UV Abuse as an Addictive Habit

Posted in GUMC Stories

Darren Mays hesitates and laughs, a bit sheepishly, in admitting that he has partaken in the addictive behavior he is now set to study. No, it’s not drug or alcohol or tobacco use — subjects that he studied while a PhD student at Emory University’s Rollins School of Public Health, and which he continues to research after joining Georgetown Lombardi Comprehensive Cancer Center in 2010.

His new project is to understand addiction to tanning — specifically, tanning bed addiction.

“I have been in a tanning bed,” Mays says. “In high school, I think I tanned for an event. I can’t say I especially enjoyed it, and I certainly didn’t continue doing it.”

That’s not true for many women ages 18 to 30, Mays adds. In fact, some studies suggest as many as one in five women in this age group who have used an indoor tanning bed are addicted to tanning.

His goal in figuring out why so many young women obsessively tan is to find ways to predict risk of addiction and ways to intervene with that behavior in order to reduce the peril of melanoma.

Mays has been granted a young investigator award by the Harry J. Lloyd Charitable Trust, which provides grants to research that advances strategies to prevent and treat melanoma. Lloyd, who founded a multi-national company in the gift industry, created the Trust before his death from melanoma in 1997.

Mays is trained to think about the ways researchers can help people make healthy decisions to reduce risk of cancer. Advising him in the tanning addiction study are his mentors, Kenneth Tercyak, PhD, whose work also focuses on the biobehavioral aspects of cancer risk, and Michael Atkins, MD, deputy director of Georgetown Lombardi, who treats people with melanoma.

The notion that UV radiation abuse is an addictive behavior is gaining currency, Mays says. Tanning addiction and its corollary behavior, tanorexia, now has a Wikipedia entry. Tanorexia is linked to low weight and body image distortion, which Mays believes could be a component of tanning addiction. In 2010, The New York Times published a feature on tanning addiction that mentioned a Canadian man who described himself as a “poster boy” for tanning obsession. He said he travels all over the world, through all seasons, to seek the sun that maintains a tan, and added that he couldn’t stop even though he knew he might develop melanoma.

Despite the anecdotes, solid science into tanning addiction is “in very early stages,” Mays says. “A lot of people theorize about what is going on, but I am coming at this with a clean slate in order to really understand the issue.”

Reward drives addiction behavior

Mays has designed a population-based study and expects to enroll up to 400 women in the D.C. community through advertisements and online notices. The participants will include women who have tanned at least once with the goal of capturing a range of behaviors from periodic use to habitual tanning.

They will be given an in-depth assessment to learn about motivations driving this high-risk behavior, such as attitudes about tanning and the positive benefits they believe they obtain, Mays says. “This may offer us ways to predict who is at risk for possible future tanning addiction.”

In the study, Mays will use criteria that help define addiction in people who use alcohol and tobacco.

“We will ask whether participants have trouble cutting down on tanning; if they become annoyed if others tell them not to tan so much; if they feel guilty about tanning; if they have to tan more and more to feel the same pleasure they once had; and we will probe how tanning affects their state of mind,” he says.

“Habitual tanners may feel tanning improves their mood, makes them feel and look better — some of the same drivers mentioned by tobacco users,” says Mays. “Gaining reward from a behavior drives the addiction.”

In addition to creating a behavioral model of melanoma risk from tanning addiction, Mays will look for possible genetic determinants to tanning addiction in a subset of participants. He will collect DNA samples from these participants and look at genes associated with reward pathways seen in other forms of addiction.

“Some genes involved in addiction are related to dopamine, serotonin and opioid neurotransmitters,” Mays says. “Certain genetic attributes may relate to how people react to these neurotransmitters, and this helps drive a habitual addictive behavior.

“We want to explore if any of these genes are also related to tanning addiction,” Mays says.

Mays hopes the findings from his study will help to develop intervention strategies that reduce the risk of melanoma among high-risk habitual tanners.

“We are testing whether tanning addiction is real, and if it is, what can be done,” he says. “I can understand how it happens, and how it becomes habitual and pleasurable. For some people who gain rewards, the behavior becomes entrenched.

“I get that — and I want to help,” Mays says.

By Renee Twombly, GUMC Communications