Public body consciousness is associated with positive tanning attitudes and behaviours regardless of gender or age

The perception of tanned skin as beautiful and desirable is pervasive in Australian society. Skin cancer campaigns, which have traditionally focused on promoting risk awareness and harm-minimisation, have had modest success to date. In our previous research, we identified that although an overwhelming majority of respondents reported agreeing that tanned skin was more beautiful than pale skin, there was a far stronger correlation between ‘feeling more attractive’ or self-confident with tanned skin and intentional tanning behaviour. We hypothesised that (i) preoccupation with external appearance, or ‘public body consciousness’, may be a driving factor in the decision to intentionally tan, (ii) this preoccupation would be more pronounced in young adult female samples, given historically young adult females have placed greater value on appearance. We invited 749 individuals attending for a skin check in 2017 to complete a survey. Individuals completed a 31-item questionnaire, which assessed tanning attitudes and behaviours and levels of public body consciousness. The importance of physical appearance was assessed using the validated Body Consciousness Questionnaire. Possible responses range from 0 (extremely uncharacteristic) to 4 (extremely characteristic). The minimum total score was 0, and maximum total score 24. Scores >20 reflected higher levels and <16 reflected nil or minimal levels of public body consciousness. Statistical analysis was performed using SPSS statistical analysis software. P-values <0.017 were considered significant, using the Bonferroni correction for multiple comparisons. A total of 524 individuals returned the questionnaire (70% response), of which 51% were female. Table 1 illustrates socio-demographics, levels of public body consciousness and tanning attitudes and behaviours of our population. Individuals were more likely to report high public body consciousness if they had completed only secondary education compared to an undergraduate education (P = <0.001). Younger age and female gender (62.9% vs 31.1% P = <0.001) were associated with higher levels of public body consciousness. Our study found a highly significant correlation between public body consciousness and positive tanning attitudes and behaviours. As described in Table 2, odds ratios with 95% confidence intervals were calculated for various dichotomous outcomes adjusted for effects of age and gender. Even after adjusting for age and gender, public body consciousness was highly significantly associated with positive tanning attitudes and behaviours, suggesting an increased vulnerability to social norms regarding appearance and tanned skin. Individuals with high public body consciousness scores were more likely to report feeling more attractive (P = <0.001) and confident (P = <0.001) when tanned, engaging in intentional tanning in the last 12 months (P = <0.001), and believe that tanned skin looks healthier (P = <0.001) and more beautiful (P = 0.016) than pale skin. Although women have historically been under greater pressure to meet cultural standards of beauty, physical Table 1 Demographics, tanning attitudes and behaviours and levels of public body consciousness