Trends in awareness and behaviour relating to UV and sun ...Results for reported sun protection...

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Trends in awareness and behaviour relating to UV and sun protection: 2003-2013 July 2014

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Contents

1. Introduction

2. Summary of findings

3. Background

4. Methods

4.1 Survey

4.2 Statistical analyses

4.3 Limitations

4.4 Response rates

5. Results

5.1 Awareness of actions to reduce the risk of cancer

5.2 Behaviours to protect from the sun and skin cancer

5.3 Agreement with the statement “Protecting myself from too much sun is important to me”

5.4 Sunbed use

5.5 Frequency of sunburn during previous summer

5.6 Personal incidence of sunburn in the UK

5.7 Personal incidence of sunburn outside of the UK

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1. Introduction

Since 2003, Cancer Research UK has commissioned the Office of National Statistics to run a SunSmart tracking survey aimed at monitoring trends in the general public’s awareness and behaviour towards sun protection. This report strives to identify and analyse awareness and behavioural trends between 2003 and 2013. The research and reporting was funded using grants from the Department of Health. The following aspects of awareness and behaviour relating to sun protection have been analysed and presented within this report:

1. Awareness of actions to reduce the risk of cancer 2. Behaviours to protect from the sun and skin cancer 3. Level of agreement with the statement “Protecting myself from too much sun is important to me” 4. Sunbed use 5. Frequency of sunburn during previous summer 6. Personal incidence of sunburn in the UK 7. Personal incidence of sunburn outside of the UK

2. Summary of findings

Awareness Some positive trends were observed in awareness of actions to reduce the risk of skin cancer, including ‘avoid sunburn’ (2003 – 2013) and ‘avoid sunbeds’ (2006 – 2013) which is encouraging, however numbers who reported these actions were consistently low over the years (less than 25%). The positive significant trends observed in awareness of actions to reduce the risk of skin cancer include:

‘Protect children’: 5.2% to 7.1%

‘Avoid sunburn’: 5.5% to 16.0%

‘Check moles / skin for changes’: 3.3% to 12.8%

‘Avoid sunbeds’ (2006-2013): 11.6% to 21.6%

Note: Responses for each of the above actions were consistently low over the years (below 25%) Significant negative trends in awareness were observed for two of Cancer Research UK’s three key messages: ‘spend time in the shade’ and ‘cover up’. A decline was also observed for ‘reduce time in the sun’ (2007-2013), however this was not observed for men. These results are initially concerning however, in contrast to the measures for which positive trends were observed, numbers reporting awareness of ‘spend time in the shade’ and ‘cover up’ have been consistently high since 2003 (above 40%). The significant negative trends observed in awareness of actions to reduce the risk of skin cancer include:

‘Spend time in the shade’: 63.6% to 59.5%

‘Cover up’: 49.7% to 44.4%

‘Reduce time in the sun’ (2007-2013): 28.4% to 23.1%

Note: response rates for of ‘cover up’ and ‘spend time in the shade’ were high to begin with.

Reported behaviour Results for reported sun protection behaviours also contrast with levels of awareness for many actions. For example, a significant increase in reported behaviour of ‘cover up’ (+10.7 percentage points) was observed between 2003 and 2013 and ‘spend time in the shade’, between 2011 and 2013 only. In fact, in terms of behaviour, the results are generally positive with significant positive trends observed for 10 out of 14 behaviours, albeit 6 out of 10 of those increases did have consistently low response rates (less than 20%). Only one significantly negative trend was observed for ‘wear a t-shirt’, however the decrease between 2008 and 2013 was relatively small and not of great concern since significant increases were observed in similar behaviours e.g. ‘cover up’. A significant positive shift was observed for the following behaviours focussed on avoiding the sun or skin cancer:

1. ‘Cover up’: 22.5% - 33.2% 2. ‘Use factor 15+ sunscreen: 37.3% - 50.5% 3. ‘Wear a hat’: 21.5% - 31.0%

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4. ‘Wear sunglasses’ (from 2008): 13.9% - 16.2% 5. ‘Reduce time in the sun’: 8.8% - 13.9% 6. ‘Avoid sunbeds: 1.1% - 9.8% 7. ‘Avoid sunburn’ (from 2008): 7.1% -11.3% 8. ‘Check moles / skin’: 0.8% - 7.3% 9. ‘See a doctor’: 1.0%– 3.2% 10. Use any sunscreen’: 35.5%– 31.4% (although a lower figure was reported in 2013, overall this was a positive

trend)

However a significant negative shift was measured for the following behaviour also aimed at avoiding the sun or skin cancer:

