Tanning Legislation: Public Health, Yes, But Maybe More

Right now the probability that a young, healthy Canadian will contact the deadly skin Cancer called melanoma is 1 in 5000. Want to know how to double those odds? Take just ONE tanning session before age 21 (source—health Canada). That’s all you have to do.

Today, January 29, 2014 the NL provincial government enacted legislation that makes it illegal for anyone under age 19 to use commercial sun-tanning equipment. Normally I’d have a problem with a heavy handed “saving us from ourselves” piece of legislation like this but maybe this one is different. Perhaps it’s more in line with seatbelt legislation and, in the end, worth parting with a precious bit of that thing we so casually refer to as “freedom” in pursuit of the greater good.

The commonly-cited justification sounds straightforward enough. The ultraviolet light (I will avoid the more correct term “radiation” lest I be accused of adding unwanted fuel to what is already an emotional issue) produced by the tanning machines has a proven causal connection to an increased risk of contracting such nasties as the aforementioned skin cancer as well as eye-ailments like cataracts. Based on that alone, it’s easy to see why there would be widespread support for a law that is designed to protect people.

But then again, the counter argument is also deceptively simple. To the extent that they harm nobody else there are many who believe that the state has no right in preventing people from participating in potentially dangerous activities. In this view it’s a personal matter and perhaps the government should mind our collective business instead of limiting individual’s freedom. After all, crossing the road, shoveling snow, driving, and eating fast food are all potentially dangerous activities, each with significant, measurable health and mortality risks. Why pick on tanning? The fact is, for most clients, it will pose much less risk in the long run than say, the poutine habit enjoyed weekly by the many finger-wagging protesters. There’s also the matter of the devastating effect this will likely have on a bunch of currently thriving suntanning establishments. To say, “We, as a society, don’t care about the owners and employees because, after all, the business was built around hurting people,” does come across as somewhat sensationalist and mean-spirited when you think about it.

But we don’t need to end it there as it turns out. There are additional and rather compelling arguments on the positive side. First we can rip a page from J S Mill and adopt a utilitarian stance; that is, maximizing the amount of good that can be done for society as a whole even if it negatively affects a few individuals along the way. Every tanning session prevented is, potentially, a life saved. OK, that’s stretching it, but you get the idea. As for poutine, let someone else argue that one because it’s probably just as justified; a battle to be fought later on.

But there’s another justification, one as easy to understand as dollars and cents. Melanoma is deadly but treatable. Approximately 10% of the patients who contract it will die from it. If caught early, though, simple removal, at a cost of around $2000 to $3000 will do the trick. A more advanced case can cost as high as $200000 or more to treat through a mixture of surgery and chemo. That’s a lot of money, any way you look at it, so there’s significant cost savings to be had, at the state level, by banning any practice that could increase the risk.

So there. Case closed, or so it seems.

But, ahhhh, icebergs again. As is often the case there’s more once you just take a few minutes to look a little deeper.

Why should it come to this? For heaven’s sake why, on earth, should we feel that a simple sun tan is something we have to take so seriously as to pass such laws? Is it really about safety, saving money and utilitarianism? If it were, after all, we’d all be eating cheap, safe state-supplied food, travelling exclusively in public transportation and so on. For anyone with more than a dust of common sense there has to be more afoot.

How about two additional items that aren’t getting talked about much?

Parents are sick and tired of costly, the over-the-top vanity. Why, after all, do young people go to those tanning salons? To get a nice, “healthy” tan, perhaps? Of course not! They go instead to tan up for any number those displays of narcissism that stress everyone’s patience and finances on a regular basis. So called “grads” (spring proms really), “sweet sixteen” parties, birthday parties, cruises; the list goes on and on. Some young people, having heard “Ooooo you’re so special” so often, finally take it to mean they really are a cut above everyone else, as opposed to unique and worthwhile (the intended message). Hey, they “deserve” the royal treatment and that includes tans! The remainder—probably the majority but I have no data to support this—feel compelled to fall in line and do the same so they, too, hound their parents for the money to burn a little colour into their skin. The result is an almost unstoppable set of pressures that results in a huge demand for tanning, whether or not the young people or their parents want any part of it. Education can’t be expected to stem this tide. Rational arguments won’t win against this level of expectation and emotion, but legislation will, and most parents are just fine with that.

