The cigarette war is winding down, as one country after another bans public smoking. A week ago, the top three soft-drink makers surrendered the first big battle of the junk-food war, agreeing to remove sodas from elementary and middle schools. A few days later, spooked by the outcry against fast food and childhood obesity, Disney fled an advertising deal with McDonald's. Nobody wants to be the new Joe Camel.
But somebody will be. Look out your window: Summer is coming. Teens are getting ready for their proms. It's tanning season—time to stretch out on the beach, or under an ultraviolet lamp, and soak up a nice, warm dose of lethal radiation.
If you've had trouble seeing Cokes or cheeseburgers as the moral equivalent of cigarettes, brace yourself for the next public health menace: the sun. You thought it was our smiley-faced friend? Think again. Skin cancer rates are soaring. We're basking outside too long and with too little protection. The health cops want us to stop, but regulating a ball of fire 1 million times the size of Earth is somewhat more difficult than regulating corn chips. So, they're going after the radiation source they can get their hands on: tanning salons. A bill in Congress would stiffen health warnings on tanning machines. The American Medical Association is asking lawmakers to put these machines off-limits to anyone under 18, and the American Academy of Dermatology wants to outlaw them altogether.
About 30 million Americans use tanning salons. At least one of every four teenage girls, and nearly one of every two girls aged 18 or 19, has tanned indoors at least three times. Why? According to this month's Archives of Dermatology, "[ultraviolet] radiation, a classified carcinogen, is commonly and specifically marketed to adolescents through high school newspaper advertising" by salons. Why do kids keep coming back? A study in the current Journal of the American Academy of Dermatology suggests "frequent tanning is driven by an opioid-dependent mechanism." In other words, it's a physical addiction. It even has a street name: tanorexia. Harmful, addictive, marketed to kids—that's the three-count indictment that brought down tobacco and soft drinks.
Like the tobacco companies, the salons live in a bubble of denial that cries out for oversight. Last year, in a survey by Consumer Reports, one of every three salons denied that tanning could cause skin cancer or would age a client's skin. Their lobbying arm, the Indoor Tanning Association, asserts that "your body is designed to repair any damage to the skin caused by ultraviolet light exposure"—as though nobody ever died of melanoma—and hilariously suggests that exposing adolescents to the summer sun for two or three more hours per day would eliminate most cases of multiple sclerosis.
Still, there's something misguided about the crusade against tanning salons. Actually, two things: liberal bias against industry, and conservative bias against sensuality.
Liberal bias puts too much scrutiny on indoor rather than outdoor tanning. Seeing nature as good and industry as evil, we treat salons as though they've perverted sunshine into a carcinogen. Politicians and medical associations say indoor tanning is worse because it cooks you faster and its risks are harder to recognize. That's exactly wrong. Outdoors, you have no clue how much radiation you're getting. Your estimate, based on the season or hour, is pure guesswork. You probably never think about altitude. You mistakenly assume that clouds, your white T-shirt, or being underwater are shielding you from more than a fraction of ultraviolet rays. You have no idea that the "SPF" factor advertised on your sunscreen tells you nothing about whether it blocks the rays that cause melanoma.
Yes, an indoor lamp can cook you faster. But you can choose the cooking rate, and knowing that rate, you can control the dose and customize it to your skin type. You can even regulate the composition of the light, avoiding rays that cause sunburns. A salon operator can program her machines to shut off after 20 minutes. Try shutting off the sun.
Conservative bias, meanwhile, puts too much emphasis on abstinence rather than moderation. Health advocates, determined to convince the public that tanning isn't risk-free, have simplified their message to the point of untruth. Even Cosmopolitan has suddenly gone prude. "A suntan is actually just as destructive to your skin as a raw, pink sunburn," the magazine warns in its May issue. Wrong again. The most thorough review of data, issued five months ago by a European Commission science panel, found clear correlations between sunburns and skin cancer, but no such clarity in studies of tanning salons and skin cancer. That's because a sunburn conveys how much radiation you got; a salon doesn't. The less often you tan, the softer the light, and the shorter your exposure, the lower your risk. It isn't the degree of risk that drives doctors crazy. It's that people are taking that risk, as the AAD puts it, "solely for cosmetic reasons." Pleasure! Superficiality! Yuck!
Listen to the arguments against tanning, and you'll hear echoes of the arguments against premarital sex. "Just one time in a tanning bed has the potential to cause harm," warns Rep. Carolyn Maloney, D-N.Y., co-author of the federal bill to regulate salons. The AAD says you should wear a broad-brimmed hat and long pants, apply sunscreen half an hour before you go out and again every two hours, and stay out of the sun until 4 p.m. You might as well be in a chador. As for the idea of getting a "base tan" to prevent sunburn, dermatologists protest that this flimsy shield will only embolden you to persist in risky activity. Sounds like the case against condoms, doesn't it?
Part these clouds of bias, and the truth shines through. You can't stop tanning; the best you can do is help people control it. Toward that end, the industrialization of ultraviolet light is a blessing. It gives us the power to clarify, modulate, and customize dosage. Salons need oversight to make sure they help clients understand and manage this power. But if you shut them down or lock out teenagers, be prepared to enforce a dawn-to-dusk curfew or face an epidemic of skin cancer. If you liked back-alley abortions, you'll love backyard tanning.
Technology without guidance can be dangerous. The emerging peril in the tanning world isn't staffed salons; it's coin-operated, unsupervised machines, already proliferating in Europe, in which kids can toast themselves for lunch money. But with guidance, technology often solves its own problems. It won't be Congress that stops teens from cooking their skin. It'll be tanning sprays and lotions, which continue to improve in appearance, durability, and popularity. And guess who's going to lead the way? Salons.
A version of this article also appears in the Outlook section of the Sunday Washington Post.
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