1. ‘Wear a t shirt’ (from 2008): 12.5% - 9.9%*

*Significant in whole group but women only when analysed by gender

There were some gender differences observed, with women more likely to report a greater number of protective behaviours than men, and women more commonly reporting sun avoidance behaviour than men e.g. ‘reduce time in the sun’ and ‘avoid sunbeds.’ Among 16 – 24 year olds, the results are particularly encouraging as no negative trends were observed and reported behaviour of Cancer Research UK’s three key messages; ‘use factor 15+ sunscreen’, ‘cover up’ and ‘spend time in the shade’ all significantly increased over time (2003 – 2013). The sample size for this group was small though (n = 339 in 2003, n = 78 in 2013, see Appendix) therefore caution is necessary when weighing improvements in their behaviour. Observations on awareness and behaviour trends Between 2009 and 2010 a sharp decline was observed in levels of awareness and reported behaviours. An explanation for this dip could be due to poor weather or economic decline, resulting in less of a requirement to take preventative measures due to less sun exposure or fewer holidays. Data from the UK Met Office does indicate a decline in hours of sunshine between summer 2009 and 2010 (Figure 1) however the level did not drop as low as in 2008, at which time awareness levels for most sun protective behaviours increased (see Figure 3). It is therefore unlikely poor weather was a contributory factor to the sharp decline in awareness levels at this time.

Figure 1: Total hours of sunshine between April and September. 2003-2011 Source: UK Met Office. www.metoffice.gov.uk (2012) However, when considering other events that occurred during 2009 and 2010, the UK economic downturn may have been a contributory factor. In 2009 and 2010, the UK economy was struggling and unemployment was rising. In addition, exchange rates, particularly for the Euro, were lower than for many years previous. This poor economic climate is likely to have raised the cost of foreign holidays resulting in fewer holidays being taken by the UK population.

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Furthermore, in 2010 there were a number of events that disrupted foreign travel including: a volcanic ash cloud (which grounded flights) and industrial action taken by British Airways staff (during summer). Data from the ONS Travel Trends (Figure 2) show that foreign travel by UK residents did decline between 2009 and 2010 however this decline began in 2008, i.e. before the sharp decline in awareness & reported behaviour began. The available data does not fully support a relationship between the economic downturn, decline in foreign travel and the steep drop in reported awareness and behaviours between 2009/10.

Figure 2: Trends over time in overseas travel by UK residents (total number of trips). 2003 – 2011. Source: ONS ‘Travel Trends 2010’ and ‘Quarterly Overseas Travel and Tourism’ Q1, 2 and 3 2011

Importance of sun protection Encouragingly there was a significant increase from 2011 to 2013 of people reporting that protecting themselves from too much sun was important to them, apart from 16-24 year olds. Between 2011 and 2013 there was a decline in reported importance of sun protection among 16 – 24 year olds however this was not statistically significant.

Sunbed use With regards to sunbed use, although a high proportion of the sample reported they ‘never used sunbeds and never intend to’ (74% in 2011, 69% in 2013), since 2011 there is evidence to suggest the use of sunbeds has increased slightly. Firstly, significantly fewer women reported ‘never used sunbeds and never intend to’ compared to men in both 2011 and 2013. A significant increase in reports of ‘have used sunbeds in the past and will continue to do so’ (although numbers were small) was also observed. Interestingly, a significant increase was also observed among women for ‘have used sunbeds but wouldn’t in future’ compared to men in both years, indicating attitudes towards sunbed use could be quite polarised among women in particular. Intentions to use sunbeds in the future were most commonly reported among the 25 – 44 age group, in both 2011 and 2013, except for in 2013 reports of ‘have used sunbeds in the past and will continue to do so in future’ were most frequently reported among 65+ year olds. Most notably, reported intentions to use sunbeds in the future were NOT most common among the current high priority audience segment of 16 – 24 year olds. However, the sample size of 16-24 year olds was consistently low over the years and it wasn’t actually possible to compare differences in age statistically because the numbers were too small. Previous research has indicated that sunbed use does vary widely across geographical hotspots within England. Although the results delivered by this report are drawn from a representative sample, further investigation into the demographics and intentions to use a sunbed of those living in areas where usage is particularly high, is recommended. Further investigation will aim to provide balanced insights around this particular behaviour.

Frequency of sunburn The evidence within this report also suggests the dangers of sunburn are not always resonating with all audiences, particularly among men and 16 – 24 year olds. Since 2003, reported awareness and behaviour for ‘avoid sunburn’ has been consistently low among the whole sample (below 20%).

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With regards to reported frequency of sunburn, only just over half of the sample (52% in 2011, 51% in 2013) reported their skin had ‘never’ gone red or been burned in strong sun the previous summer. There was an increase in reported frequency of sunburn among men and 16 – 24 year olds in particular, with significantly less men and 16-24 year olds, reporting ‘never’ going red or getting burnt in 2013 and significantly more men and 16-24 year olds reporting ‘rarely’ going red or getting burnt in 2013 compared to 2011. However again, caution should be applied when drawing conclusions regarding the 16-24 year old group due to the small sample size.

