By LARRY LIPMAN
c.1997 Cox News Service
WASHINGTON -- The indoor tanning industry is about to launch a nationwide
campaign to convince Americans that ``moderate'' exposure to sunlight not
only isn't harmful, but could save 30,000 lives a year by reducing the
risk of cancer.
And they're serious.
``We're trying to put perspective into something that has lost perspective,''
said Joseph A. Levy, executive director of the International Smart Tan
Network, a Jackson, Mich.-based group that represents 27,000 indoor tanning
facilities throughout North America.
``People don't realize there may be risks in avoiding the sun,'' he
adds.
Not surprisingly, the group's claims fly in the face of nearly unanimous
opposition from the medical community. The latter warns that there is no
proof that exposure to the sun can prevent cancer, and there are mountains
of research indicating a strong relationship between exposure to the sun's
-- and tanning salons' -- ultraviolet rays and skin cancer.
To carry their ``sun-is-good'' message to the public, the tanning industry
is focusing on journalists, particularly health reporters.
Last month, the Smart Tan Network began running the first of six monthly
advertisements in ``Editor & Publisher,'' a weekly journalism trade
publication. It also began issuing press releases on the Public Relations
Newswire. And that will be followed up this spring with an information
kit ``to every health reporter that we know of in North America,'' Levy
said.
Levy declined to disclose the cost of the campaign, but said it would
pale in comparison to what the pharmaceutical and cosmetic companies spend
in advertising sunscreens and related products.
``We'll probably spend less than a full-page ad in ``Cosmopolitan''
which is about $50,000,'' Levy said. ``The beauty magazines run about 20
pages of cosmetic or sunscreen ads that relate to UV (ultraviolet) damage
an issue.
``It's a big business -- fear of the sun,'' he adds with a hint of sarcasm.
Although the Smart Tan Network is composed of indoor tanning companies,
their message primarily deals with exposure to natural sunlight. Levy said
that is because people who tan in the sun are most likely to use indoor
tanning facilities during the winter.
``The sun is not a competitor to the indoor tanning industry, the sun
is a complement,'' Levy said.
Still, there has been a steady increase in melanomas -- the most common
form of skin cancer -- since the early 1970s. The American Cancer Society
predicts that there are about 35,000 new cases of melanoma a year, 7,200
of which will result in death.
Rex Amonette, immediate past president of the American Academy of Dermatology,
said there are two types of melanoma: one that develops without apparent
exposure to sunlight and one that is stimulated by exposure to sunlight.
People who tan easily, usually darker-skinned people, generally develop
melanomas at a lower rate than fair-skinned people who do not tan easily,
but that doesn't mean people should develop a tan to prevent melanomas,
Amonette said.
The tanning industry argues that people who develop a gradual tan are
less likely to develop melanomas than those who tan erratically or get
sunburned.
The basis for the tanning industry's arguments are a handful of reports
which either claim beneficial results from moderate exposure to sunlight
or warn of potential health problems from sunlight depravation.
The common factor in these reports is the theory that vitamin D reduces
colon and breast cancer, which have high mortality rates and cause about
138,000 deaths annually.
Indeed, the National Institutes of Health is in the midst of a multi-year
clinical trial evaluating whether calcium and vitamin D supplements could
reduce colon cancer and bone fractures in post-menopausal women.
Since the body's production of vitamin D is activated by sunlight, some
reports suggest that exposure to the sun could reduce some forms of cancer.
The tanning industry has seized on these works and, in some cases gone
beyond the scientific findings, to bolster their claims.
Several studies by epidemiologists Frank and Cedric Garland of the University
of California at San Diego have noted a link between sun exposure and certain
forms of cancer deaths.
Their 1980 study, for instance, showed that colon-cancer death rates
were significantly lower in parts of the United States where there was
more sunshine. The Garlands' more recent studies in the U.S. and Russia
showed a similar pattern for breast cancer.
The mortality rate for all forms of cancer in the United States in 1995
was lowest in sun-drenched Utah and Hawaii, according to the Cancer Journal
for Clinicians. In Utah it was 107 deaths per 100,000 residents; in Hawaii
it was 112 per 100,000. By comparison, it was 148 in Alaska and 152 in
Maine. (It was 134 in Florida; 133 in Georgia; 132 in Texas, 134 in North
Carolina, 149 in Ohio, 124 in Colorado).
But Dr. Michael Thun, an epidemiologist with the American Cancer Society,
said the link between cancer deaths and geographic titude ``is rather weak.''
``Sunlight is not the only thing that changes as you go from north to
south,'' Thun said, noting differences in physical activity, diet and access
to vegetables.
Among the reports most often quoted by the indoor tanning industry is
a 1993 study by H. Gordon Ainsleigh, a Meadow Vista, Calif., chiropractor
whom the Smart Tan Network identifies as a physician.
Ainsleigh's report is an analysis of previous studies on the impact
of sunlight or vitamin D that begins with a 1937 study which found that
U.S. Navy sailors had eight times the expected rate of skin cancer, but
only two-fifths the expected rate of internal cancer.
Ainsleigh strongly supports the tanning industry's contention that people
can protect themselves from cancer by moderate tanning -- including the
use of artificial tanning beds.
But two other researchers whose work is used the by the tanning industry
to bolster its claims said they don't advocate using tanning salons to
reduce cancer.
In its information packet, the Smart Tan Network quotes one, Dr. Michael
Holick, chief of endocrinology, nutrition and diabetes at Boston University,
as advocating exposure to sunlight to prevent disease.
But Holick, noting ``intriguing evidence'' in laboratory studies that
vitamin D may have beneficial effects, said ``there is not enough evidence,''
to suggest that exposure to sunlight can prevent cancer.
One reason is that, although sunlight activates the vitamin D that may
reduce the growth of cancer cells, the body only produces as much activated
vitamin D as it can use, Holick said. Therefore, increased exposure to
sunlight does not increase the amount of activated vitamin D the body will
produce.
``I don't advocate it (tanning) as a healthful measure. I simply say
that if you're going to do it, do it responsibly,'' Holick said.
Levy said that's what the tanning industry is advocating, and that's
why he supports the use of sun index guides in newspaper weather reports.
``I don't use the word safe (when referring to tanning) because safe
assumes that something can be done recklessly without fear of injury,''
Levy said. ``We're saying this is a smart activity, and you need to be
thinking about what your skin can handle... What we're trying to promote
is being sun smart and avoiding sunburn.''
The tanning industry argues that people who tan indoors are 57 percent
less likely to get sunburns -- which are linked to melanomas.
Dermatologists argue, however, that the best way to be sun smart is
to avoid tanning.
``There is no such thing as a safe tan,'' said Dr. Darrell Rigel, professor
of dermatology at New York University and secretary-treasurer of the American
Academy of Dermatology. ``Tanning means your body senses that it's being
injured by the ultraviolet rays that hit it. To get tanned you have to
be injured ... To go into a tanning salon just to get a tan makes absolutely
no sense.''
Thun, of the American Cancer Society, said ``it's a long leap to claim
that the potential benefits of moderate tanning in reducing the risk of
internal cancer exceeds the known risk of skin cancer, including melanoma...
The advertising is ahead of the science.''
For clients of The New York Times News Service
NYT-02-24-97 1424EST
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