Do Australian adolescent female fake tan (sunless tan) users practice better sun-protection behaviors than non-users?

Objective: To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users. Design: Cross sectional survey. Method: 398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were self-reported fake tan usage in the past 12 months, frequency of sunburns and habitual sun-protection behaviours. Setting: Surveys were completed in New South Wales, Australia. Results: The prevalence of self-reported use of fake tanning products in the past 12 months among Australian adolescent females was 34.5%. Female fake tan users were significantly less likely to report wearing a hat, wearing a shirt with sleeves or wearing pants covering to the knees. There was no difference between fake tan users and non-users in use of sunscreen, seeking shade, wearing sunglasses or avoidance of peak ultraviolet (UV) hours. Logistic regression modelling, when accounting for age, desire for a tan and skin type, revealed fake tan users were more likely to experience frequent sunburns and less likely to wear protective clothing. Conclusions: Our findings show that fake tan use among Australian female adolescents is associated with decreased sun protection, specifically reduced use of both upper and lower body protective clothing. Fake tan users were significantly more likely to experience repeated sunburns, after controlling for skin type. These findings provide impetus for the development of health education programmes targeting a new sub-group of adolescents with distinct tanning behaviours.