The Journal of Primary Prevention

, Volume 37, Issue 5, pp 421–432 | Cite as

Acculturation, Skin Tone Preferences, and Tanning Behaviours Among Young Adult Asian Australians

  • Ashley K. Day
  • Carlene J. Wilson
  • Amanda D. Hutchinson
  • Rachel M. Roberts
Original Paper

Abstract

Australia has a significant proportion of residents of Asian heritage. Although the incidence of skin cancer is lower in those of Asian heritage than Caucasians, their prognosis is often worse. Sociocultural variables are central to the tanning behaviours of individuals from Western cultures. We examined the role of sociocultural variables in the tanning behaviours (outdoor tanning, indoor/solarium and fake tan use) among Asian Australians. A sample of 399 young adults identifying either as a person of Asian heritage or as Asian Australian participated in an online survey. Our results suggest that Asian Australians are at risk of skin cancer; over 35 % of the sample reported engaging in outdoor tanning and over 10 % in solarium tanning. After controlling for demographic factors and skin cancer knowledge, preferring a darker skin tone and being acculturated to Australia were significantly associated with tanning behaviour. Participants’ low levels of skin cancer knowledge are of concern, and possibilities for improving knowledge levels in this group are considered. Further, we recommended that future research studies investigate sociocultural and appearance-related beliefs associated with tanning behaviours in this population, in order to determine best avenues for intervention.

Keywords

Tanning Sun behaviour Acculturation Skin cancer Asian 

Notes

Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest or financial disclosures to report.