There’s a strong bandwagon effect. Yes, there’s powerful peer pressure for tanning among our young people but there’s a strong push-back from a different crowd, the one that reacts with horror at each and every perceived social ill…at least the ones that appear to be on the hit-list for their in-group. You know the ones: they react with indignation whenever anybody drops the hot button words. There are quite a few of those words and most are steeped in controversy—so we won’t go there right now. Underage smoking and drinking & driving come to mind, though, as ones we all can mostly agree on. There are many others. Hey, the causes are mostly good, or at least well-intentioned, but one suspects, from the ferocity of their commitment that there’s a bit more at stake here than a simple desire for social justice. It goes into the realm of the pathological. For some, it seems, the rewards gained from being perceived as saving others transcend all else. Perhaps the urge to win, at all costs, is part of it too. In the end, viewed objectively, the passion and the motives of this group just seem a little off. They are nonetheless a force dedicated to social improvement, regardless of the deeper motives, and tanning salons are among the many things they wish to say “NO!” to.

Me? I’ve always loved being outdoors. Whether it was playing some games, cycling somewhere, hanging out by the beach or just going out on the water in a boat doing…whatever, as a child I spent every moment I could outdoors. Still do.  Most of it is grey now but once my hair was that colour most refer to as auburn. I just called it red and left it at that. Like most redheads I’m fair skinned and burn easily in the sun. It’s happened more times than I can count.

Every so often I visit my family doctor. She knows where to find them, the basal cell carcinomas that dot my skin here and there, the result of too many sunburns when I was much younger. For now they’re excised easily enough; just a little squirt of liquid nitrogen kills the growth. They come back.

These days I slather on SPF30 or better every time I go out in the sun. If I’d used it when I was younger the current problem would likely not exist.

Obviously I have my reasons why I support the current legislation but, admittedly, that’s just a personal opinion with an underlying rationale that smacks a bit of self-righteousness tinged with regret. As with most social issues it’s hard to talk, with any credibility, in absolutes.

We can make our choices, though.


About Maurice A. Barry

Coordinator: Teaching and Learning Commons, Faculty of Education, Memorial University of Newfoundland, Parent & Husband. eLearning consultant/coordinator. Program Development Specialist - eLearning (Department of Education; Retired). Writer: over 40 Math/Physics texts/webs. Developer & Manager of web content. Geek. Not into awards but loves comments.
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14 Responses to Tanning Legislation: Public Health, Yes, But Maybe More

  1. Oh dear. This one is attracting my itchy fingers on at least two levels. Wicked you.

    First though, my confession. I have partaken of the evil tanning sessions on one or two occasions. The first one was at Bridlington swimming baths, where I went a rosy pink, and I was very excited until it promptly faded away. Now you see it, now you don’t.

    Then, some years later, when I was attending a sports centre, I had another go. Why do they put tanning beds in sports centres? Are tanned people sportier? They spend their time doing indoor sports so need to look tanned? Anyway, second time around, still no result. At which point I spent my money on saunas, fencing, canoeing, swimming, and doing something rather than lying there radiating my body.

    Now after purging my soul, the sensible comments. Well, maybe.

    Without a doubt it is all about vanity. Long gone are the days when white skin was fashionable because that belonged to the rich – the poor worked outside and got brown leathery skin. Nowadays, brown skin belongs to those who can holiday or live in sunny climes (me for example). I go to the beach, primarily to swim, I lie on a towel to dry off inbetween swims. I am pretty well covered up most of the time, I wear a hat etc etc etc. I have a nonwhite skin, ie vaguely tanned, and I pass the not a bottle of milk test. Not deliberate, just that walking outside, doing the garden ensures a light colouring.

    My Spanish neighbour referred to a British woman who sunbathed endlessly as a woman with elephant skin. Adelina is as white as you can get. Not for her the brown skin or elephant piel. You see a lot of expats with rather brown wrinkly skins.

    Appearance, appearance, appearance. Rather like buying a house. Location, location, location. Will we ever get away from judging each other on our appearance, or succumbing to fashion?

    Melanoma. Sure, most of it is treatable. But I had a friend whose wife died of melanomic metastases a few years back, say in her early forties. No idea how she contracted it, but not a happy ending.

    But it is so dangerous that our addiction to looking good and our fixation with how we look can lead to death.

    The nanny state argument is an interesting one. I do not like the nanny state. Personally I think tanning establishments are unwarranted (incidentally I thought this was going to be a post about leather tanning but there again perhaps there is verbal link) but would I ban them? restrict them? make them age-related? So under 19s are more susceptible than over 19s? Really? I doubt that very much. There are uninformed idiots at 30 and 40 as much as there are aged under 19. Or 50 and 60 if you look at the leather skinned wrinklies on the Costa del Sol.

