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Body Image 11 (2014) 93–96

Contents lists available at ScienceDirect

Body Image

journa l homepage: www.e lsev ier .com/ locate /bodyimage

rief research report

dolescents’ reasons for tanning and appearance motives:preliminary study

uzanne M. Prior ∗, Kimberley D. Fenwick, Jasmine C. Peterson1

epartment of Psychology, St. Thomas University, Fredericton, NB, Canada

r t i c l e i n f o

rticle history:eceived 6 February 2013eceived in revised form 3 September 2013ccepted 3 September 2013

a b s t r a c t

We examined adolescents’ reasons for tanning and how these relate to appearance evaluation and orien-tation. Two hundred and sixty-four Canadian adolescents (age range 15–19 years) in grades 10, 11, and 12completed a survey that included scales measuring their reasons for tanning, appearance evaluation, andappearance orientation. It was found that girls and boys differed on four of nine subscales measuring rea-sons for tanning. Girls believed more strongly than boys that tanning improved their general appearance

eywords:anningV exposuredolescentsotives

ppearance

and that friends influenced their decision to tan. Girls also expressed less concern than boys that tanningcaused immediate skin damage or premature aging. The pattern of correlations between the reasonsfor tanning and appearance orientation was similar for girls and boys. For both, appearance reasons fortanning and sociocultural influences on tanning were positively associated with appearance orientation.Suggestions for future research with adolescents and a proposal for a guiding model are provided.

ancer prevention

Introduction

Ultraviolet (UV) radiation from the sun or from artificial tanningquipment has been identified as a causal factor in the developmentf cutaneous malignant melanoma (CMM), as well as basal andquamous cell carcinomas (Boniol, Autier, Boyle, & Gandini, 2012;

ehner, Shive, Chren, Han, Quereshi, & Linos, 2012). Globally, thencidence of CMM is increasing among White populations (Garbe &eiter, 2009; Godar, 2011; Lostritto et al., 2012). Over the past fourecades, the rate has grown annually by approximately 3–7%, withhe highest rates occurring in Australia and the southern Americantates (Garbe & Leiter, 2009). The increase is particularly evidentmong young adults and especially young women (Lostritto et al.,012).

The International Agency for Research on Cancer of the Worldealth Organization has classified UV radiation from the sun andV-emitting tanning devices as a group 1 carcinogen, meaning

hat there is sufficient evidence that UV radiation is carcinogenico humans (El Ghissassi et al., 2009; World Health Organization,012). This places it in the same category as tobacco. Both tobacco

se and UV exposure are lifestyle choices; therefore, their relatedancers are largely preventable. People can protect themselvesrom UV radiation by engaging in sun-protective behaviors and

∗ Corresponding author at: Department of Psychology, St. Thomas University,redericton, NB, Canada E3B 5G3. Tel.: +1 5064520497; fax: +1 5064509615.

E-mail address: prior@stu.ca (S.M. Prior).1 Now at: Department of Psychology, Lakehead University, Canada.

740-1445/$ – see front matter © 2013 Elsevier Ltd. All rights reserved.ttp://dx.doi.org/10.1016/j.bodyim.2013.09.004

© 2013 Elsevier Ltd. All rights reserved.

by not using artificial tanning equipment. However, the evidencesuggests that many people, especially young adults and ado-lescents, are not making these choices. This is of concern tocancer-prevention organizations because UV exposure before age35 is associated with an increased risk of skin cancers (Lostrittoet al., 2012). The risk of early exposure for CMM is particularly highwith use of UV-emitting tanning devices (Boniol et al., 2012).

Despite education campaigns about the health dangers of UVexposure, tanning remains popular (Hillhouse, Turrisi, Holwiski, &McVeigh, 1996). This suggests that risk awareness alone is ineffec-tive in changing behavior and that there is a need to shift the focusof research and prevention to other factors that may motivate tan-ning (Hillhouse & Turrisi, 2002; Hillhouse, Turrisi, & Kastner, 2000).Recent studies suggest that young adults desire a tan for reasonsrelated to physical attractiveness; that is, a tan helps them meetpersonal and societal expectations of beauty (Boniol et al., 2012;Cash, Grasso, & Mitchell, 2005; Lazovich & Forster, 2005; Lostrittoet al., 2012). Moreover, the perceived body image benefits of a tanare immediately salient compared to the more distant prospect ofskin cancer (Hillhouse & Turrisi, 2002).

