Brooke Budke can never be sure what led to her skin cancer.
Was it all the time spent outdoors on vacation without wearing enough sunscreen? Or was it the tanning bed?
A survivor of melanoma going on nine years, Budke, 30, believes both factors could have contributed to the cancer. But looking back, there’s one certainty.
Budke would have skipped those visits to the tanning salon so long ago, even if it was the thing to do among her peers when she was a teen.
“There’s no benefit to it,” Budke said.
Already targeted by government regulators nationwide, the tanning bed is under growing scrutiny in Kansas and Missouri.
Kansas lawmakers are considering legislation banning minors from indoor tanning. Missouri is considering a measure requiring anyone under 17 to get his or her parents’ consent before tanning.
“It’s a very, very important public health issue,” said Kansas Rep. David Crum, R-Augusta and chairman of the House Health and Human Services Committee.
The legislation is a response to public health advocates sounding alarms about risks associated with indoor tanning and added exposure to ultraviolet light, especially among teens.
The federal Centers for Disease Control and Prevention warns that tanning beds are especially dangerous for those who begin tanning before they are 35.
The CDC says those people have a 59 percent increased chance of contracting melanoma, the deadliest type of skin cancer.
“It’s kind of like playing Russian roulette,” said Jerry Brewer, a dermatology specialist at the Mayo Clinic who studied a rise in the number of melanoma cases from 1970 to 2009.
The industry supports the Kansas and Missouri measures, hoping the bills will cool what it sees as rhetorical overstatements about the dangers of indoor tanning.
“We need to get away from that. The public is not helped by that,” said Joseph Levy, scientific adviser to the American Suntanning Association, which represents about 700 salon owners nationally.
Levy and others in the tanning business say the legislation will affect only a sliver of their clientele. A 2011 study showed that about 13 percent of high school students use a tanning bed.
Tanning more intense
Not all ultraviolet exposure is hazardous, Levy said. He added that consumers are more exposed to ultraviolet radiation from the sun than they are from a tanning bed, but he acknowledged the indoor tanning is more intense.
“This isn’t any different than sunshine,” Levy said. “The point of indoor tanning is to be a surrogate for what nature intended.”
Momentum has been building in recent years against the tanning industry, which is estimated to serve 28 million Americans annually, including 2.3 million teens.
Five years ago, the International Agency for Research on Cancer, an arm of the World Health Organization, determined that tanning beds posed a cancer risk to humans. The agency recommended banning commercial indoor tanning for minors.
Two years ago, researchers at the University of California at San Francisco concluded that indoor tanning was responsible for more than 170,000 new cases of nonmelanoma skin cancers in the United States each year.
Another study done at the Mayo Clinic found that melanoma cases among women younger than 40 were eight times higher in 2009 than in 1970. Melanoma in men increased fourfold. Researchers suspected tanning beds were the culprit.
Kansas and Missouri are just the latest to consider measures the tanning industry opposes.
The federal government enacted a 10 percent tanning tax as part of the Affordable Care Act in 2010. The tax, coupled with the recession, was blamed for closing nearly half the tanning salons nationwide.
The Food and Drug Administration is considering a rule requiring labels for tanning beds that would discourage teens from using them.
Six states ban tanning for anyone under 18, and the state of Washington is considering a ban. At least 33 states regulate tanning for minors, many requiring parental consent for teens or parents accompanying their kids to a salon.
Two years ago, congressional Democrats, led by Henry Waxman of California, released a scathing report accusing the industry of providing misleading health information to teens about tanning.
The mounting government pressure is getting too heavy-handed for some salon owners. They say they take safety precautions for their customers. They say initiatives like the tanning tax give them a dirty name.
“I can get really mad about the whole situation,” said Terri Wheeler, owner of the Sun Scene salon in Raymore, Mo. “I think that the government is overstepping their bounds. It’s up to the parents to parent. It’s not up to the government to parent the children.”
Wheeler and other salon owners say they restrict tanning for minors. They say they survey their clients about skin type and provide them with educational material about how to tan safely.
“As a business owner, you have to make sure that you’re educating your customer,” said Lori Chapman, owner of Bask Tanning in Bonner Springs. “It’s not all about making money.”
Making risks known
Kansas already licenses tanning salons and requires them to give customers a written statement warning about the risks of tanning, including the possibility that repeated exposure could lead to skin cancer.
Salons also must post signs alerting consumers to the risks of tanning. Salons are barred from claiming or distributing promotional material stating that tanning beds are safe.
If Kansas eventually bans tanning for minors, it would be a setback for Chapman’s salon, which is down the road from Basehor-Linwood High School. She estimates 40 percent of her clients are teens. She already requires parents’ permission for clients under 18.
“By no means is it going to put me out of business, but it will definitely hurt my bottom line,” Chapman said.
Alexis Nichols, 17, tans for a couple of weeks twice a year to get ready for school dances. She recognizes the health issues. So she limits her tanning.
“In the winter, I get really, really pale,” she said. “When springtime comes and you want a bright dress for a dance, then you want color, or otherwise it will wash you out.”
A law banning teens from tanning would probably tick off her friends. She said they sometimes tan for self-confidence, but she understands the worry.
“I feel like they are looking out for our best interests.”