoma are about 0.4%.

      So if that 40% in your graph is also how many Europeans use sunbeds, it would seem using them gives you about a one percent chance at this disease.

      But that’s an awfully roundabout way of getting at the number I want. Surely there is something better.

      I’m not taking a side here, except to say you had given me a number I can’t use to evaluate whether a tax is worthwhile.

    • “Why can’t people differentiate risk appropriately?”

      Why would you expect them to?

      We are not wired to accurately assess and compare risks of different magnitudes. There’s a whole fascinating literature in evolutionary psychology on this topic. The entire recent financial crisis is partially due to a lack of understanding of risk by otherwise extremely bright, educated, and successful people. (Taleb and Silver both discuss this in recent books.) It takes training and hard work to approach risk rationally and accurately.

    • What is the actual risk? Are these girls “doubling their risk of melanoma” from one in a million to one in 500,000?

      Big whoop, and mind your own business.

      • Don’t go look it up or anything. Be proud of your ignorance!

        From SEER:

        Based on rates from 2008-2010, 2.03% of men and women born today will be diagnosed with melanoma of the skin at some time during their lifetime.

    • Actually, Didn’t NJ and Gov. Christie reject a tanning tax and implement a health club tax instead?

    • It’s possible that some of the tanning was not strictly for cosmetic purposes but preparation for actual outdoor exposure – why tan your body if it’s not going to be displayed or exposed outdoors? If you’re an adolescent female who plans to hit the beach as soon as the school year is over, you may try to get a head start on your tan so you won’t burn when actually outdoors. The message in such cases should be that ultraviolet exposure – sun as well as indoor lights – may kill you. Don’t think that a natural tan avoids risk.

      Many adolescents may use UV treatment for acne. The short-term benefits might outweigh the long-term risk when acne is severe.

    • One reason people don’t understand risk is the media talks about large percent changes to a small risk, without ever telling us the underlying unadjusted base risk. A 100% increase in a risk may be trivial, or it might be bad. A 100% increase in risk of death in a car accident would be very bad. A 100% increase in the risk of getting hit by lightning would be trivial.

      In this case, its probably somewhere in between. The overall lifetime risk of melanoma is about 2%. This presumably includes those with bad behavior so the non-tanning number is likely lower, but we will use 2% as our base risk understanding that it is likely high. The 5-year survival rate from these cancers (which by the way tend to show up after the age 60) is 90+% (if you are white — if you are black it is much lower. I don’t know if that is a socio-economic problem or some aspect of the biology of darker skin).

      So a teenager has a lifetime chance of dying early from melanoma of about 0.2%. A 50% increase to this would raise this to 0.3%. An extra 1 in 1000 chance of dying early from something likely to show up in old age — is that “so, so, so, so, so, so, so bad”? For some yes, for some no. That is what individual choice is all about. I can send you some literature on it.

      But I would argue that you, rather than commenting on our inability to parse risk well, are contributing to it.

      • Stop. A 2% risk of cancer (as a starting point) versus no measurable risk at all from diet soda. That’s what I’m talking about.

        • ” … vs. no measurable risk at all from diet soda.”

          Really no measurable risk from diet soda. I find that really hard to buy, because as one the trades for a living (and rides a motorcycle for transportation) I find that there is risk in everything, no matter how minuscule. For you to state this shows that you too have the heuristic that causes improper risk assessment.

          Trying to talk down to the little people by showing how smart you are really just shows what a busybody you are and that you are incapable of solving your own problems because you are so busy “fixing” other peoples problems.

          Please do us all a favor and solve your own problems and let the rest of solve ours no matter how imperfectly you might think that we solve them.

          • I let this through just because no one believes me when I talk about comments like yours. There is a literal, greater than zero, risk of cancer from indoor tanning. People, in measurable numbers, die every year.

            There is NOTHING like that for diet soda, and way, way, way more people drink diet soda than engage in indoor tanning.

