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Sunburn paradoxes and the New Zealand population

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Over the past decade, paradoxes have emerged in the skin cancer prevention and sunburn reduction literature. These include that individuals with higher sun protection knowledge; lower positive attitudes towards tanning; and who are users of sunscreen have higher odds of sunburn. It is also possible that sunburn paradoxes may be associated with those whose sunburn was unintended. New Zealand and Australia have, by far, the highest age standardised incidence rates of melanoma skin cancer in the world, and this study examines the extent to which sunburn and unintended sunburn is associated with the sunburn paradox variables.


Sun Exposure Survey data New Zealanders aged 15 + years were gathered by the New Zealand Health Promotion Agency in 2016.


Linkages were examined between sunburn, unintended sunburn and the paradox variables: sun protection knowledge, attitudes towards tanning and use of sunscreen. Sunburn was associated with higher respondent sun protection knowledge. No statistically significant associations were found between unintended sunburn and the paradox variables.


This research indicates that in a well-designed study of a sample representative of the New Zealand population, the sun protection knowledge sunburn paradox still exists. Despite a high level of sun protection knowledge, many people still become sunburned. Therefore, it is important to examine this paradox further in order to find ways to reduce sunburn frequency among New Zealanders. Potential ways to reduce sunburn are discussed.

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Data for this project was provided by the Health Promotion Agency, New Zealand. The results presented in this paper are the work of the authors.


This project received support from the University of Otago, New Zealand; and funding from the Cancer Research Trust New Zealand.

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Correspondence to Geraldine F. H. McLeod.

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McLeod, G.F.H., Dhakal, B., Reeder, A.I. et al. Sunburn paradoxes and the New Zealand population. J Public Health (Berl.) 29, 387–392 (2021).

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