Incidence of sunburn in UK There were no significant trends in reported personal incidence of sunburn in the UK between 2011 and 2013. While around 40% of people reported ‘I didn’t get sunburned’ in both 2011 and 2013, around half reported that they had been burned ‘once or twice’ (47% in 2011, 50% in 2013) The only significant trend observed was in women only - there was a significant decrease in those reporting being burned more than ten times.

Incidence of sunburn outside of UK

No significant differences were observed for reported incidence of going red or getting burnt outside of the UK for any of the groups. However it is worth noting, more people reported not getting burnt at all when they were outside of the UK (65% in 2011 and 70.7% in 2013), compared to when they were in the UK (38.4% in 2011 and 40.8% in 2013). This could be a reflection of a decline in holidays abroad, with more people spending time in the UK and therefore increasing their opportunities to be exposed to UK sun. Alternatively, this result could reflect a more relaxed attitude to sun protection in the UK. A summary of the awareness and behaviour trends observed can be found in Table 1 below.

Table 1: Reported awareness and behaviour of sun protective actions between 2003 and 2013 in the whole sample

Awareness of actions Behaviour

% in 2013

Trend 2003-2013

% in 2013 Trend 2003-

2013

Spend time in shade 59.5 41.7

Cover up 44.4 33.2

Protect children 7.1 5.0

Avoid sunburn 16.0 11.3

Avoid sunbeds 21.6 9.8

Use factor 15+ sunscreen

45.7 50.5

Use any sunscreen 37.3 31.4

Reduce time in sun 23.1 13.9

Use UV index 3.4 0.8

Check moles / skin 12.8 7.3

See doctor 9.2 3.2

Note: only significant trends in the whole group are illustrated with an arrow

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3. Background

Between 2003 and 2012 Cancer Research UK lead a skin cancer prevention programme (SunSmart), funded by the UK

Health Departments. SunSmart was originally developed through, and built around: research, public communication,

professional support and policy development. The main aims of the programme and associated campaigns were to

maintain awareness of the link between UV and skin cancer, increase knowledge of the individual and behavioural risk

factors associated with skin cancer, increase knowledge and understanding of effective methods of preventing skin

cancer and increase the number of people who take action to protect their skin from UV damage.

Since 2012 Cancer Research UK has continued to promote SunSmart messages to targeted audiences through

intermittent grant funding from the UK Health Departments (England and Scotland) and via a partnership with Nivea

Sun.

Cancer Research UK commissioned the Office for National Statistics (ONS) to run a yearly tracking survey to monitor

trends in the general public’s knowledge, attitudes and behaviour towards sun protection between 2003 and 2011.

The survey wasn’t executed in 2012 due to budget constraints however a smaller wave of the survey was conducted in

2013.

The aims of this phase of analysis of ONS SunSmart survey data are to: i) Identify trends between 2003 and 2013 in:

a. Awareness and reported behaviour of actions to prevent skin cancer

b. Actions taken in the whole sample

c. Actions taken in specific audience groups of ‘males and females’ and ‘16-24 year olds’

ii) To compare 2011 and 2013 data sourced from questions regarding ‘sunbed use’ and ‘sunburn’, which were first

introduced in 2011.

4. Methods

4.1 Survey

The 2013 SunSmart tracking survey data was extracted from a larger, Opinions and Lifestyle Survey (OLS) developed

and run by ONS. The OLS used a random probability sample stratified by region, proportion of households with no car

and socio-economic classification (NS-SEC). One person per household (who was at least 16 years old at the time of

survey) was randomly selected as the respondent. Letters were issued in advance giving details of the survey, followed

by face-to-face interviews which were delivered by trained interviewers.

Specific SunSmart questions were included in the OLS survey including questions to assess awareness of actions and

behaviour (2003-2011), importance of sun protection, and personal experience of sunbed use and sunburn (2011 and

2013).

4.2 Statistical analyses

All data are presented as percentages (or means where appropriate) with 95% confidence intervals (CIs) given in

parentheses. Trends over time were analysed using linear regression and linear trends were tested. Percentages and

95% confidence intervals from the initial (usually 2003) and final (2013) data are presented in tables for summary

purposes, but it is possible that CIs may overlap despite a significant linear trend over time. Trends are presented for

the whole group (‘overall’), then among males and females separately. Data are also presented for 16-24 year olds

since this age group are Cancer Research UK’s primary audience when delivering SunSmart skin cancer prevention

campaigns. Two sample t tests were used to compare groups, e.g. males and females, and to compare 2011 and 2013

data.

Data were weighted to reduce possibility of response bias (e.g. by only interviewing one member of a household). The

weighting variables were provided by ONS.

Statistical significance was set at <0.05 and analyses carried out in SPSS v18.

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4.3 Limitations

The number of participants in the 16 to 24 year old sample was relatively small therefore

confidence intervals were wide. In light of this, where a finding was approaching statistical significance this is

highlighted, as results may have been significant in larger samples.