Body image motives and their relation to reasons for tanningappear to be well established by young adulthood (Cafri et al., 2008;Cafri, Thompson, Jacobsen, & Hillhouse, 2009; Hillhouse & Turrisi,2002; Hillhouse et al., 2000; Olson & Starr, 2006). This means thatthe link probably develops earlier developmentally. Research on

adolescents shows that they engage in sun and artificial tanning(Demko, Borawski, Debanne, Cooper, & Stange, 2003; Lazovich &Forster, 2005), but little is known about adolescents’ body imagemotives in relation to their reasons for tanning. In order to design

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ffective skin cancer prevention programs, we need to understandhis relationship, particularly since the perceived benefits of a tannfluence current and future UV-exposure behaviors (Cafri et al.,008).

In this preliminary study, we sought to address the gap in theiterature on adolescents’ motives for tanning by examining a sam-le of Canadian adolescents’ reasons for tanning in relation to twospects of body image: appearance evaluation and appearance ori-ntation. We predicted that appearance reasons to tan would bessociated with more satisfaction with appearance (appearancevaluation) and greater importance placed on looks (appearancerientation).

Method

articipants

Participants were 264 students (age M = 16.94, SD = 0.85) attend-ng two New Brunswick, Canada, high schools in grades 10 (53 girls,ge M = 15.91, SD = 0.31; 26 boys, age M = 16.20, SD = 0.61), 11 (59irls, age M = 16.92, SD = 0.37; 50 boys, age M = 16.96, SD = 0.38), and2 (44 girls, age M = 17.82, SD = 0.34; 32 boys, age M = 18.12 years,D = 0.49).

aterials

The Fitzpatrick Skin Type scale is a self-reported standard scaleased on tanning and burning and indicates an individual’s riskrom UV exposure (Fitzpatrick, 1988). It consists of six skin types: Ivery fair; always burns and never tans), II (fair; always burns andometimes tans), III (medium fair; sometimes burns and alwaysans), IV (olive/light brown; sometimes burns and always tans), Vbrown; never burns and always tans), and VI (dark brown/black;ever burns and always tans). It is the most widely accepted mea-ure of skin type and has good intra-rater reliability, with quadraticeighted kappas ranging from 0.76 to 0.81 (Magin, Pond, Smith,oode, & Paterson, 2012) and good indices of validity (Fitzpatrick,988).

Two subscales of the Multidimensional Body-Self Relationsuestionnaire (MBSRQ) were used: Appearance Evaluation andppearance Orientation (Cash, 2000). Several studies have estab-

ished its reliability and validity (e.g., Brown, Cash, & Mikulka,990). The Appearance Evaluation subscale measures evaluativeody image. This is the overall satisfaction or dissatisfactionperson feels about his/her appearance that results from the

ongruence or discrepancy between perceived actual appear-nce and ideal appearance (Cash, 2002; Muth & Cash, 1997).igher scores for Appearance Evaluation indicate mostly posi-

ive feelings about one’s appearance. The Appearance Orientationubscale measures body image investment. This is a person’segree of cognitive-behavioral investment in his/her appearanceCash, 2002; Muth & Cash, 1997). Higher scores for Appear-nce Orientation indicate greater importance and attention giveno appearance and appearance-managing behaviors (Muth &ash, 1997). In the present study, Cronbach’s alpha for Appear-nce Evaluation was .85 for girls and .83 for boys; Cronbach’slpha for Appearance Orientation was .87 for girls and .84 foroys.

The Physical Appearance Reasons to Tan Scale (PARTS) consistsf nine subscales. Three subscales measure Appearance Reasonso Tan: General, Acne, and Body Shape (Cafri, Thompson, Roehrig,

an den Berg, Jacobsen, & Stark, 2006; Cafri et al., 2008). Highercores indicate agreement that a tan improves one’s appearancen general, the appearance of acne and body shape. Two subscales

easure Appearance Reasons Not to Tan: Immediate Skin Damage

ge 11 (2014) 93–96

and Aging. Higher scores indicate agreement that tanning leads toskin damage and premature skin aging. Finally, the PARTS has foursubscales that assess Sociocultural Influences: Media, Friends, Fam-ily, and Significant Other. Higher scores indicate agreement that themedia, friends, family, and significant others influence the decisionto tan. The PARTS has good reliability, ranging from .74 to .92, andvalidity (Cafri et al., 2008). In the present study, Cronbach’s alphafor the PARTS subscales ranged from .76 to .96 for the girls, andfrom .77 to .96 for the boys.

