LAUSR

Melanoma is a major public health challenge globally. Over the past several decades, incidence of melanoma has steadily increased across the world, almost faster than any other cancer, with the highest incidence rates in Australia and New Zealand. The increasing health and economic burden of this disease adds weight to the need to implement prevention and early detection policies and interventions that can have a significant impact on melanoma incidence. One area where many governments have implemented policy interventions to reduce the risks associated with melanoma has been in relation to the commercial sale and use of artificial tanning beds (sunbeds). At present, 24 countries prohibit sunbed use in persons aged under 18 years and three countries – Australia, Brazil and Iran – have a total ban on commercial sunbeds. These artificial tanning policies and bans are making significant strides to reduce melanoma risk. People who have used sunbeds increase their risk of melanoma by almost 60%. In Australia, where an outright ban of commercial sunbeds has been in place since 2016, the experience has demonstrated that such preventive policy intervention can be not only highly effective, but can also have strong public support. The Australian experience also showed that when the sunbed industry was given sufficient time to reform, they were quick to reorientate their cosmetic services to accommodate the new laws without significant job losses. As state governments took an active role in the monitoring and enforcement of the ban, there were only a small number of breaches that declined over time. To support the retailer’s transition away from indoor tanning services prior to the ban taking effect, in some Australian states, there was a ‘buy-back’ scheme where retailers were able to sell their tanning units back to the government to enable the safe disposal of the units and to reduce the number of units being sold into the private market. The ban applies only to sunbeds used commercially, therefore it is still possible for an individual to have a tanning bed for personal use at home; however, this market for domestic sales of sunbeds is extremely small. The article by Eden et al. in the present issue of the BJD adds to the growing body of evidence that nationwide bans lead to large health and economic benefits. Health economists estimate a total saving to the Australian health system of over AU$64 million dollars, and productivity gains of AU$516 million. In the UK, where melanoma rates are continuing to increase, this new research study now estimates that if England were to implement a similar ban on artificial tanning devices, this would result in a net monetary benefit of £10.6m and a net health benefit of 530 quality-adjusted life-years. In light of the policy experience, combined with this new strong evidence that an outright ban of commercial sunbeds can be successfully implemented without significant unintended consequences, we conclude that this modelling provides further justification for banning commercial sunbeds as both an effective health and economic policy.