Exploring young adults' perspectives on alternatives to sunbed use: a cross-sectional survey

Background: Despite clear evidence linking indoor sunbed use to an increased risk of skin cancer (melanoma), sunbed use among young adults in the UK remains prevalent. This research explored barriers and facilitators influencing the use of sunbeds and tanning alternatives among young adults in the UK, aiming to inform strategies to encourage safer tanning behaviours.Methods: An online, cross-sectional survey was conducted between February and June 2025. Using purposive sampling, we recruited UK-based young adults (aged 18–24) who had used sunbeds in the past year. A total of 502 participants (Mage = 21.73, SDage = 1.76) completed the survey and were included in the analysis. Measures included demographics (e.g., age, ethnicity), social deprivation, skin cancer risk, sun protection behaviours, willingness to use alternatives, and barriers/facilitators to indoor sunbed and sunbed alternatives use, based on the Theoretical Domains Framework (TDF). Backward stepwise linear regressions predicted frequency of using indoor sunbeds and alternatives (past year) from TDF constructs. Significant predictors were entered into separate linear regressions controlling demographics in the first model. Qualitative feedback was gained to further assess barriers/facilitators for using each alternative; analysed using content analysis.Results: Quantitative findings indicated that facilitators for indoor sunbed use related to tanning addiction (behavioural regulation), lower intentions to reduce or replace sunbed tanning, achieving tanning goals, less knowledge relating to associated health risks, and beliefs that alternative tans are temporary. Frequent use of sunbed alternatives was associated with perceptions of a natural-looking tan, stronger future intentions, identity alignment, and social influence from other users. Qualitative findings indicated positive emotion and beliefs about consequences as key facilitators of sunbed use, whereas knowledge of health risks and costs were barriers. For alternatives, greater facilitators were associated with convenience and affordability. There were mixed views regarding beliefs about consequences between alternatives.Conclusions: Efforts to promote switching from sunbeds to sunbed alternatives should target sunbed tanning addiction, knowledge of health risks, intentions to replace sunbed use, and beliefs about consequences from using sunbed alternatives. Understanding modifiable behavioural drivers can inform targeted strategies.