Procedure

Following approval from the St. Thomas University Depart-ment of Psychology Research Ethics Committee, the investigatorscontacted the superintendents of two provincial school districts.Each permitted the researchers to conduct the study in a districthigh school, subject to the principals’ agreement. The principalsapproved and provided written consent in loco parentis. Data col-lection took place during classroom time in March and May 2010.The investigator first provided an explanation of the study. Then,students who wished to participate provided written informedconsent before they received the questionnaires. Participationwas voluntary, anonymous, and non-remunerated. All participantsreceived a debriefing form consisting of an explanation of the study,the researchers’ contact information, and links to information onUV exposure and skin cancer by the Canadian Dermatology Asso-ciation.

Results

The most commonly reported skin type for girls was Type III(43.5%), followed by Type II (24.6%), Type IV (15.2%), Type I (10.1%),and Type V (6.5%). No girls reported their skin type as Type VI. Themost commonly reported skin type for boys was Type III (45.4%),followed by Type II (24.7%), Type IV (13.4%), Type V (12.4%), Type I(2.1%), and Type VI (2.1%).

Multivariate analyses of variance (MANOVAs; Gender × Grade)were performed on the subscales of the MBSRQ and PARTS. As canbe seen in Table 1, there was a significant main effect of genderfor both subscales of the MBSRQ. For Appearance Evaluation, girls(M = 3.24, SD = 0.76) scored significantly lower than boys (M = 3.60,SD = 0.70). For Appearance Orientation, girls (M = 3.55, SD = 0.75)scored significantly higher than boys (M = 3.03, SD = 0.68). For thePARTS, there was a significant main effect of gender for the Gen-eral and Friends subscales. Girls (M = 2.84, SD = 1.27) believed morestrongly than boys (M = 3.26, SD = 1.16) that tanning improved theirgeneral appearance, and that friends influenced their decision totan (girls M = 2.47, SD = 1.03; boys M = 2.06, SD = 0.96). There wasalso a significant main effect of gender for the subscales mea-suring Appearance Reasons Not to Tan. Girls (M = 3.16, SD = 1.03)expressed less concern than boys (M = 3.70, SD = 1.01) that tanningcaused immediate skin damage or premature aging (girls M = 3.01,SD = 1.38; boys M = 3.94, SD = 1.26). There was also a significantmain effect of grade for Immediate Skin Damage. Post hoc analysesusing Scheffé revealed that grade 12 students (M = 3.09, SD = 1.09)were significantly less concerned about immediate skin damagethan grade 11 students (M = 3.63, SD = 1.07). Grade 10 students(M = 3.36, SD = 0.94) did not differ significantly from grade 11 or12 students.

Pearson correlation coefficients were calculated among the sub-

scales of the PARTS, MBSRQ, and Skin Type for girls and boys.There were no significant correlations between the subscales of theMBSRQ and Skin Type. Among the girls, there were significant butmodest correlations between Skin Type and four subscales: General

S.M. Prior et al. / Body Image 11 (2014) 93–96 95

Table 1Means and standard deviations for MBSRQ and PARTS subscales across gender and grade.

Girls Boys MANOVA

Grade 10 Grade 11 Grade 12 Grade 10 Grade 11 Grade 12 Gender Grade Gender × Grade Gender Grade GXGMean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) Mean (SD) F F F �2

p �2p �2

p

MBSRQAE 3.39 (0.57) 3.17 (0.83) 3.12 (0.85) 3.37 (0.75) 3.50 (0.68) 3.69 (0.68) 15.74*** 1.42 0.78 .06 .01 <.01AO 3.58(0.69) 3.59(0.77) 3.55 (0.81) 2.88 (0.55) 3.19 (0.70) 2.93 (0.68) 31.19*** 1.69 0.86 .12 .01 <.01

