The effectiveness of public health interventions in reducing sunbed use and rates of skin cancer

The HRB conducted a systematic review to provide evidence on the effectiveness of public health interventions in reducing sunbed use and rates of skin cancer. This review was undertaken to inform policy-makers at the Department of Health in Ireland who are considering the development or revision of regulations relating to sunbed use.

Skin cancer is the most common cancer in Ireland, with an average of 11,358 new cases diagnosed each year during 2020–2022. The chief environmental cause is ultraviolet radiation (UVR), which comes mainly from the sun but also from artificial sources like sunbeds used for cosmetic purposes.

The review examined two categories of interventions:

1. Education interventions (25 studies) – delivered through various formats including in-person sessions, workbooks, social media, and web platforms, targeting adolescents, young women, parents, and high-risk patients
2. Regulation interventions (9 studies) – including prohibition of unsupervised artificial tanning services and age limits on sunbed use

The review answered questions on how effective these interventions are in reducing sunbed use and sunbed use intentions. No included studies assessed skin cancer rates.

There was very low-certainty evidence that education interventions did not statistically significantly decrease sunbed use, but they did statistically significantly reduce sunbed use intentions. There was also very low-certainty evidence that regulation interventions did not statistically significantly decrease sunbed use or sunbed use intentions.

Overall, the synthesis of evidence highlights the need for a combined intervention approach that leverages both education and regulation strategies for the control of sunbed use. Both types of interventions showed an inclination towards reducing sunbed use in many individual studies, suggesting that a combination of regulation and education interventions is necessary for more robust outcomes, similar to approaches used for tobacco and alcohol control.