An Initial Investigation of the Effects of Tanning-Related Cues on Demand and Craving for Indoor Tanning
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Melanoma and other skin cancers have become the most commonly diagnosed cancers in the United States. Despite the well-established link between skin cancer and indoor tanning, approximately 30 million Americans report engaging in indoor tanning each year, and the majority of these users are white females aged 16 to 29 years. Although some studies have suggested that exposure to ultraviolet radiation may produce reinforcing effects in frequent tanners paralleling the characteristic features of substance use disorders, no previous study has explored the impact of tanning-related cues on demand for tanning. The aim of the present study was to examine the effects of tanning-related cues on participants’ behavioral economic demand and craving for indoor tanning. Participants were 23 undergraduate students (22 females, one male), each of whom underwent a cue-exposure procedure consisting of experiencing neutral- and tanning-related cues. Results suggest that participants exhibited an increase in behavioral economic demand and self-reported craving in the condition associated with tanning-related cues relative to neutral-cues. We conclude by discussing notable limitations and offering directions for future research.
KeywordsCue reactivity Behavioral economics Indoor tanning Demand Craving Skin cancer
The current study was conducted by the first author in partial fulfillment of the requirements for the MA degree in Applied Behavioral Science at the University of Kansas.
The first author expresses sincere gratitude to Florence D. DiGennaro Reed, Brent A. Kaplan, Gideon P. Naudé, Bryan T. Yanagita, and Rachel E. Jackson for their valuable feedback and guidance on previous versions of this paper.
This project was supported by the University of Kansas New Faculty General Research Fund allocation #2302290 and General Research Fund allocation #2301722. The third author’s contributions were supported by the Peter Boris Centre for Addictions Research.
Compliance with Ethical Standards
Conflict of Interest
All authors declare they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The University of Kansas Institutional Review Board and Human Subjects Committee approved the protocol used in this study (approval #HSCL1355).
Participants indicated consent by completing a consent form and clicking a button in the online survey to initiate the study tasks. The University of Kansas Institutional Review Board and Human Subjects Committee approved the informed consent method used in this study (approval #HSCL1355).
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Amlung, M. T., Acker, J., Stojek, M. K., Murphy, J. G., & MacKillop, J. (2012). Is talk "cheap"? An initial investigation of the equivalence of alcohol purchase task performance for hypothetical and actual rewards. Alcoholism: Clinical and Experimental Research, 36, 716–724. doi: 10.1111/j.1530-0277.2011.01656.x.CrossRefGoogle Scholar
- Bickel, W. K., & Vuchinich, R. E. (2000). Reframing health behavior change with behavioral economics. Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
- Bizzozero, J. (2009). The state of the industry report 2008. Available at: http://www.lookingfit.com/articles/2009/05/the-state-of-the-industry-report-2008/. Accessed January 21, 2015.