PARTSTan

Gen 2.68 (1.31) 2.88 (1.28) 2.98 (1.21) 2.30 (1.35) 2.21 (0.91) 2.66 (1.33) 7.75 ** 1.45 0.51 .03 .01 <.01Acne 2.65 (1.35) 2.25 (1.24) 2.50 (1.28) 2.16 (1.34) 2.13 (1.14) 2.57 (1.18) 1.14 1.52 0.89 .01 .01 <.01BS 2.26 (1.17) 2.06 (1.10) 2.27 (1.03) 2.04 (1.28) 1.88 (0.88) 2.44 (1.14) 0.27 2.40 0.67 <.01 .02 <.01

Not TanISD 3.09 (0.82) 3.51 (1.07) 2.83 (1.10) 3.86 (1.02) 3.74 (1.04) 3.48 (0.93) 16.86*** 4.50* 1.67 .07 .04 .01Aging 2.98 (1.33) 3.21 (1.40) 2.82 (1.43) 4.08 (1.31) 3.99 (1.28) 3.73 (2.12) 27.05*** 1.20 0.28 .10 .01 <.01

SocioCMedia 1.90 (1.12) 2.13 (1.33) 2.05 (1.19) 1.81 (1.30) 1.57 (0.81) 2.34 (1.35) 0.56 2.04 2.56 <.01 .02 .02Friends 2.54 (1.06) 2.42 (1.12) 2.45 (0.91) 1.97 (1.11) 1.85 (0.71) 2.48 (1.05) 7.47** 2.17 2.16 .03 .02 .02Family 2.04 (1.15) 1.67 (0.82) 1.95 (1.00) 2.00 (1.38) 1.70 (0.91) 2.03 (1.01) 0.03 2.65 0.06 <.01 .02 <.01SO 2.39 (1.38) 2.42 (1.30) 2.60 (1.39) 2.50 (1.49) 2.16 (1.12) 2.84 (1.35) 0.03 2.07 0.81 <.01 .02 .01

Note. MBSRQ = Multidimensional Body-Self Relations Questionnaire; AE = Appearance Evaluation; AO = Appearance Orientation; PARTS = Physical Appearance Reasons to TanScale; Tan = Appearance Reasons to Tan; Gen = General; BS = Body Shape; Not Tan = Appearance Reasons Not to Tan; ISD = Immediate Skin Damage; SocioC = Sociocultural;SO = Significant Other.

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* p < .05.** p < .01.

*** p < .001.

r = .24, p = .004), Acne (r = .24, p = .006), Body Shape (r = .21, p = .015),nd Significant Other (r = .23, p = .008).

Table 2 presents correlations among the subscales of the PARTSnd MBSRQ. For girls, the PARTS subscales were unrelated toppearance Evaluation. For boys, there was a moderate associationetween the PARTS General subscale and Appearance Evaluation.he PARTS Acne and Body Shape subscales were modestly corre-ated with Appearance Evaluation. For the girls, seven of the nineARTS subscales were associated with Appearance Orientation.here were moderate associations between the PARTS General,edia, Friends, and Significant Other subscales and Appearancerientation. The PARTS Acne, Body Shape, and Family subscalesere modestly related to Appearance Orientation. For boys, eight

f the nine PARTS subscales were associated with Appearance Ori-ntation. The PARTS General, Acne, Body Shape, Media, Friends, andignificant Others subscales were modestly related to Appearancerientation. Finally, among the boys, there was a modest negative

orrelation between Immediate Skin Damage and Appearance Ori-ntation and a moderate negative correlation between Aging andppearance Orientation.

able 2orrelations between scores on the PARTS and MBSRQ.

PARTS Girls

MBSRQ MBSRQAppearance Evaluation Appearance O

Appearance Reasons to TanGeneral .16 .32**

Acne .01 .20*

Body Shape .02 .18*

Appearance Reasons Not to TanImmediate Skin Damage −.08 −.12Aging .05 −.15

Sociocultural InfluencesMedia .02 .33**

Friends .11 .31**

Family .02 .21*

Significant Other .16 .32**

ote. MBSRQ = Multidimensional Body-Self Relations Questionnaire; PARTS = Physical App* p < .05.

