Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness: A cross-sectional study

Objectives: To describe Scottish adolescents’ sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness. Design: Cross-sectional study. Setting: 20 state secondary schools in one Scottish local authority (Glasgow City). Participants: 2173 adolescents (females: 50.7%, n=1102) with a mean age of 12.4 (SD=0.55). Outcome measures: Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use), tanning attitudes, skin cancer-related symptom and risk factor awareness. Results: Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised ‘change in the appearance of a mole’ as a cancer symptom, and 39% agreed that ‘getting sunburnt more than once as a child’ increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing (p < 0.001), use of lotions or oil to aid tanning (p=0.009) and sunburn (p < 0.001); know that changes in the appearance of a mole was a skin cancer symptom (p=0.036) and sunburn more than once as a child was a skin cancer risk factor (p=0.005); perceive their friends to hold protanning attitudes (p < 0.001) and indicate that a tan made them feel better about themselves (p < 0.001), more attractive to others (p=0.011) and healthier (p < 0.001). Conclusions: Scottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun-safe interventions