Association between State Indoor Tanning Legislation and Google Search Trends Data from 2006 to 2019: Time Series Analysis (Preprint)
BACKGROUND Exposure to ultraviolet radiation from the sun or indoor tanning is the cause of the majority of skin cancers. Though indoor tanning has decreased in recent years, it remains most common among adolescents and young adults, whose skin is particularly vulnerable to long-term damage. States have adopted several types of legislation to attempt to minimize indoor tanning by minors: ban of all minors from indoor tanning, partial minor ban by age (e.g., under 14 years old), or requiring parental consent or accompaniment for tanning. Currently, there are only six states with no indoor tanning legislation for minors. OBJECTIVE This study investigated whether internet searches (as an indicator of interest) related to indoor tanning varied across states by type of indoor tanning legislation, using data from Google Trends from 2006 to 2019. METHODS A time series analysis of Google Trends data on indoor tanning from 2006 to 2019 by US state was conducted. Time series linear regression models were created to assess the Google Trends data over time by type of indoor tanning legislation. RESULTS It was found that indoor tanning search rates decreased significantly for all 50 states and the District of Columbia over time. There was a peak in searches in 2012 when there was significant attention on indoor tanning (e.g., it was banned for all minors by the first state, California). The decreasing search rate was significantly greater for states with full minor bans compared to those with less restrictive types of legislation. CONCLUSIONS These findings are consistent with other studies demonstrating the association between indoor tanning regulation and tanning attitudinal and behavioral trends. The main limitation of the study is that raw search data were not available for more precise analyses. As interest and norms change, indoor tanning and skin cancer risk among young people may change. Future work should continue to determine the impact of such public health policies in order to inform policy efforts and minimize risks to public health.