A scoping review: Screening questionnaires for identifying tanning addiction

Introduction

There is a growing body of evidence that ultraviolet (UV) tanning, whether practiced in indoor tanning salons or outdoors in the sun, is not only linked to detrimental health outcomes but is also addictive through both psychological and physiological mechanisms. In clinical practice, it can be challenging to determine which patients will continue tanning despite being at high risk for developing skin cancer. Our study seeks to identify all available screening questionnaires for tanning addiction that could be used in clinical practice and report on published measures of validity for each screening questionnaire.

Methods

An exhaustive literature search of EMBASE, PubMed, PsycINFO, and Scopus was performed using search criteria including the concepts “UV” and “Addiction.” The most recent search was performed in March 2024 and included all articles from database inception to the time of the search. Studies were included if they reported on screening questionnaires for UV addiction. Articles were excluded from the study if they did not report primary data or did not report on measures of questionnaire validity. Methodology was created using best practices for scoping reviews.

Results

After identifying 171 articles, 106 articles underwent full-text review, and 26 were included in data extraction. We identified nine questionnaires for tanning addiction, with the modified Cut-down, Annoyed, Guilty, Eye-opener (mCAGE), and modified Diagnostic and Statistical Manual of Mental Disorders (mDSM) being most frequently reported on, and the Behavioral Addiction Indoor Tanning Screener (BAITS) being the most promising for future use.

Conclusions

This information should be used to choose questionnaires to be studied against a “gold-standard” of a panel of psychologists. After defining accuracy of diagnostic tests, studies can be designed to examine interventions for treating tanning addiction, so at-risk patients can receive specialized therapy, reducing the overall burden of skin cancers.