Content Analysis of Health Warning Labels for Indoor Tanning in the United States

ABSTRACT

Background: State-level legislation regulates the posting of health warning labels (HWLs) in indoor tanning (IT) salons in the United States. Purpose: The purpose of this study was to determine the content and appearance of state-level legislation-mandated IT HWLs. Methods: We conducted a directed content analysis of IT HWLs, evaluating location, health and aesthetic risk information, health communication theory constructs, and visual components. Results: Thirty-three states require IT HWLs: 30 states require one and 3 states require two. Text for 36 labels was analyzed: 94.4% (n = 34) mentioned skin cancer and eye risks, 91.7% (n = 33) mentioned aesthetic risk, and none mentioned death. One label suggested an ultraviolet (UV)-tanning alternative and none addressed barriers to reducing IT. Seventeen electronic labels were available for visual analysis: 5.9% (n = 1) contained a symbol and 11.8% (n = 2) contained an image. Discussion: IT HWLs are widely used and present basic risk information, yet their content and design may not be robustly informed by health communication best practices, theory, or research in the comparable field of tobacco HWLs. Translation to Health Education Practice: By understanding the current content and appearance of IT HWLs, we can substantiate the need for improvements to maximize their effectiveness as educational tools for deterring IT and reducing skin cancer risk.

Acknowledgments

We thank Dr. Seema Mutti-Packer and Alessia Borgo for their contribution to the development of the codebook used to conduct the content analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Not applicable.

Supplementary material

Supplementary material for this article can be accessed here.

Additional information

Funding

This work did not receive any specific financial support.