Teens’ views on tanning and sunscreen linked to lower sun-safe behaviors

Adolescents who view tanning as attractive or sun protection as inconvenient may be less likely to engage in behaviors that reduce ultraviolet radiation (UVR) exposure, according to findings from a study published in Cancer Epidemiology, Biomarkers & Prevention and presented at the 2026 American Association for Cancer Research Annual Meeting.^1,2

The study evaluated baseline survey data from 2105 high school students enrolled in the Sun-safe Habits Intervention and Education (SHINE) trial, a cluster-randomized study conducted in Utah high schools between 2021 and 2023. Investigators examined whether adolescents’ perceptions of the “costs” of sun protection and the “rewards” of tanning were associated with UVR-protective behaviors.

Researchers reported that students who perceived greater drawbacks to sun protection, such as sunscreen being uncomfortable or protective clothing being inconvenient, were less likely to practice sun-safe behaviors. Likewise, adolescents who associated tanning with improved appearance or social appeal were also less likely to engage in UVR protection.

“These data remind us that knowing about the risks of overexposure to the sun isn't enough to change teens' behavior,” said senior author Kenneth P. Tercyak, PhD, professor of oncology, pediatrics, and psychiatry and co-leader of the Cancer Prevention and Control Program at Georgetown University’s Lombardi Comprehensive Cancer Center. “To do that, we have to understand what they think about the pros and cons of staying safe, and help shift that perspective."

How often did teens practice sun-safe behaviors?

The analytic cohort had a mean age of 15.3 years, 52.7% were female, and 77% identified as White. Approximately one-third attended rural schools.

Participants completed surveys assessing skin cancer prevention knowledge, time spent outdoors, perceived barriers to UVR protection, perceived benefits of tanning, and frequency of sun-safe behaviors.

Overall engagement in UVR-protective behaviors was low. The mean UVR-protection score was 19.8 on a 40-point scale, representing approximately 50% adherence across behaviors such as sunscreen use, staying in the shade, and wearing protective clothing.

More than 63% of participants reported spending more than 1 hour outdoors daily on weekdays. Students who spent more time outside reported fewer UVR-protective behaviors. Investigators also found inverse associations between UVR-protective behaviors and both perceived costs of sun protection and perceived rewards of tanning.

What factors predicted lower sun protection in adolescents?

In multivariable analyses adjusted for grade level, ethnicity, and attentiveness, lower skin cancer prevention knowledge, higher perceived protection costs, and greater perceived tanning rewards independently predicted lower engagement in sun-safe behaviors.

The authors noted that knowledge of skin cancer risk alone appeared to have only a weak association with behavior, reinforcing prior evidence that appearance-based motivations and social influences contribute substantially to adolescent tanning behaviors.

Investigators suggested that school-based prevention programs may benefit from moving beyond traditional health-risk messaging and incorporating appearance-focused interventions. Proposed strategies included UV photography and photoaging simulations designed to demonstrate the visible effects of UV exposure.

“This study drives home the importance of reaching people early in life with more effective skin cancer prevention strategies that resonate, and working with communities to help lower the cancer burden,” said first author Omar U. Anwar, a biology student at Georgetown University.

Could appearance-based interventions improve adolescent sun safety?

The study authors acknowledged several limitations, including the cross-sectional design, reliance on self-reported behaviors, and recruitment from a single US state with elevated UV exposure because of climate and altitude. Still, they concluded that adolescence remains a critical period for establishing long-term cancer-prevention behaviors and that interventions targeting both perceived barriers and perceived benefits of tanning may improve sun safety practices.

References

1. Georgetown University Medical Center. Study finds teen perceptions of sun protection and tanning shape skin cancer risk behaviors. Eurekalert. April 21, 2026. Accessed May 15, 2026. https://www.eurekalert.org/news-releases/1124686

2. Anwar OU, Wu YP, Stump T, et al. Associations between Perceived Costs and Rewards of Sun Protection and Sun Safety Practices among Rural and Urban High School Students. Cancer Epidemiol Biomarkers Prev. 2026;35(5):728-732. doi:10.1158/1055-9965.EPI-25-1753