4.4 Response rates

In 2013, ONS received 1,003 completed surveys from respondents aged between 16-96 years; the number of

interviews completed per year can be found in Appendix Table 1. In 2013 just over half of respondents were female

(54%), 8% were in the 16-24 years age category, 30% in the 25-44 years, 34% in the 45-64% and 28% were >65 %.

These proportions were very similar for all survey years.

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5. Results

5.1 Awareness of actions to reduce the risk of skin cancer

The following question was used to assess awareness of actions to reduce the risk of skin cancer:

Q1.What actions should you take to reduce the risk of skin cancer?1

1Responses:

Spend time in the shade Use factor 15+ sunscreen

Cover up Use any sunscreen

Protect children Reduce time in sun

Don't burn Use UV index

Avoid sunbeds Check moles / skin

See doctor

Results for the whole sample:

The results observed in the whole sample are summarised in Table 1 below with significant positive trends highlighted in green and significant negative trends in red.

Table 2. Awareness of actions to reduce the risk of skin cancer in the whole sample

2003 2013 Significant trend? Action % 95% CI % 95% CI

Spend time in shade 63.6 61.0 66.2 59.5 55.8 63.3 Yes ↓

Cover up 49.7 47.0 52.4 44.4 41.0 47.9 Yes ↓

Protect children 5.2 4.1 6.3 7.1 5.4 8.8 Yes ↑

Avoid sunburn 5.5 4.2 6.7 16.0 13.6 18.5 Yes ↑

Avoid sunbeds* 11.6 9.6 13.5 21.6 18.6 24.5 Yes ↑

Use factor 15+ sunscreen 43.8 41.2 46.5 45.7 42.1 49.3 No ↑

Use any sunscreen 38.5 57.0 1.3 37.3 33.6 40.9 No ↓

Reduce time in sun** 28.4 25.4 31.4 23.1 20.1 26.0 Yes ↓

Use UV index** 3.4 2.1 4.8 3.4 2.1 4.6 No ↑

Check moles / skin 3.3 2.4 4.1 12.8 10.6 15.1 Yes ↑

See doctor ** 7.1 5.4 8.8 9.2 7.2 11.2 No ↑

A significant positive shift (between 2003 and 2013) in awareness of four actions to reduce the risk of skin cancer were identified including; ‘protect children’, ‘avoid sunburn’, ‘avoid sunbeds’ and ‘check moles/skin’. These positive trends are illustrated in Figure 1.

The proportion of people reporting ‘avoiding sunburn’ as an action to reduce the risk of skin cancer has increased substantially between 2003 and 2013, from around 6% in 2003 to 16% in 2013. There was also a significant increase between 2011 and 2013 from 12% to 16%. ‘Avoiding sunbeds’ as an action to reduce the risk of skin cancer also increased between 2006 and 2013, from around 12 – 22%, and ‘check moles/skin’ increased by around ten percentage points from 3% to 13%. The proportion of people reporting ‘protect children’ as a action however was low, increasing from around 5% in 2003 to only 7% in 2013.

A significant negative trend was observed between 2003 to 2013 for actions including; ‘spend time in the shade’,

‘cover up’ and ‘reduce time in the sun’, see Figure 1. Despite observing a negative trend for ‘spend time in the shade’, this action was commonly reported (60%) in both 2003 and 2013. Furthermore, in more recent years between 2011 and 2013, there was actually an increase1 in reported awareness of ’spend time in the shade’ therefore this trend may not be quite as negative as it first appears.

1 Approaching statistical significance

*data from 2006 onwards **data from 2007 onwards

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Figure 3. Significant trends over time in awareness of actions to reduce the risk of skin cancer

There were no significant changes in those reporting ‘use any sunscreen’, ‘use factor 15+ sunscreen’, ‘use UV index’ or ‘see a doctor’. With regards to the actions ‘use factor 15+ sunscreen’ and ‘use any sunscreen’, these were relatively commonly reported actions at all time-points with 43% of respondents reporting awareness of ‘use factor 15+ sunscreen’ in 2003, and 45% reporting it in 2013. Similarly 38% of respondents reported ‘use any sunscreen’ in 2003, and 37% in 2013. Although fairly consistent, these figures only equate to less than half of the sample citing awareness of the use of sunscreen as an action to reduce the risk of skin cancer.

Comparing results for men and women:

There were no significant differences in awareness of any actions among men and women in 2013 yet in 2003, awareness of ‘protect children’ was significantly higher in women than in men (yet numbers were low). In 2013, awareness of this action had increased by approximately 9 percentage points in males (4% to 13%), thereby balancing out previous gender differences.

As observed in the whole sample, awareness of; ‘protect children’, ‘avoid sunburn’, ‘avoid sunbeds’ and ‘check moles / skin’ all showed significant positive trends between 2003 – 2013 for both men and women (Table 2).