** p < .01.

Discussion

In this preliminary study we examined the reasons for ado-lescents’ UV exposure in relation to appearance evaluation andappearance orientation. This kind of research is especially impor-tant with youth who are at higher risk of skin cancers becauseof their skin type. The majority of the adolescents in the presentstudy had skin types I–III and thus are more vulnerable to burning,a known risk factor for skin cancers (Diepgen & Mahler, 2002).

Our analyses revealed that girls and boys differed on only fourout of the nine subscales of the PARTS. Moreover, the effect sizesfor the differences were small (General and Friends) and medium(Immediate Skin Damage and Aging). These findings suggest thatgirls and boys are fairly similar in their reasons for tanning, despitethe fact that their actual tanning practices tend to differ quite sig-nificantly. That is, past studies have shown that girls are much morelikely than boys to use artificial tanning equipment, whereas boys

are more likely to tan in the sun because they do not practice sun-protective behaviors (Demko et al., 2003; Livingston et al., 2007).Thus, if cancer-prevention programs target reasons for tanning as

Boys

MBSRQ MBSRQrientation Appearance Evaluation Appearance Orientation

.33** .45**

.26* .48**

.22* .44**

.00 −.27**

−.08 −.31**

.06 .27**

.12 .28**

.20 .18

.21 .25*

earance Reasons for Tanning Scale.

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Indoor tanning and non-melanoma skin cancer: Systematic review and meta-analysis. British Medical Journal, 345, 1–9. http://dx.doi.org/10.1136/bmj.e5909

6 S.M. Prior et al. / Bod

means to effect behavior change, then the strategy can be quiteimilar for girls and boys, despite differing UV-exposure behaviors.

The findings also suggest possible motives for tanning thatay influence UV-exposure behaviors. For both girls and boys,

he majority of significant correlations were between the PARTSubscales and the Appearance Orientation subscale of the MBSRQ,he subscale that measures the importance and attention giveno appearance and appearance-managing behaviors. More specif-cally, for both girls and boys, all of the appearance reasons toan were positively related to appearance orientation, as well ashe sociocultural influences of friends, the media, and significantthers. For girls, this was also the case for family. For boys only,ppearance Reasons Not to Tan were negatively associated withppearance orientation.

These results suggest that there is a connection between rea-ons for tanning and appearance orientation that warrant furthernvestigation, especially with respect to how they may interacto influence UV-exposure behaviors. A study with college-agedomen found that body image investment dimensions were

elated to more frequent tanning activities (Cash et al., 2005).t would be interesting to explore this relationship, along witheasons for tanning, in an adolescent sample. A limitation of theresent study is that actual UV-exposure behaviors were not inves-igated. Although past research indicates that motives influenceV-exposure behaviors (Cafri et al., 2008), it would be valuable

n the future to assess such behaviors and to analyze how theseelate to the relationships found in the present study. Further, theausal relationship among these variables remains unclear. A multi-aceted guiding model is required in order to further understandingf these associations. This would clarify what they mean for ado-escents’ tanning, and ultimately how they can be used to changedolescents’ UV-exposure behaviors.

One model that has shown promising utility with adults in mod-ling tanning salon behavior is the Theory of Planned Behavior.sing this theory, Hillhouse et al. (2000) demonstrated that theotivation to improve one’s appearance has indirect effects on tan-

ing salon behavioral intentions through its effect on tanning salonttitudes. In addition, high self-monitors (individuals principallyuided by external situational cues, such as people important tohem) appeared to be more likely to heed the attitudes and opin-ons of significant people in their lives when it came to makingehavioral decisions regarding tanning salon use (Hillhouse et al.,000). Given the associations found in the present study amongppearance reasons to tan and appearance orientation, as well asociocultural influences and appearance orientation, it would bealuable to use the Theory of Planned Behavior in future studies.t could be used as a guiding model with an adolescent sampleo examine how these relationships may influence UV-exposureehaviors, both sun and artificial.

Acknowledgments

We thank the principals, teachers, and students of Woodstockigh School and Minto Memorial High School for their participation

n the study. We also thank Douglas Vipond, Ph.D. for his feedbackn a draft of this paper. We are grateful to Thomas Cash, Ph.D. (edi-or), Viren Swami, Ph.D. (associate editor), and three anonymouseviewers for their helpful revisions and suggestions.

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