Purpose: Despite the established causal links to skin cancer, skin aging and eye inflammation, people continue to use indoor-tanning devices. Understanding the reasons underlying the use of sunbeds is essential for developing effective interventions. The purpose of this study was to collate all existing evidence from qualitative papers published to date that had assessed reasons for using indoor-tanning devices and to synthesise using the COM-B theoretical-framework (i.e., that capability, opportunity and motivation are influences on behaviour).
Methods: Six databases were searched from inception to March 2022 for qualitative-studies that explored adults’ experiences of using indoor-tanning devices. Seventeen studies met the inclusion criteria and both thematic and framework-analysis were used. A narrative evidence synthesis was used to collate findings from each primary study.
Results: Five of the six COM factors were found in the data – engaging in tanning and quitting tanning were influenced by reflective and automatic-motivation, social and physical-opportunity and psychological-capability. Cross cutting themes were: aesthetic-values, physical-effects, psychological-effects, risk-perceptions, acceptable-alternatives and availability/accessibility.
Conclusions: This comprehensive explanation for the practice of indoor-tanning provides the basis for development of complex interventions to reduce the harm caused by indoor-tanning. Effective interventions should address aesthetic appeal, perceived benefits, risks, cultural-norms, availability/accessibility of salons, acceptability of alternatives and breaking habits.