Table 3. Positive trends in awareness of actions to reduce the risk of skin cancer, comparing men vs. women

2003 2013

Significant trend? Action % 95% CI % 95% CI

Protect children

Males 4.0 2.5 5.6 13.2 9.8 16.7 Yes ↑

Females 6.2 4.7 7.8 11.2 8.3 14.0 Yes ↑

Avoid sunburn

Males 5.5 3.8 7.2 16.0 12.7 19.3 Yes ↑

Females 5.4 3.7 7.1 16.1 12.3 19.9 Yes ↑

Avoid sunbeds*

Males 8.7 5.8 11.7 19.5 15.2 23.8 Yes ↑

Females 14.0 11.2 16.8 23.3 19.3 27.3 Yes ↑

Check moles / skin

Males 2.7 1.4 4.0 12.3 9.1 15.5 Yes ↑

Females 3.7 2.5 4.9 13.3 10.1 16.5 Yes ↑

*Data from 2006 onwards

There were substantial increases of around 10-11 percentage points, in ‘avoid sunbeds’ and ‘check moles/skin’ but numbers of both men and women reporting these actions were small. Following a slight decline in those reporting

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10

20

30

40

50

60

70

80

2003 2004 2005 2006 2007 2008 2009 2010 2011 2013

Time in shade

Cover up

Reduce time in sun

Avoid sunbeds

Avoid sunburn

Check moles / skin for changes

Protect children

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‘avoid sunburn’ in 2011, awareness increased significantly between 2011 and 2013 in both genders. Despite this, less than 20% of men and women recognised this as an action to protect against skin cancer at any time point.

There were two significant negative trends observed in men: ‘spend time in the shade’ and ‘cover up’ and three in women; ‘spend time in the shade’, ‘cover up’ and ‘reduce time in the sun’ (Table 3).

Table 4. Negative trends in awareness of actions to reduce the risk of skin cancer, comparing men and women

2003 2013


Spend time in shade

Males 63.1 59.0 67.3 57.3 51.6 62.9 Yes ↓

Females 64.0 60.6 67.4 61.5 56.5 66.4 Yes ↓

Cover up

Males 51.9 47.8 56.1 42.4 37.4 47.4 Yes ↓

Females 47.8 44.4 51.3 46.1 41.4 50.9 Yes ↓

Limit time in sun**

Males 29.3 24.7 34.0 23.2 18.7 27.8 No ↓

Females 27.6 23.7 31.6 23.0 19.1 26.9 Yes ↓

**Data from 2007 onwards

As observed in the whole sample, there were no significant trends observed in either men or women for reported actions of ‘use any sunscreen’, ‘use factor 15+ sunscreen’, ’use the UV index’ or ‘see a doctor’ (Table 4).

Table 5. No significant trends in awareness of actions to reduce the risk of skin cancer, comparing males vs. females

2003 2013


Use factor 15+

Males 43.0 38.9 47.0 44.9 39.4 50.4 No ↑

Females 44.6 41.1 48.0 46.3 41.6 51.1 No ↑

Use any sunscreen

Males 34.7 36.5 44.4 31.0 25.2 36.7 No ↓

Females 36.7 33.3 40.2 36.5 31.7 41.3 No ↓

See doctor**

Males 6.5 4.0 8.9 9.2 6.3 12.1 No ↑

Females 7.6 5.2 10.0 9.2 6.4 12.0 No ↑

Use UV index**

Males 3.5 1.6 5.4 2.7 1.1 4.4 No ↓

Females 3.4 1.5 5.4 3.9 2.1 5.8 No ↑

** Data from 2007 onwards

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Results for age group 16-24 only

Responses to the question ‘What actions should you take to reduce the risk of skin cancer?’ from 2003 to 2013 in the age group 16-24 are summarised in Table 5, with significant positive results highlighted in green and significant negative results in red.

Table 6. Awareness of actions to reduce the risk of skin cancer among 16-24 year olds

2003 2013


Spend time in shade 65.2 53.9 76.4 68.2 48.0 88.5 No ↑

Cover up 57.6 46.2 68.9 27.8 14.6 41.0 Yes ↓

Protect children 3.9 0.5 7.4 27.8 14.6 41.0 Yes ↑

Avoid sunburn 8.1 1.1 15.2 25.8 10.6 40.9 Yes ↑

Avoid sunbeds* 19.9 11.0 28.8 47.3 28.8 65.9 Yes ↑

Use factor 15+ sunscreen 54.3 46.4 62.3 46.6 29.5 63.8 No

↓


Reduce time in sun** 35.0 21.0 49.0 30.6 15.4 45.9 No ↓

Use UV index** 9.0 0.2 17.8 7.0 -1.0 14.9 No ↓


See doctor** 10.4 2.0 19.0 13.9 2.8 25.0 No ↑

*data from 2006 onwards **data from 2007 onward

Again, as with the whole sample, significant positive trends were observed in the four actions of; ‘protect children’, ‘avoid sunburn’, ‘avoid sunbeds’ and ‘check moles / skin for changes’ (Figure 5). Only one significant negative trend was observed for the action ‘cover up’, there was a substantial decline in awareness of this reported action, from 58% in 2003 to 27% in 2013 (see Figure 2).

