Addiction to Indoor Tanning Relation to Anxiety, Depression, and Substance Use

Objective: To assess the prevalence of addiction to indoor tanning among college students and its association with substance use and symptoms of anxiety and depression. Design: Two written measures, the CAGE (Cut down, Annoyed, Guilty, Eye-opener) Questionnaire, used to screen for alcoholism, and the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (DSM-IV-TR) criteria for substance-related disorders, were modified to evaluate study participants for addiction to indoor tanning. Standardized self-report measures of anxiety, depression, and substance use also were administered. Setting: A large university (approximately 18 000 students) in the northeastern United States. Participants: A total of 421 college students were recruited from September through December 2006. Main Outcome Measures: Self-reported addiction to indoor tanning, substance use, and symptoms of anxiety and depression. Results: Among 229 study participants who had used indoor tanning facilities, 90 (39.3%) met DSM-IV-TR criteria and 70 (30.6%) met CAGE criteria for addiction to indoor tanning. Students who met DSM-IV-TR and CAGE criteria for addiction to indoor tanning reported greater symptoms of anxiety and greater use of alcohol, marijuana, and other substances than those who did not meet these criteria. Depressive symptoms did not significantly vary by indoor tanning addiction status. Conclusion: Findings suggest that interventions to reduce skin cancer risk should address the addictive qualities of indoor tanning for a minority of individuals and the relationship of this behavior to other addictions and affective disturbance. Arch Dermatol. 2010; 146(4): 412-417