            But feel free to do what you like. No one is stopping you.

            • ” No one is stopping you.”

              Actually you are.

              You and others like you help get laws passed that tax things that people do or buy that you don’t like, because that is really the crux of the matter here. If we were to follow your logic then the tax for gasoline would push prices into the $10 per gallon level. Trying to say that you are protecting people is foolish, and you do it because you don’t like the stereotypical person that uses the tanning salon. What you don’t get is that others use tanning salons for many reasons that you may or may not know about. e.g. I used to live in Seattle, could you maybe see a far removed reason why I might want to use a tanning salon? The world is far to complicated and people’s choices are also very complicated for one person to decide and who will and won’t do what they think is right.

              Imagine that I decided that something that you do was something that I don’t like and I had the power to make you pay more for it, would you like that? No, because you would say that I am being arbitrary, and even if you did say that you wouldn’t mind, what about all the people that use the thing that is being taxed. Do you speak for them?

              Please let people solve their own problems, because at the end of the day they are the only ones that can.

              You will probably not let this comment through but I will try anyway.

            • Actually, I used to live in Seattle, too, and that makes no difference.

              You couldn’t be more wrong about my preferences for people who have frequented tanning salons. Ask my wife. As to paying more for things I like, happens all the time. My alcohol is taxed at higher rates than other stuff. So are hotels. Find me one post here that complains about either.

              But, please, continue to enlighten us with your wisdom!

            • Ok

              ” … no measurable risk at all from diet soda.”


              “Actually, I used to live in Seattle, too, and that makes no difference.”

              Makes no difference? You don’t see that people do different things for different reasons but you are going to paint all of those people with one brush because some people that do this activity may get cancer? Did you miss my point about $10 a gallon gas?

              People assess risk the best that they can, and that is imperfectly, this is a known heuristic. The problem is that you can’t see yourself falling into the same trap as all of the people that you say are falling into a risk assessment trap, and somehow they need your help to not do this in the form of a tax …. !!!??

              ” … Ask my wife.”

              I am not really sure that that is possible, so using this as some sort of corroboration seems unusual.

              ” My alcohol is taxed at higher rates than other stuff. So are hotels. Find me one post here that complains about either.”

              So what about all of the other people don’t want those things taxed. Why don’t we take the tax away and you can pay extra for those things if you like.

              Can you not see that you are trying to impose your morals, values life experiences on other people in the form of a tax. Just because you are Ok with the tax doesn’t mean others are, and the law of unintended consequences means that the tax on those things is hurting people in ways that you can’t expect. See that is the tough part about life, people have different needs, wants, and desires and dictating to them through a tax what they will and won’t do is foolish.

    • “And who would fight a tax on this?”

      I can think of one particular party….

    • On skimming the paper they don’t seem to have done much to control for sun exposure in genernal. So the sunbed exposure might just be representing their general sun exposure which is what is increasing the cancer risk. Or it’s a mixture of sunbed and natural sun more likely. I would expect those that tan in sunbeds more often also spend more time in the sun. But I just skimmed the article and I’d be happy to be corrected.

    • Only my congressman from FL, Ted Yoho, would call this a racist tax.

    • My Danish grandfather died of skin cancer. My Danish/Irish/English father has been having basal, squamous, and pre-cancerous growths removed from his skin regularly since he was in his 30’s. My father is thus very adamant as to the merits of protecting oneself from the sun, especially with his 4 children. My school district (in AZ) had cut down trees on the elementary playground such that there was no shade, advanced the school year start into August, and banned hats as ‘gang related.’ My father had to go all the way to the school board and threaten lawsuits to get his daughters allowed to wear straw hats in the Arizona sun.

      Here’s where it gets very irritating. Several of my nieces and cousins (some of whom lived in the same household with my grandfather as he was dying of skin cancer) use tanning salons regularly. I am awestruck at people’s willingness to die for fashion.

    • One could do the same about motorcycles. It is truly weird how people assess risk.