References

  1. Armstrong, B. K., & Kricker, A. (2001). The epidemiology of UV induced skin cancer. Journal of Photochemistry and Photobiology B: Biology, 63, 8–18. doi: 10.1016/S1011-1344(01)00198-1.CrossRefGoogle Scholar
  2. Australian Bureau of Statistics. (2011). Geographical Areas (Usual Residence) Database “2011 Census—Cultural and Language Diversity” Table builds from; BPLP (Country of Birth of Person); ANC1P (Ancestry1), LANP (Language Spoken at home). http://www.abs.gov.au/websitedbs/censushome.nsf/home/tablebuilder. Accessed 5 Jul 2015.
  3. Australian Education International. (2012). International Student Enrolment Data 2011 “Detailed monthly tables (December)”. https://aei.gov.au/research/International-StudentData/Pages/InternationalStudentData2011.aspx. Accessed 3 Jun 2015.
  4. Australian Institute of Health and Welfare. (2011). Non-melanoma skin cancer, all types—Australian Cancer Incidence & Mortality Book. http://www.aihw.gov.au/acim-books/. Accessed 3 Jun 2015.
  5. Australian Institute of Health and Welfare. (2016). Australian Cancer Database (ACD). http://www.aihw.gov.au/australian-cancer-database/. Accessed 4 Jan 2016.
  6. Bellew, S., Del Rosso, J. Q., & Kim, G. K. (2009). Skin cancer in Asians: Part 2: Melanoma. The Journal of Clinical and Aesthetic Dermatology, 2(10), 34–36.PubMedPubMedCentralGoogle Scholar
  7. Blashill, A. J., & Safren, S. A. (2014). Skin cancer risk behaviors among US men: the role of sexual orientation. American Journal of Public Health, 104(9), 1640–1641. doi: 10.2105/ajph.2014.301993.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Blashill, A. J., & Traeger, L. (2013). Indoor tanning use among adolescent males: the role of perceived weight and bullying. Annals of Behavioral Medicine, 46(2), 232–236. doi: 10.1007/s12160-013-9491-9.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bradford, P. T., Goldstein, A. M., McMaster, M. L., & Tucker, M. A. (2009). Acral lentiginous melanoma: Incidence and survival patterns in the United States, 1986–2005. Archives of Dermatology, 145(4), 427–434. doi: 10.1001/archdermatol.2008.609.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Brock, K. E., Ke, L., Tseng, M., Clemson, L., Koo, F. K., Jang, H., et al. (2013). Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney. Journal of Steroid Biochemistry and Molecular Biology, 136, 214–217. doi: 10.1016/j.jsbmb.2012.12.005.CrossRefPubMedGoogle Scholar
  11. Cancer Council Australia. (2016). Skin cancer. http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html. Accessed 4 Aug 2016.
  12. Cormier, J. N., Xing, Y., Ding, M., et al. (2006). Ethnic differences among patients with cutaneous melanoma. Archives of Internal Medicine, 166(17), 1907–1914. doi: 10.1001/archinte.166.17.1907.CrossRefPubMedGoogle Scholar
  13. Coups, E. J., Stapleton, J. L., Hudson, S. V., Medina-Forrester, A., Natale-Pereira, A., & Goydos, J. S. (2012). Sun protection and exposure behaviors among Hispanic adults in the United States: Differences according to acculturation and among Hispanic subgroups. BMC Public Health, 12, 985. doi: 10.1186/1471-2458-12-985.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Coups, E. J., Stapleton, J. L., Hudson, S. V., Medina-Forrester, A., Rosenberg, S. A., Gordon, M. A., et al. (2013). Linguistic acculturation and skin cancer-related behaviors among Hispanics in the southern and western United States. JAMA Dermatology, 149(6), 679–686. doi: 10.1001/jamadermatol.2013.745.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Day, A. K., Wilson, C. J., Hutchinson, A. D., & Roberts, R. M. (2015). Sun-related behaviours among young Australians with Asian ethnic background: differences according to sociocultural norms and skin tone perceptions. European Journal of Cancer Care, 24(4), 514–521. doi: 10.1111/ecc.12275.CrossRefPubMedGoogle Scholar
  16. Day, A. K., Wilson, C., Roberts, R. M., & Hutchinson, A. D. (2014). The skin cancer and sun knowledge (SCSK) Scale: Validity, reliability, and relationship to sun-related behaviors among young western adults. Health Education and Behavior, 41(4), 440–448. doi: 10.1177/1090198114529129.CrossRefPubMedGoogle Scholar
  17. Dissel, M., Rotterdam, S., Altmeyer, P., & Gambichler, T. (2009). Indoor tanning in North Rhine-Westphalia Germany: A self-reported survey. Photodermatology, Photoimmunology and Photomedicine, 25(2), 94–100. doi: 10.1111/j.1600-0781.2009.00417.x.CrossRefPubMedGoogle Scholar
  18. Ezzedine, K., Malvy, D., Mauger, E., Nageotte, O., Galan, P., Hercberg, S., et al. (2008). Artificial and natural ultraviolet radiation exposure: Beliefs and behaviour of 7200 French adults. Journal the European Academy of Dermatology and Venereology, 22(2), 186–194. doi: 10.1111/j.1468-3083.2007.02367.x.Google Scholar
  19. Francis, K., Dobbinson, S., Wakefield, M., & Girgis, A. (2010). Solarium use in Australia, recent trends and context. Australian and New Zealand Journal of Public Health, 34(4), 427–430. doi: 10.1111/j.1753-6405.2010.00578.x.CrossRefPubMedGoogle Scholar
