Abstract

Background: Indoor tanning (IT) causes skin cancers, including potentially deadly melanoma. IT often starts during youth, a critical time for deleterious skin damage. About half of the US states have enacted laws banning IT for minors under age 18.

Purpose: This study reports qualitative findings from interviews with key informants (KIs) involved in IT legislative efforts to identify/describe factors influencing law enactment, based on the multiple streams framework.

Methods: Guided by expert advisors and using snowball-sampling, KIs from 16 states with most recently enacted IT laws regulating minor access and states without restrictions were contacted. In virtual interviews, KIs shared their unique “story” of IT bill efforts, enactment, implementation, impact, and potential future directions, which were transcribed and qualitatively coded by trained staff.

Results: Although KI roles (e.g. legislators, advocates, clinicians, and melanoma survivors; n = 64) and legislative processes vary by state, similar facilitators and barriers to IT bill passage were identified: personal stories, advocacy, opposition, preparation, legislator education, economic/ enforcement issues, bill stringency, political values/partisanship, and legislative process. Other factors influencing bill enaction included failed Food and Drug Administration attempts toward federally banning minor IT and competing priorities.

Conclusions: Despite evidence of laws’ impact on minors’ IT, policy enaction is challenging and slow. Understanding key facilitators and barriers may help advocates to advance legislation efforts. Advocating for stringent laws necessitates consideration of potential downstream effects. For example, even with policy enactment, KIs believed enforcement and compliance were likely insufficient and variable, with minors continuing to indoor tan, putting them at risk for potentially deadly skin cancer.

Document Type

Article

Publication Date

2025

Notes/Citation Information

© Society of Behavioral Medicine 2025. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

Digital Object Identifier (DOI)

https://doi.org/10.1093/tbm/ibaf044

Funding Information

This study was funded by the National Cancer Institute (R01CA204271 and P30CA072720-6852). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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