Factors Associated with Sunbed use in Women: the E3N-SunExp Study

Objectives: In this study, we attempt to describe the profile of sunbed users among cancer-free French women. Methods: E3N is a prospective cohort including 98,995 French women aged 40- 65 years in 1990. In 2008, a specific UV questionnaire was sent to all reported skin cancer cases and 3 controls per case, matched on age, county of birth, and education. We used logistic regression models adjusted for pigmentary traits. Results: Compared with non-users, ever-users of sunbeds were younger (p_trend < .0001), had higher levels of education (p_trend = .0004) and income (p_trend = .002), and were more likely to be divorced/separated (OR = 1.58). They were more likely to be smokers (OR = 1.59) or former smokers (OR = 1.64), had higher alcohol intakes (p_trend = .001), and lower physical activity levels (OR = 0.54), although they had a lower BMI (p_trend = .004) and a thinner body shape (p_trend = .006). Sunbed users were also more likely to report many freckles (p_trend = .01) and sunburns in adulthood (p_trend = .008), to use sunscreen (SPF<8: OR = 2.15), and to renew sunscreen application (sometimes: OR = 1.49). Conclusions: Sunbed use is associated with intentional sun exposure and several unhealthy behaviors. Our findings call for further re- search towards the development of targeted prevention campaigns to reduce sunbed use.