    I don’t buy into the public health ethos of if you get this many people to take up screening, fluoridation, eating five pieces of fruit and veg a day then X number of people will have their lives saved. And as I worked in the health service, and specifically screening, I have some idea about it.

    But I really do not like my individual rights being curtailed for the benefit of morons. Not that I want to go on a tanning bed, but I would prefer to buy flour without folic acid, and have water without added fluoride.

    My last two neighbours in the UK were teachers. One had worked in Africa and later had an operation for melanoma. Shortly afterwards she was happily lying in the garden sunbathing. FFS!

    And if you ban tanning beds for a certain age group, do you ban them going out in the sun?

    If we are that concerned about preventing cancer, how about some legislation against junk food? About how much meat people eat? Or how much they drink? Introduce ration books?

    Per se, I would ban tanning shops, but then they would go underground like prohibition.

    What can we do, issue a disclaimer ‘ you do understand that if you take a tanning session you are possibly increasing your risk of getting skin cancer’? Whereupon, person wanting suntan signs, either with or without reading.

    What success do health warnings have on the side of fag packets?

    OK, I’ll shut up, pour a beer, and eat (veg) sausages for brunch 😀

    • I particularly like the quote, “But I really do not like my individual rights being curtailed for the benefit of morons,” because, in the final analysis that, too, is my position in general. I am making an exception here based on what are to some extent self-serving reasons and cannot properly rationalize it. The “nanny State” laws, of which this is an example, are really a slippery slope. Once you start, as you pointed out, it becomes practically impossible to set further limits. In the end, all of this is unnecessary given that most people do posses sufficient presence of mind to make their own choices. of course it could be argued that they, too, should be left to live with the consequences. In CA, health care is state-supplied so there’s always the argument, “why should society pay for your treatment when you willingly ignored the warnings?” And, no, there is no clear answer to this, just increasingly silly responses on how to “fix” THAT issue!

      • Morons was an unreasonable word, but I was too idle to think of something more accurate and less offensive. Idiots was the second word that came to mind, so I gave up after that and settled for morons.

        However, when I used the word, I wasn’t denoting any typical group of people, either low or non-income groups, or those lacking in education. Probably rather more the case, that people with money and with education were even more moronic for not choosing to inform themselves about – anything? when the opportunities were around them.

        I suspect your subsonscious rationalisation is the personal bsc, guilt for not being smarter when younger? and the thought that it is basically a waste of time and money and serves no value to anyone apart from the ones making money out of it. If people want to get a tan, they would be better off outside, slathered with cream, but at least in the fresh air and being active, or even lying on a beach. But a tanning bed??

        I seem to remember a discussion years ago in the UK about whether health care for smokers should be rationed, similarly obesity in later years. But while people should be able to make choices, I’m not sure many are well informed enough to do so. And determining the cause of an illness isn’t that easy. eg for the person with a chest infection that causes their death – was it working in the asbestos factory that manufactured brake linings, their smoking, the damp environment they lived in, or even their parents/spouse/work colleagues smoking.

        We did have a health promotion drive about colorectal cancer. I figured telling people that don’t do this doesn’t work. Gut reaction because it doesn’t work for me. Twenty focus groups and similar meetings later, the same result was reached. So we published a nice soft leaflet that mentioned eating veg, that not all problems would be cancer, and blah blah blah. No idea how useful it was but it looked pretty and at least contained useful advice instead of DO NOT DO THIS. Suppose the same approach could be taken to sunbeds. Or at least suntanning. The Aussie Slip Slop Slap one has always been good.

  2. A well considered and balanced undertaking Maurice. For me the issue is one of poor choices by others costing ME money! Perhaps the cost of medical care is high because the system is stressed by having to treat too many folks who have made poor choices … they have spent time in tanning beds … and they have indulged in Poutine (had to look that up) and Big Macs way too many times, and have made the decision to smoke (the list goes on). Don’t ask why … but I once found myself on YouTube watching one of those ‘fail’ videos which showed kids trying to do absolutely impossible things on skateboards and motorcycles … and clearly damaging themselves such that it was obvious that the next stop was the emergency room. People do any number of senseless things which ultimately drive the cost of health care, for all of us, up. The same can be said, in a general sense, about poor choices leading to obesity and diabetes and coronary heart disease and cancers. I put tanning beds in the same category. Perhaps what we should do is write legislation which allows the use of tanning salons as long as folks sign a release that says they will never seek medical attention for lesions resulting from such use? Sell cigarettes only to those who will sign a similar release? I’m just tired of having to take up the slack. Am I misguided on this one? D

