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TAXING TOXIC TANNING: HEALTH CARE REFORM

Jennifer Wider, MD Society for Women's Health Research

The tanning industry came into focus recently during the national debate on health care. One of the changes included in the new health care reform legislation is a tax on tanning salons. Under the new law, tanning salons will start charging a 10 percent tax on all indoor tanning services. The tax is expected to generate roughly $2.7 billion dollars over ten years.

Not surprisingly, there are people upset by the new measure. According to Joseph Levy, the vice president of the International Smart Tan Network, tanning salon owners and industry professionals are working to have the taxes removed. He reports that businesses and customers have sent over 200,000 letters to Congress asking for a reconsideration and removal of the tax, which will be effective July 1, 2010.

And then there are many people who feel the tax is justified. The American Academy of Dermatology Association (AADA) has long held the position that indoor tanning is dangerous and increases a person’s risk of skin cancer. Dr. William James, president of the Academy, believes that there should be a federal ban on the use and sale of tanning beds in this country. In written testimony to the government, James states that a proposed ban would be: “an important step toward reducing the incidence of skin cancer in the United States and building a greater public understanding of the dangers of UV exposure.”

Skin cancer cases are at an all-time high in the United States. According to the American Cancer Society, more than one million new cases of skin cancer will be diagnosed this year. Melanoma, which is the most dangerous type of skin cancer, has also become the most common cancer among women aged 25-29, according to the Centers for Disease Control and Prevention in Atlanta, Ga. Bad sunburns that include blistering increase melanoma risk. Long-term exposure to the sun increases risk for melanoma and the two other less serious types of skin cancer, basal cell and squamous cell carcinoma. The use of tanning salons also has been linked to skin cancer.

According to Elizabeth C. Smith, MD, a dermatologist at Cohen Dermatology Associates in Fairfield, CT and member of the teaching faculty at The Mount Sinai School of Medicine in New York City, “In addition to escalating the risk of potentially fatal melanoma, a person who tans is 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma than a person who does not. Multiple studies have shown the earlier a person begins to go to tanning salons, the greater the risk of skin cancer later in life.”

The dangers of indoor tanning have long been established, but health organizations have recently stepped up their warnings. “In 2009, the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) classified tanning beds as an exposure that is “carcinogenic to humans,” says Dr. Smith. “The IARC went further, grouping tanning beds with other Group I carcinogens such as asbestos, arsenic and cigarettes. Given the well-documented and widely accepted danger of tanning beds, the government has an obligation to regulate the industry and to inform the public of the hazards associated with tanning.”

Despite the myriad of public service announcements and warnings, young people still frequent tanning salons in large numbers, especially young women. According to Smith, “Young women often report wanting “color” before a vacation or event, and some confess to tanning for relaxation.” Many don’t seem to understand the risks involved: “most young people do not fully understand the risk of ultraviolet exposure, partly due to the tanning industry’s confusing campaign touting the merits of tanning to raise Vitamin D levels (important for bone health). In fact, most tanning beds emit primarily UVA light, which does not efficiently convert Vitamin D to its active form.”

Many health professionals feel that the new tax on tanning salons will send a clear message to the public that indoor tanning has real risks and potentially lower the number of young people using them on a regular basis.

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