A national survey of high school students finds that indoor tanning is a common practice, particularly among female, older and non-Hispanic white students, and is associated with several other risky health-related behaviors, according to a study by Gery P. Guy Jr., Ph.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues.

The incidence of skin cancers, both nonmelanoma and melanoma, is increasing in the United States. UV light exposure, such as through indoor tanning, is a preventable risk factor for skin cancer, particularly in individuals younger than 35 years. As a result, reducing exposure to artificial UV light, especially among adolescents, is a way to decrease skin cancer, according to the study background.

The authors used data from the 2009 and 2011 national Youth Risk Behavior Surveys, which represent 15.5 million high school students in the United States. The authors' analysis included 25,861 students who answered a question about indoor tanning, as well as measuring other health-related behaviors including smoking, sex, steroid use, and suicide attempts.

An estimated 13.3% of high school students reported engaging in indoor tanning in 2011, and indoor tanning was associated with an increase in binge drinking, unhealthy weight control practices and having sex. Among girls, indoor tanning also was associated with illegal drug use and having sex with 4 or more partners. Among boys, indoor tanning was associated with the use of non-prescribed steroids, daily cigarette use and attempted suicide, according to the study results.

"Public health efforts are needed to change social norms regarding tanned skin and to increase awareness, knowledge, and behaviors related to indoor tanning," the study concludes.