Figure 3.Significant trends over time in awareness of actions to reduce the risk of skin cancer among 16-24 year olds

There were no significant trends for ‘spending time in the shade’, which was reported as an action in more than 60% of respondents in both 2003 and 2013. Similarly, ‘use of any sunscreen’ and ‘use of factor 15+ sunscreen’ were frequently reported actions in both 2003 and 2013, but there were no significant changes in awareness of these over time.

0

10

20

30

40

50

60

70

80

2003 2004 2005 2006 2007 2008 2009 2010 2011 2013

Cover up

Avoid sunbeds

Avoid sunburn

Check moles

Protect children

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5.2 Reported behaviours to protect from the sun and skin cancer

The following question was used to assess reported personal behaviours to reduce the risk of skin cancer:

Q2. Do you personally do anything to protect yourself from the sun and / or skin cancer? 1

1Responses:

Spend time in shade Reduce time in sun

Cover up Avoid sunbeds

Use factor 15+ sunscreen Avoid sunburn

Use any sunscreen Use UV index

Wear a hat Check moles / skin

Wear sunglasses See a doctor

Wear a t-shirt Protect children Results for the whole sample: Since 2003 more than 80% of people surveyed have reported doing at least something to protect their skin from the sun however there was no significant trend between 2003 and 2013. In 2003, 83.9% (CI: 81.4%, 86.4%) reported they did something to protect themselves and in 2013 this figure was very similar (83.8%, CI: 82.6% to 84.6%). However, year on year around 15% of people still report doing nothing to protect themselves, 16% (CI: 14.8, 16.3) in 2013.

There were a number of significant positive trends in sun protection behaviours between 2003/2008 and 2013 (see Table 6 and Figure 3). The number of people reporting they ‘cover up’ to protect themselves from the sun and/or skin cancer increased by nearly 11 percentage points, from 23% to 33%. There was also a substantial increase in people reporting ‘use factor 15+ sunscreen’, from 37% to around half (51%) of those surveyed. Although there was a slight decline in people reporting ‘use any sunscreen’ from 2003 to 2013, the overall trend was significantly positive. There was around a 9 percentage point increase in those reporting ‘wear a hat’ and overall this trend was significant and positive. There was also a significant positive trend in ‘wear sunglasses’, although overall the numbers reporting this behaviour in 2013 were relatively low (16%).

Table 7. Reported personal behaviours used to protect from the sun and/or skin cancer

Action 2003 2013 Significant trend? % 95 % CI % 95 % CI

Spend time in shade 29.2 26.9 31.5 41.7 37.9 45.6 No ↑

Cover up 22.5 20.4 24.6 33.2 29.6 36.9 Yes ↑

Use factor 15+ sunscreen 37.3 34.8 40.0 50.5 46.4 56.7 Yes

↑

Use any sunscreen 35.5 32.9 38.0 31.4 27.7 35.2 Yes ↑

Wear a hat 21.5 19.4 23.6 31.0 27.5 34.4 Yes ↑

Reduce time in sun 8.8 7.3 10.3 13.9 11.3 16.5 Yes ↑

Avoid sunbeds 1.1 0.6 1.5 9.8 7.4 12.1 Yes ↑


See doctor 1.0 0.4 1.6 3.2 1.8 4.6 Yes ↑

Wear sunglasses * 13.9 11.2 16.3 16.2 13.3 19.1 Yes ↑

Wear a t-shirt * 12.5 10.3 14.6 9.9 7.6 12.1 Yes ↓

Avoid sunburn * 7.1 5.5 8.7 11.3 9.0 13.7 Yes ↑

Protect children * 4.5 3.2 5.8 5.0 3.5 6.6 No ↑

UV index * 1.5 0.7 2.3 0.8 0.2 1.4 No ↓ *Data from 2008 onwards

Less commonly reported behaviours that showed significant positive trends were ‘limit time in the sun’, ‘avoid sunbeds’, ‘check moles’ and ‘see a doctor’. A significant positive trend was observed for ‘avoid sunburn’ between 2008 and 2013, shifting from around 7% to 11% however proportions reporting these behaviours have been consistently low (generally <15%) since 2003.

The only significant negative trend was for those reporting ‘wear a t shirt’, which declined from around 13% in 2008 to around 10% in 2013. This is not of great concern in light of the fact reports of ‘cover up’ have increased.

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Although there were no significant trends for ‘spend time in the shade’ between 2003 and 2013 there had been a sharp decline in 2011, followed by a stark increase between 2011 and 2013 which was statistically significant. Numbers of people reporting ‘protect children’ and ‘use UV index’ were extremely low at all time-points and have shown little change between 2008 and 2013.