- Boniol, M., Autier, P., Boyle, P., & Gandini, S. (2012). Cutaneous melanoma attributable to sunbed use: Systematic review and meta-analysis. BMJ, 345.Google Scholar
- Cafri, G., Thompson, J. K., Roehrig, M., van den Berg, P., Jacobsen, P. B., & Stark, S. (2006). An investigation of appearance motives for tanning: The development and evaluation of the Physical Appearance Reasons For Tanning Scale (PARTS) and its relation to sunbathing and indoor tanning intentions. Body Image, 3(3), 199–209. doi: 10.1016/j.bodyim.2006.05.002.CrossRefPubMedGoogle Scholar
- Carter, B. L., & Tiffany, S. T. (1999). Meta‐analysis of cue‐reactivity in addiction research. Addiction, 94, 327–340.Google Scholar
- Cartmel, B., Ferrucci, L. M., Spain, P., Bale, A., E., Pagoto, S. L., Leffell, D. J., … & Mayne, S. T. (2013). Indoor tanning and tanning dependence in young people after a diagnosis of basal cell carcinoma. JAMA Dermatology, 149, 1110-1111.Google Scholar
- Culley, C. A., Mayer, J. A., Eckhardt, L., Busic, A. J., Eichenfield, L. F., Sallis, J. F., … & Woodruff, S. I. (2001). Compliance with federal and state legislation by indoor tanning facilities in San Diego. Journal of the American Academy of Dermatology, 44, 53-60.Google Scholar
- D’Agostino, R. B., & Pearson, E. S. (1973). Tests for departure from normality: Empirical results for the distributions of b 2 and √b 1. Biometrika, 60, 613–622.Google Scholar
- 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
- Guy, G. P., Berkowitz, Z., Watson, M., Holman, D. M., & Richardson, L. C. (2013). Indoor tanning among young non-Hispanic white females. JAMA Dermatology, 173, 1920–1922.Google Scholar
- Heckman, C. J., Darlow, S., Kloss, J. D., Cohen-Filipic, J., Manne, S. L., Munshi, T., … & Perlis, C. (2014). Measurement of tanning dependence. Journal of the European Academy of Dermatology and Venerology, 28, 1179-1185.Google Scholar
- Holman, D. M., Fox, K. A., Glenn, J. D., Guy, G. P., Jr., Watson, M., Baker, K., … & Geller, A. C. (2013). Strategies to reduce indoor tanning: current research gaps and future opportunities for prevention. American Journal of Preventive Medicine, 44, 672-681.Google Scholar
- Levine, J. A., Sorace, M., Spencer, J., & Siegel, D. (2005). The indoor UV tanning industry: A review of skin cancer risk, health benefit claims, and regulation. Journal of the American Academy of Dermatology. 1038-1044.Google Scholar
- MacKillop, J., Menges, D. P., McGeary, J. E., & Lisman, S. A. (2007). Effects of craving and DRD4 VNTR genotype on the relative value of alcohol: An initial human laboratory study. Behavioral and Brain Functions, 3. doi: 10.1186/1744-9081-3-11
- MacKillop, J., O'Hagen, S., Lisman, S. A., Murphy, J. G., Ray, L. A., Tidey, J. W., … & Monti, P.M. (2010). Behavioral economic analysis of cue-elicited craving for alcohol. Addiction, 105, 1599-1607. doi: 10.1111/j.1360-0443.2010.03004.x
- Reed, D. D., Yanagita, B. T., Becirevic, A., & Kaplan, B. A. (2014). Consumer foraging for safer tanning alternatives: A naturally occurring experiment on informational reinforcement in the UK. European Journal of Behavior Analysis, 15, 241–248.Google Scholar
- Reynolds, E. K., & Monti, P. M. (2012). The cue reactivity paradigm in addiction research. In J. MacKillop & H. de Wit (eds.), The Wiley-Blackwell Handbook of Addiction Psychopharmacology (pp. 381–410). Oxford, UK: Wiley-Blackwell.Google Scholar
- Samuelson, P. A., & Nordhaus, W. D. (1985). Economics. New York, NY: McGraw-Hill.Google Scholar
- Stapleton, J., Turrisi, R., Hillhouse, J., Robinson, J. K., & Abar, B. (2010). A comparison of the efficacy of an appearance-focused skin cancer intervention within indoor tanner subgroups identified by latent profile analysis. Journal of Behavioral Medicine, 33(3), 181–190. doi: 10.1007/s10865-009-9246-z.CrossRefPubMedGoogle Scholar
- U.S. Department of Health and Human Services. (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.Google Scholar
- U.S. Department of Health and Human Services. (2014). The Surgeon General’s call to action to prevent skin cancer. Washington, DC: Department of Health and Human Services, Office of the Surgeon General. Retrieved from http://www.surgeongeneral.gov/library/calls/prevent-skin-cancer/call-to-action-prevent-skin-cancer.pdf.Google Scholar
- Wehner, M. R., Shive, M. L., Chren, M. M., Han, J., Qureshi, A. A., & Linos, E. (2012). Indoor tanning and non-melanoma skin cancer: Systematic review and meta-analysis. BMJ, 345, e5909.Google Scholar