For several years, opponents of tanning bed use in teens have been pushing to ban the practice for kids under 18. Just when they thought they would get a bill out of committee, it got derailed.
By Rose Hoban
After a year of committee meetings about banning tanning bed use for teens under 18 years old, proponents who wanted to limit their use finally thought their bill would make it out of committee.
But an impassioned plea from a tanning industry representative at the close of a committee meeting Tuesday morning convinced lawmakers to delay consideration of the Youth Skin Cancer Prevention Act (House Bill 18).
Joseph Levy, scientific advisor for the American Suntanning Association, told the House Health and Human Services Committee that the science around tanning beds and their relationship to skin cancer and melanoma is still unclear.
Levy, who travels the country on behalf of the tanning salon industry to testify at legislative hearings, said he believed that North Carolina’s requirement for adolescents under 18 years of age to get parental permission to use a tanning salon is sufficient.
“We just heard a tremendous amount of misinformation about melanoma and photobiology and about UV light,” Levy told the committee. He went on to contradict an earlier presentation about skin cancer by the head of the Duke University Medical Center melanoma clinic. Levy asked for a “higher level” discussion on the science of tanning.
His seven-minute presentation was enough to raise doubts for the legislators sitting in the room.
“It is very disturbing to me to hear testimony from people I believe have legitimate credentials that are so contradictory,” said Rep. Verla Insko (D-Chapel Hill). “I agree that we need more time.”
A motion to keep the bill in committee passed easily.
Science contradictory?
“This bill has been heard in the Child Fatality Task Force for the past year, and it’s had time to be aired in public,” said bill sponsor Rep. Mark Hollo (R-Taylorsville).
“The science is contradictory, if you want to call it that,” Hollo said, visibly frustrated. He went on to give a laundry list of the bill’s supporters, including the American Cancer Society and the North Carolina Medical Society.
But much of the science is not contradictory, said DeAnn Lazovich, an associate professor of epidemiology at the Masonic Cancer Center at the University of Minnesota School of Public Health. She cited a recent paper that aggregated data from dozens of other pieces of research.
“They concluded indoor tanning was a human carcinogen,” she said.
Lazovich, who has published extensively on the use of tanning by adolescent and young women, said the use of indoor tanning has changed over time. The industry really took off in the 1980s and ’90s, far enough in the past, she said, that young women who used tanning beds heavily a decade or two ago are starting to have negative effects.
About 37 percent of young women reported using indoor tanning, according to the 2009 national Youth Risk Behavior Survey. A 2005 National Cancer Institute survey found about the same use rates in women aged 18 to 30, with rates highest for Caucasian women.
“It’s a staggering prevalence of use in women, especially when you take into account age, race and ethnicity,” Lazovich said. “There is use in other groups, but for young girls and women, it’s far higher than tobacco use.”
“If you look at documents that Levy presented to the Connecticut legislature, he says that melanoma is really affecting older men,” she said. “But if you look under the age of 40, melanoma is higher in women than in men. It’s increasing in all age groups, but it’s increasing especially rapidly in young women.”
“And the timing coincides with when people really started tanning,” she said.
That was the message sent by Ann Bowman, a 34-year-old cancer survivor from Charlotte who testified at the committee meeting.
“I first used tanning when I was 16 years old to get a base tan for proms, sorority formals and later my wedding,” she told the committee while showing photographs of the scars on her legs and left torso left from removal of melanoma tumors.
Bowman, who now represents the advocacy group AIM at Melanoma, was diagnosed with melanoma in 2010. “My melanoma was the size of a pencil eraser, but they had to take out enough tissue that it left a six-inch scar,” she said.
Levy claimed that Bowman’s organization is funded by the sunscreen industry in an attempt to scare people into using more sunscreen. An examination of the organization’s IRS filings for the past three years found it was difficult to determine where the group gets funding.
Paralysis by analysis
According to the National Cancer Institute, about 76,000 new cases of melanoma will be diagnosed in the U.S. in 2013, and 9,480 people will die from the disease.
“It’s a rare cancer, compared to breast or prostate cancer,” with an incidence of about 10 cases per 100,000 among Caucasians younger than age 65, in the absence of indoor tanning use, Lazovich said.
“But unlike those other cancers, a high proportion of those who get it are under 50,” she said. In her data and that of others, Lazovich found tanning beds use increases the overall risk in the population to about 23 cases per 100,000, more than double the risk.
After the meeting, Levy said that “from a health standpoint, the discussion we heard today did not address this issue in a balanced fashion.”
“The greatest risk factor for melanoma is having a high number of moles, red hair – genetic factors. Those are what we need to be concentrating on in terms of skin cancer prevention,” Levy said. “It’s conspicuous that time after time we hear testimony that attempts to say that sunlight is bad in a dogmatic fashion.”
He also warned that kids who can’t legally use tanning beds would buy their own on eBay or Craigslist and create a “garage tanning industry.”
“I’ve never seen a study that if you couldn’t tan at a salon that you would seek tanning elsewhere that’s been published in the scientific literature,” retorted Lazovich, who’s published data on usage habits of tanning salon patrons. “We’ve surveyed this many times. I don’t know where they got this data.”
She said the delaying tactic called for by Levy is a common industry ploy, a tactic often called “paralysis by analysis,” whereby study commissions substitute for action.
Lazovich also said she’s been targeted by the industry in the past, which distributed materials calling into question her credibility as a scientist in advance of the publication of a paper critical of the industry.
‘Selective’ data
Advocates for the bill were dismayed that the bill failed to get referred to the House floor for a vote.
“The selective utilization of data was something we did not expect,” said Kelly Nelson from the Duke University Medical Center melanoma clinic. “We’re disappointed.”
One of the only votes against delaying the tanning bed bill came from Rep. Nelson Dollar (R-Cary), who said it’s hard on parents to resist their teens’ requests to tan.
“Kids will say, ‘Sally’s mom lets her do it,’ and then it becomes hard to say no,” Dollar said. “We afford the same protections for young people in other areas like smoking. They’re not prepared to think about the long-term effects of what they’re doing.”
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