Figure 4. Significant trends 2003-2013 for personal behaviours used to protect from the sun or skin cancer

0

10

20

30

40

50

60

2003 2004 2005 2006 2007 2008 2009 2010 2011 2013

%

Use factor 15+

Cover up

Wear a hat

Use any sunscreen

Wear sunglasses

Reduce time in sun

Avoid sunburn

Wear a t-shirt

Avoid sunbeds

Check moles / skin

See a doctor

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Comparing results for men and women

All significant trends observed in the sample overall were observed in both males and females when split by gender. There were significant positive trends between 2003 and 2013 in ‘cover up’, ‘use factor 15+ sunscreen’, ‘wear a hat’, ‘reduce time in the sun’, ‘avoid sunbeds’, ‘check moles/skin’ and ‘see a doctor’ in both sexes (Table 7). There were negative trends in ‘use any sunscreen’ for both men and women.

Table 8. Reported personal behaviours used to protect from the sun or skin cancer in men and women 2003-2013


Spend time in shade

Males 23.6 20.4 26.9 36.8 31.2 42.3 No ↑

Females 33.9 30.8 37.1 45.5 40.3 50.8 No ↑

Cover up

Males 22.4 19.2 25.6 33.9 28.2 39.5 Yes ↑

Females 22.6 19.7 25.4 32.7 27.9 37.5 Yes ↑


Males 33.3 29.6 37.1 49.3 42.7 55.9 Yes ↑

Females 40.7 37.3 44.2 51.5 46.2 56.8 Yes ↑

Use any sunscreen

Males 34.7 30.9 38.5 31.0 25.2 36.7 Yes ↓

Females 36.1 32.7 39.5 31.8 26.8 36.8 Yes ↓

Wear a hat

Males 23.9 20.6 27.3 36.2 30.5 41.8 Yes ↑

Females 19.4 16.8 22.1 27.0 22.6 31.3 Yes ↑

Reduce time in sun

Males 8.5 6.1 10.8 13.4 9.4 17.4 Yes ↑

Females 9.0 7.1 11.0 14.2 10.9 17.6 Yes ↑

Avoid Sunbeds

Males 0.3 -0.1 0.7 9.2 5.7 12.6 Yes ↑

Females 1.7 0.9 2.5 10.3 7.1 13.5 Yes ↑

Check moles / skin

Males 0.7 0.0 1.5 4.9 2.4 7.3 Yes ↑

Females 0.9 0.3 1.5 9.2 6.3 12.1 Yes ↑

See a doctor

Males 0.4 0.0 0.8 2.3 0.5 4.0 Yes ↑

Females 0.2 -0.1 0.4 3.9 1.7 6.0 Yes ↑

Between 2003 and 2013, women were significantly more likely than men to ‘reduce time in the sun’, ‘avoid sunbeds’, ‘check moles / skin’ and ‘see a doctor’ whereas men were more likely to ‘wear a hat’, ‘wear a t-shirt’ and slightly more likely to ‘cover up’ or ‘use any sunscreen’. Differences in reported behaviours from 2003 – 2013 between men and women are presented in Figure4.

Between 2008 and 2013 women were more likely to report ‘wear sunglasses’, ‘avoid sunburn’, ‘protect children’ and ‘use UV index’, although proportions reporting these behaviours were small overall. During this time period, there was a significant negative trend observed for ‘wear a t-shirt’ among women, but this was not observed in men. Furthermore, ‘Protect children’ and ‘avoid sunburn’ significantly increased in men, but not in women (Table 8).

Significant differences in reported behaviours between 2008 – 2013 among men and women are shown in Figure 5.

16

Table 9. Reported personal behaviours used to protect from the sun or skin cancer in men and women 2008-2013

Figure 5. Significant differences in sun protection behaviours between men and women: 2003 – 2013 Data are from 2 sample t-test of overall means from 2003 to 2013

Figure 6. Significant differences in sun protection behaviours between men and women: 2008 – 2013 (mean averages) Data are from 2 sample t-test of overall means from 2003 to 2013


Reported behaviours taken to personally protect from the sun/skin cancer in 16-24 year olds are shown in Table 9 and significant trends between 2003/2008 and 2013 are presented in Figure 6.

Six behaviours showed significant positive trends; ‘spend time in the shade’, ‘cover up’, ‘use factor 15+ sunscreen’, ‘avoid sunbeds’, ‘check moles/skin’ and ‘see a doctor’. The proportion of 16-24 years olds reporting the behaviour ‘cover up’ increased by around 10 percentage points between 2003 and 2013, from 26% to 36%. Similarly the behaviour ‘use factor 15+ sunscreen’ showed a substantial increase from 2003 to 2013, with over a third reporting this in 2003 (37%) compared to three-quarters (75%) in 2013.

