The tanning industry found little to celebrate during Barack Obama’s presidency, but it’s starting to cheer up.
Obama’s signature health law, the Affordable Care Act, put a 10 percent excise tax on indoor tanning services, and during his two terms, the federal government and states sought to deter the use of tanning beds by young people in particular, citing evidence that it causes skin cancer.
The tanning industry says the tax has helped force thousands of salons out of business. But the bill Republicans proposed last week to repeal the ACA would abolish the tanning tax, along with an array of other taxes imposed to help finance expanded health insurance coverage.
An important public health question — whether the tax has deterred people from using tanning beds — remains tricky to answer, researchers say. It is clear that fewer teenagers have been using indoor tanning facilities. According to the Centers for Disease Control and Prevention, the prevalence of indoor tanning among high school students decreased to 7.3 percent in 2015, from 15.6 percent in 2009, a year before the ACA and its taxes took effect.
But other factors could also have a role, including that a growing number of states have banned or restricted indoor tanning among minors. Not only that, but there is a growing awareness of “what’s becoming well accepted — that indoor tanning is a cause of melanoma,” said DeAnn Lazovich, an epidemiologist at the University of Minnesota whose research focuses on skin cancer. Her study published in JAMA Dermatology last year found that women who tanned indoors were six times more likely to be diagnosed with melanoma before they turned 30.
The American Suntanning Association, an industry group, says the number of tanning salons around the country has shrunk by about half, dropping to about 9,500, from about 18,500 in 2010. And while it is hard to confirm the accuracy of those numbers, Chris Sternberg, a spokesman for the group, said most of the closings stemmed from the tanning tax and various state and federal efforts to regulate indoor tanning.
“It certainly takes away the negative perception that the government has over the last number of years tried to cast upon the industry,” Sternberg said of the planned repeal of the tax, which the Joint Tax Commission estimates will cost the federal government $600 million over 10 years. “We think lifting the tan tax is an important step to letting folks know it’s OK to tan.”
Many dermatologists and researchers strongly disagree. A review of the scientific research published in 2014 estimated that tanning beds accounted for as many as 400,000 cases of skin cancer in the United States each year, including 6,000 cases of melanoma, the deadliest form. And a 2012 study found a 15 percent increase in the risk of certain skin cancers with every four sessions in a tanning bed before age 35.
But unlike with taxes on tobacco, the deterrent effect of taxes on tanning salons — which are typically passed onto customers — have not been carefully studied.
“Certainly we know from tobacco research, there’s very clear evidence that increasing taxation results in declines in adolescent smoking,” Lazovich said. “Adolescents are very susceptible to the price increases, so one could imagine that it could also work here. But we don’t know the price point at which it will be a deterrent.”
One small study out of Illinois found that while 26 percent of tanning salons surveyed there reported fewer clients after the ACA tax went into effect, “distinguishing the impact of the tax from the current economic climate as the source of decline was difficult.” Not only that, but 78 percent of salons reported that clients did not seem to care about the tax.
Still, Lazovich said that if the tanning industry’s numbers are accurate and there are fewer salons since the ACA passed, that in and of itself could curb use. “The less access, the fewer people who will be exposing themselves to tanning beds,” she said.
Dan Humiston, who opened his first tanning salon in Buffalo, New York, in 1985 and grew it into a chain of several dozen, gave up on the business in 2015. He said the tanning tax made a difficult climate worse.
“It let into people’s minds that this is really not good for you,” said Humiston, a former president of the Indoor Tanning Association, another industry group. “It also emboldened all the regulatory agencies; they just felt like they had to come down on us harder on everything.”
But the atmosphere seems to be changing, said John Overstreet, executive director of the Indoor Tanning Association. Among other things, the industry is increasingly confident that a 2015 proposal by the Food and Drug Administration to ban tanning among minors will be quashed by the Trump administration.
“For this industry,” he said, “it’s certainly a time of hope.”