Adolescents' use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy-level correlates.

OBJECTIVES We evaluated psychosocial, built-environmental, and policy-related correlates of adolescents' indoor tanning use. METHODS We developed 5 discrete data sets in the 100 most populous US cities, based on interviews of 6125 adolescents (aged 14-17 years) and their parents, analysis of state indoor tanning laws, interviews with enforcement experts, computed density of tanning facilities, and evaluations of these 3399 facilities' practices regarding access by youths. After univariate analyses, we constructed multilevel models with generalized linear mixed models (GLMMs). RESULTS In the past year, 17.1% of girls and 3.2% of boys had used indoor tanning. The GLMMs indicated that several psychosocial or demographic variables significantly predicted use, including being female, older, and White; having a larger allowance and a parent who used indoor tanning and allowed their adolescent to use it; and holding certain beliefs about indoor tanning's consequences. Living within 2 miles of a tanning facility also was a significant predictor. Residing in a state with youth-access legislation was not significantly associated with use. CONCLUSIONS Current laws appear ineffective in reducing indoor tanning; bans likely are needed. Parents have an important role in prevention efforts.