    • I should amend that … the release should say that folks will pay out-of-pocket for such medical care, and not seek coverage by insurance. D

    • As I see it, there’s no consistent solution possible at all. The thing about the waivers is that, later on when the issues do appear it will be even more costly sorting out the liability from a legal perspective. Anyone who signs the waiver will say that the issue was caused by something else and it will be very costly for the legal system to sort it out–probably as expensive as treating it in the first place.
      Couple that with the other real possibility of the waivers being deemed unusable since they were essentially decisions made by minors.
      That’s the thing about “the rules” — all of them fail under stress. That is, it’s always possible to come up with scenarios in which they just become useless. As for suntanning beds I’m just stuck that the legislation is the best of a bad lot of options, unfortunately.

  3. I suppose … but that is an awfully slippery slope?

    • And there we are. That slippery place is awkward, inconsistent and un-sustainable (should not be used to set precedent). And that, unfortunately, is one of the many downfalls of democracy, as I see it. Plato would suggest we forget the whole thing and let the wisdom of some “Philopher Kings” guide us. Many days I see the value in that…until I start thinking about the selection process and where that will lead us, LOL!

  4. Mary says:

    The legislation is for those under 19 so I think it is a very good one. Saving youngsters from inflicting harm on themselves before they are old enough to perhaps make an educated decision -to be aware of the long term consequences . It’s also good because it creates a debate and an awareness.
    Cigarettes have def lost their cool quotient with young people as a combined result of vigilant legislation and education. With old folks too actually.
    Also, I could be wrong but I think most consumers of this ‘service’ would be young ladies – some gentlemen -but mostly young women who feel under so much pressure to strive for that unattainable airbrushed photoshopped version of beauty – ultra thin – tanned etc ..
    I like this legislation very much as at least it protects vulnerable high school students from one more dangerous avenue of exploitation.
    ( Keep on slathering on the SPF – even in that Nfld. fog:)

  5. Tiny says:

    I would support that kind of legislation as well. I lost my mother to melanoma when she was only 39, now about 40 years ago. Then the odds to survive were minimal, I’d say about 10%. Her melanoma didn’t come from tanning beds but from burning herself every single spring. When I was young (and foolish) the tanning beds were touted to be much safer than being in the sun, so I did go there a few times too…luckily I didn’t like it. But still need to watch for skin cancer, of course. Being out a lot for my whole life and living in Africa at the time when the strongest SPF was 4 adds to the need for vigilance. So it’s a yes for me.

  6. elkement says:

    Very interesting and thoughtful post, Maurice! I often say that I would admire a politician more who would be able to build a “fair” system of taxes and social security than the researcher who develops the theory of quantum gravity. Solving these intricate ethical questions is the ultimate challenge in my point of view (human-centric, of course…)

    I try to apply the most practical approach possible, that is – as you did – calculating costs… Austria is a very socialist country and we have more than enough redistribution of taxes already. Many people here think it is OK to have the public paying for their, say, removal of tattoos or in vitro fertilization, or at least get some tax exemption. I don’t like this “somebody else will fix anything…” mentality.

    I believe, that if there is some proven causal chain between behavior and impact on health citizens should be held more accountable. There are two ways to do this: Let them pay afterwards (this might require the difficult proof of the causal link) or protect them before themselves.
    Probably I try to circumvent the deep philosophical questions here – but I just think from a pragmatic and legal perspective the second is easier to implement. It would simpler be more expensive (all that administrative efforts!) to prove that somebody has skin cancer because of too many tans. How would you prove this unless you spy on people NSA-style?

  7. TamrahJo says:

    Every time I see legislation such as this, I wonder, “Why isn’t bungee jumping outlawed? Or extreme rock climbing? Skydiving? Snowmobiling when avalanches are soon to come?”

    And I always view these within the context of those who wail about how overpopulated our world is – – yet every day, legislation is passed to make sure everyone is protected from their own stupidity and drugs/machines are invented/marketed to keep everyone alive for as long as possible, whether they have quality of life or not – whether they want to be here or not – –

    I don’t know – there is a huge incongruence between it all – guess that’s why it’s all such a touchy subject….

    • Touchy it is! and now, with better weather finally hitting all of us, the season of “what’s inappropriate clothes at school,” has started. As for me, I discuss the matter with my own children and expect them to make intelligent choices, which, thankfully they have. I really don’t want to get into the business f dictating what others wear.

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