  20. Gloster, H. M., Jr., & Neal, K. (2006). Skin cancer in skin of color. Journal of the American Academy of Dermatology, 55(5), 741–760. doi: 10.1016/j.jaad.2005.08.063.CrossRefPubMedGoogle Scholar
  21. Gorell, E., Lee, C., Munoz, C., & Chang, A. L. (2009). Adoption of western culture by Californian Asian Americans: Attitudes and practices promoting sun exposure. Archives of Dermatology, 145(5), 552–556. doi: 10.1001/archdermatol.2009.39.CrossRefPubMedGoogle Scholar
  22. Hamid, P. D., Simmonds, J. G., & Bowles, T. V. (2009). Asian Australian acculturation and attitudes toward seeking professional psychological help. Australian Journal of Psychology, 61(2), 69–76.CrossRefGoogle Scholar
  23. Hutchinson, A. D., Prichard, I., Ettridge, K., & Wilson, C. (2014). Skin tone dissatisfaction, sun exposure, and sun protection in Australian adolescents. International Journal of Behavioral Medicine,. doi: 10.1007/s12529-014-9441-3.Google Scholar
  24. Ishihara, K., Saida, T., & Yamamoto, A. (2001). Updated statistical data for malignant melanoma in Japan. International Journal of Clinical Oncology, 6(3), 109–116. doi: 10.1007/PL00012091.CrossRefPubMedGoogle Scholar
  25. Jang, H., Koo, F. K., Ke, L., Clemson, L., Cant, R., Fraser, D. R., et al. (2013). Culture and sun exposure in immigrant East Asian women living in Australia. Women and Health, 53(5), 504–518. doi: 10.1080/03630242.2013.806386.CrossRefPubMedGoogle Scholar
  26. Koh, D., Wang, H., Lee, J., Chia, K. S., Lee, H. P., & Goh, C. L. (2003). Basal cell carcinoma, squamous cell carcinoma and melanoma of the skin: Analysis of the Singapore cancer registry data 1968–97. British Journal of Dermatology, 148(6), 1161–1166. doi: 10.1046/j.1365-2133.2003.05223.x.CrossRefPubMedGoogle Scholar
  27. Levine, J. A., Sorace, M., Spencer, J., & Siegel, D. M. (2005). The indoor UV tanning industry: a review of skin cancer risk, health benefit claims, and regulation. Journal of the American Academy of Dermatology, 53, 1038–1044. doi: 10.1016/j.jaad.2005.07.066.CrossRefPubMedGoogle Scholar
  28. Montague, M., Borland, R., & Sinclair, C. (2001). Slip! Slop! Slap! and SunSmart, 1980–2000: Skin cancer control and 20 years of population-based campaigning. Health Education and Behavior, 28(3), 290–305. Retrived from http://heb.sagepub.com/.
  29. National Insitutes of Health. (2014). Vitamin D fact sheet for health professionals. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed 2 Feb 2016.
  30. Sng, J., Koh, D., Siong, W. C., & Choo, T. B. (2009). Skin cancer trends among Asians living in Singapore from 1968 to 2006. Journal of the American Academy of Dermatology, 61(3), 426–432. doi: 10.1016/j.jaad.2009.03.031.CrossRefPubMedGoogle Scholar
  31. Stapleton, J., Turrisi, R., & Hillhouse, J. J. (2008). Peer crowd identification and indoor artificial UV tanning behavioral tendencies. Journal of Health Psychology, 13(7), 940–945. doi: 10.1177/1359105308095068.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Stern, R. S., & Momtaz, K. (1984). Skin typing for assessment of skin cancer risk and acute response to UV-B and oral methoxsalen photochemotherapy. Archives of Dermatology, 120(7), 869–873. doi: 10.1001/archderm.1984.01650430055010.CrossRefPubMedGoogle Scholar
  33. Suinn, R. M., Ahuna, C., & Khoo, G. (1992). The Suinn-Lew Asian Self-Identity Acculturation Scale: Concurrent and factorial validation. Educational and Psychological Measurement, 52, 1041–1046. doi: 10.1177/0013164492052004028.CrossRefGoogle Scholar
  34. Swerdlow, A. J. (1990). International trends in cutaneous melanoma. Annals of the New York Academy of Sciences, 609, 235–251.CrossRefPubMedGoogle Scholar
  35. The University of Adelaide. (2016). Minimum English language proficiency for entry. http://www.adelaide.edu.au/graduatecentre/handbook/03-considerations-in-applying/02-entry-requirements/03-english-language/. Accessed 8 Aug 2016.
  36. Universities Australia (2013). Australian Universities Data Snapshot 2013. https://www.universitiesaustralia.edu.au/australias-universities/key-facts-and-data#.U4qdmpQWXCo. Accessed 5 Jul 2015.
  37. US Department of Health and Human Services. (2014). The Surgeon General’s Call to Action to Prevent Skin Cancer. Washington (DC).Google Scholar
  38. Yoo, J. J., & Kim, H.-Y. (2012). Adolescents’ body-tanning behaviours: Influences of gender, body mass index, sociocultural attitudes towards appearance and body satisfaction. International Journal of Consumer Studies, 36(3), 360–366. doi: 10.1111/j.1470-6431.2011.01009.x.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.School of PsychologyUniversity of AdelaideAdelaideAustralia
  2. 2.Rutgers Cancer Institute of New JerseyRutgers, The State University of New JerseyNew BrunswickUSA
  3. 3.Flinders Centre for Innovation in CancerFlinders UniversityAdelaideAustralia
  4. 4.Cancer Council South AustraliaAdelaideAustralia
  5. 5.School of Psychology, Social Work and Social PolicyUniSAAdelaideAustralia

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