Post-California tanning ban: a brief update on current youth access laws.

aging, and immunosuppression due to the exposure of UV radiation. As a consequence, there has been an alarming rise in melanoma incidence, especially in young women ages 15 to 39 years. Indeed, it has been shown that tanning bed use increases the risk of melanoma by 75% when use occurs before age 35 years. In response to these alarming trends, numerous health and medical organizations have characterized tanning beds as carcinogenic and encouraged increasing state regulations to limit youth access to tanning salons. In February 2012, California became the first state to implement a universal tanning ban for minors younger than 18 years. In light of this instrumental piece of legislation, this commentary serves to delineate the current status of tanning access restrictions and describe the challenges in the legislative path to “ban the tan.” Tanning legislation is drafted and enforced by each state, with an overall lack of federal oversight. The legislationpertains toanumberofareas, suchasequipmentstandards, facilityandoperator-related regulations, enforcement and legal issues, and minors’ access to tanningservices.Most legislationcentersaroundtanningaccess with a variety of age requirements. Each state can issue up to 3 different types of age requirements: (1) for parental consent, (2) for parentalaccompaniment,and(3)forabsoluteagerestrictiontotanning(ban). Now, there are 32 states which have at least 1 of the 3 age requirements. In2003,only3stateshad inplace the third criterion: Texas, Illinois, and Wisconsin had a minimum age limit for tanning customers of 13, 14, and 16years,respectively.Currently,there are 11 states that dictate an absolute age restriction (Figure). The presence of various state legislation has had a dramatic impact on changing tanning access to minors. An important study conducted in 2009 assessed the practices of 3647 tanning facilities in cities from all 50 states. Data collectors posing as 15year-old female customers solicited each facility’s requirements for minimum age, parental consent, parental accompaniment, and tanning frequency. The results were significant. In states where laws for a 15-yearold customer were present, a higher percentage of surveyed facilities required parental consent and accompaniment compared with facilities in states without the specific law. In Wisconsin, which has a tanning ban for those younger than 16 years, 70.0% of facilities did not allow the caller to tan compared with 3.5% of facilities in states without the ban (P .001). This study demonstrated that tanning facilities are significantly more likely to abide by a teen access law in states where that specific law is in place. Yet, in view of this progress, the current legislation is not strong enough to completely deter minors’ access to tanning. Enforcement is not uniform within these states, with low rates of citations and inspections contributing to noncompliance. Advertising strategies, such as discounts and unlimited tanning packages that market to minors, are not monitored or restricted heavily. In fact, those misleading and false advertising campaigns have been cited and criticized by the Federal Trade Commission and the US Congress. Furthermore, many facilities are in direct opposition to the US Food and Drug Administration– recommended exposure schedule of no more than 0.75 minimal erythemal dose 3 times the first week, incentivizing frequent tanning proSee related article