y 

Skin cancer is the most common type of cancer in the United States, 

developing in approximately one million Americans each year. 

Nonmelanoma skin cancers (basal cell cancer and squamous cell cancer) 

are much more common than melanoma; however, melanoma is the 

most serious type of skin cancer. Exposure to ultraviolet (UV) rays 

(both A and B rays) appears to be the most important environmental 

risk factor for the development of skin cancer. The most effective way 

to lower the risk of skin cancer is to engage in sun-safety practices, such 

as wearing sunscreen and protective clothing, seeking shade, and avoiding 

artificial sources of UV rays (tanning booths and sunlamps). 

Respondents to the 2005 Health Information National Trends Survey 

(HINTS 2005) were asked a series of questions about the frequency 

with which they engage in sun-safety practices. Only a minority of 

Americans reported “always or often” engaging in protective behavior 

when outside for an hour or more on a warm, sunny day. Although 

43.4% of respondents reported “always or often” seeking shade, half said 

they “rarely or never” used sunscreen. Other protective strategies were 

also used more commonly than sunscreen: 45.4% “always or often” wore 

long pants and 34.7% “always or often” wore a hat. Only 16.1% “always 

or often” wore a long-sleeved shirt. Data from the National Health 

Interview Survey (NHIS) confirm relatively low prevalence of sun-safety 

behaviors, with estimates of use of sunscreen, protective clothing, or 

seeking shade hovering around 30% since the early 1990s. In HINTS 

2005, 91.7% of American adults reported that they had not used indoor 

tanning devices during the previous 12 months. 

Sun-Safety Practices in the U.S. Population 

Always or often 

Sometimes 

Rarely or never 28.3% 

21.2% 

50.4% 

Sunscreen 

19% 

34.7% 

46.3% 

Hat 

19.2% 

37.4% 

43.4% 

Shade 

16.1% 

22% 

61.9% 

Long-sleeved Shirt 

45.4% 

26.3% 

28.3% 

Long Pants 

How Can This Inform Your W

• There is a need for improved sun-safety behavior amon

most notably, the use of sunscreen and protective cloth

• According to HINTS, sun-safety practice varies by socio

characteristics, including age, race/ethnicity, and gender. 

o Because women tend to use sunscreen more oft

efforts to encourage use of sunscreen among me

o The harm of indoor tanning devices should be em

women, as they use these devices more often than 

o Seeking shade is infrequently practiced by you

and the importance of this behavior should be 

to this population. 

o Although men report wearing hats more often th

these may not be the wide-brimmed hats that of

sun protection. Both men and women should be 

to wear wide-brimmed hats that protect their fa

from UV rays. 

• The risk for skin cancers is highest for fair-skinned 

but skin cancer can develop in all individuals, regard

skin pigmentation. 

• The Centers for Disease Control and Prevention (C

recommends the following sun-safety practices: 

o Seek shade, especially during midday hours (10:

4:00 p.m.), when UV rays are strongest and can d

most damage. 

o Cover up with protective clothing, such as long-

and long pants of tightly woven fabrics. 

o Wear a hat with a wide brim to shade the face

and neck. 

o Wear sunglasses that wrap around the head and t

to block as close to 100% of both UV-A and UV-B r

o Use sunscreen that protects against UV-A and 

has a sun protective factor (SPF) of at least 15. A

and often while exposed to the sun. 

In this HINTS Brief, we examine sun-safety practices in the U.S. population and explore diff

sociodemographic characteristics according to HINTS 2005 data. 
Spotlight on Research 

Emerging Issues in Sun Safety 

Sunless tanning products, also called self-tanners, can give skin a tanned 

look without exposure to harmful UV. Sunless tanning products are 

generally considered a safe alternative to sunbathing. The American 

Academy of Dermatology (AAD) recommends the use of sunless tanning 

products as a substitute for harmful UV-induced tans. In an analysis of 

HINTS 2005 data, published in 2007, investigators described the use of 

sunless tanning products and related sun-safety practices of adults in the 

United States. Frequent use of sunless tanning products was uncommon, 

with only 11% of respondents reporting use in the past year. Investigators 

compared sun-safety behavior among four groups of respondents: 

exclusively sunless tanners, exclusively indoor tanners, both indoor and 

sunless tanners, and nontanners. Some sun-safety practices during 

outdoor activities differed significantly by group. Individuals who were 

exclusively sunless tanners were significantly more likely to use sunscreen 

and significantly less likely to seek shade than nontanners. However, there 

were no significant differences between the groups with respect to the 

use of protective clothing (hat, long-sleeved shirts, or long pants). 

Exclusively sunless tanners were significantly more likely than exclusively 

indoor tanners to practice all five sun-safety practices. Indoor tanners 

were significantly less likely than nontanners to practice all of the sunsafety behaviors except use of sunscreen. These findings add to our 

understanding of population practices with regard to sun safety and reveal 

interesting differences in sun-safety practices among subgroups. 

Sun-Safety Behavior by Tanning Statu

Sunscreen Shade Hat Longsleeved Long 

pants 

5 

4 

3 

2 

1 

Sun-Safety Behavior 

Note: 

summa

Stryke

Weighted Mean Sun Protective Behavior 

Sun

Never Always 

About H

http://hints.c

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 

and 2003, surveying 6,369 Americans, and the second in 2005, surveying 5,586 Americans. Data for this brief are from 

2005. Sun-safety behavior will be assessed again in HINTS 2007. HINTS was created to monitor changes in the rapidly evolving field o

communication. The survey data can be used to understand how adults 18 years and older use different communication channels to 

information for themselves and their loved ones and to create more effective health communication strategies across populations. 

HINTS Briefs provide a snapshot of noteworthy, data-driven research findings. They introduce population-level estimates for specific q

survey and summarize significant research findings that are a result of analyzing how sociodemographic variables influence specific ou

Briefs are intended to highlight top-level findings derived from analyses reported in other venues and are not meant to be comprehe

For More Information on Cancer 

• Call the NCI Cancer Information Service at 1-800-4-CANCER 

(1-800-422-6237) 

• Visit http://cancer.gov 

• Order NCI publications at http://www.cancer.gov/publications 

References Used in This HINTS Brief 

American Cancer Society. Cancer Facts and Figures 2007. Atlanta, Ga: Americ

National Institutes of Health. PDQ Skin Cancer Prevention.
 

Available at www.cancer.gov/cancertopics/pdq/prevention/skin/patient/page2 


Stryker JE, Yaroch AL, Moser RP, Atienza A, Glanz K. Prevalence of sunless ta

related behaviors among adults in the United States: Results from a national s

2007; 56:387-90.
 

May 2007