Prevalence, predictors and psychological conditions of tanning behavioural addiction - A meta-analysis

Although regulatory and public concerns have implemented policies to minimize risk-associated tanning, little is known about tanning behavioural addiction (TBA).

To estimate and summarize the prevalence and predictors of TBA and its association with substance use and psychological conditions among tanners.

We systematically searched six electronic databases and grey literature from inception to February 26, 2026, without language restrictions, to identify all relevant studies addressing TBA among adolescents or adult tanners. Considering the identified validated instruments, the prevalence of TBA and its association with substance use and psychological conditions were estimated using random-effects meta-analysis, corresponding with 95% confidence intervals. Narrative synthesis was employed to summarize the predictors of TBA.

Following the five identified validated instruments for TBA, 20 unique studies among tanners (n = 7222; mean age, 18.2-36.2 years; proportion of females, 64%-100%) were included. With substantial heterogeneity, the pooled prevalence was 23.1% (18.9%-27.5%) for any aspect of TBA, ranging from 8.7% (6.1%-11.8%) for SITAD - dependence criteria to 36.8% (30.1%-43.7%) for tanning - DSM-IV-TR/DSM-IV criteria (p for difference between diagnostic criteria <0.001). Regarding narrative synthesis with limited data, frequent indoor tanning sessions (consistent evidence) and several individual characteristics (mixed or limited evidence) were identified as potential or possible predictors of TBA. With very low evidence certainty, individuals with TBA were not associated with substance use but were associated with psychological conditions: depression (odds ratio [OR], 1.88 [1.12-3.15]), obsessive-compulsive disorder ([OCD], OR, 2.81 [1.30-6.07]), body dysmorphic disorder ([BDD], OR, 1.55 [1.05-2.28]) and seasonal affective disorder ([SAD], OR, 2.00 [1.01-3.97]).

Evidence drawn from predominantly young adult White women has shown that the prevalence of TBA varies widely depending on the diagnostic criteria employed. With very low evidence certainty, individuals meeting criteria for TBA are at heightened risk for multiple psychological conditions (i.e. depression, OCD, BDD and SAD).