0

5

10

15

20

25

30

35

%

Men

Women

0

1

2

3

4

5

6

7

Wear sunglasses

Avoid sunburn

Protect children

UV index

M

E

A

N

A

V

E

R

A

G

E

%

Men

Women


Wear sunglasses*

Males 11.7 8.5 14.9 16.8 12.0 21.5 No ↑

Females 15.7 12.4 19.0 15.8 12.3 19.2 No ↑

Wear a t-shirt

Males 11.4 8.3 14.5 13.7 9.8 17.7 No ↑

Females 13.4 10.3 16.4 6.9 4.4 9.4 Yes ↓

Avoid sunburn*

Males 4.0 2.3 5.8 11.9 8.2 15.6 Yes ↑

Females 9.7 7.2 12.2 10.9 7.8 13.9 No ↑

Protect children*

Males 1.3 0.3 2.4 4.6 2.3 6.9 Yes ↑

Females 7.0 4.9 9.2 5.4 3.3 7.5 No ↓

UV index*

Males 1.4 0.1 2.8 0.8 -0.1 1.7 No ↓

Females 1.6 0.6 2.5 0.8 0.0 1.6 No ↓

*data only available from 2008 onwards

17

Other behaviours that showed substantial increases in this age group were ‘avoid sunbeds’ and ‘check moles / skin’; both increasing from around 2% in 2003 to around 19% in 2013.

As was observed in the whole sample there was a large (and significant) increase between 2011 and 2013 in ‘spend time in the shade’. There was a dip in 2011, yet in 2013 this returned to previous levels of around 41%.

Reports of the behaviour ‘avoid sunburn’ significantly increased from <5% in 2008 to 18% in 2013. Although numbers were small for reports of ‘see a doctor’ (generally around 1-2%) every year, a slight significant positive trend was observed between 2003 and 2013.

Table 10. Reported personal behaviours used to protect from the sun or skin cancer in age group 16-24

Action 2003 2013 Trend?

% 95 % CI % 95 % CI

Spend time in shade 18.3 10.9 25.6 41.4 23.3 59.5 Yes ↑

Cover up 25.8 17.2 34.5 35.9 17.6 54.2 Yes ↑

Use factor 15+ sunscreen 36.8 26.9 46.7 74.6 51.4 97.7 Yes

↑


Wear a hat 22.5 14.3 30.7 21.2 7.5 34.8 No ↓

Reduce time in sun 6.2 1.7 10.7 15.1 5.7 24.5 No ↑

Avoid sunbeds 1.7 -0.1 3.4 19.3 2.8 35.9 Yes ↑


See doctor 2.6 -2.6 7.8 3.7 -3.7 11.1 Yes ↑

Wear sunglasses* 20.0 7.8 32.2 27.6 10.3 44.9 No ↑

Wear a t-shirt* 15.2 5.3 25.0 9.2 0.0 18.4 No ↓

Avoid sunburn* 3.0 -1.3 7.4 18.4 3.9 32.9 Yes ↑

Protect children* 1.8 -1.8 5.4 2.8 -2.8 8.3 No ↑

UV index* 3.0 28.8 3.0 0.0 0.0 0.0 No ↓

*data from 2008 onwards

There were no significant trends observed in ‘wear a hat’ (over one fifth in both 2003 and 2013), ‘wear sunglasses’ (20% in 2008 and 28% in 2013) or ‘wear a t-shirt’ (around 15% in 2008 and 9% in 2013). Those reporting they ‘protect children’ or ‘use the UV index’ were very low (generally less than 5%) at all-time points, with no evidence of a trend over time. There were no significant negative trends in reported behaviour over time observed in the 16-24 year old age group.

18

Figure 7. Significant trends 2003-2013 in reported personal behaviours used to protect from the sun/skin cancer in age group 16-24

0

10

20

30

40

50

60

70

80

2003 2004 2005 2006 2007 2008 2009 2010 2011 2013

%


Cover up

Spend time in shade

Avoid sunbeds

Check moles / skin

Avoid sunburn

See doctor

19

5.3 Importance of protecting from too much sun

Q3: How much do you agree with the following statement: “Protecting myself from too much sun is important to me”

1

1Responses:

Strongly agree [5]* Disagree [2]

Agree [4] Strongly disagree [1]

Neither agree or disagree [3]

Continuous scale with possible score of 1-5.*Note; scores have been reversed so that higher scores are positive [previously strongly agree = 1] Main results are comparison of the mean of the continuous scale, but % also presented for interest

Results for the whole sample, males and females and 16-24 year olds Overall, in 2011 the vast majority of people either strongly agreed (32.0% CI: 28.8%, 34.9%) or agreed (47.1% CI: 40.2%, 47.4%) that protecting themselves from the sun was important to them (79.1% in total). 5.1% (4.1%, 6.0%) of people actively disagreed it was important, 0.9% (0.5%, 1.3%) strongly disagreed and the rest neither agreed nor disagreed. There was a significant increase in those who strongly agreed or agreed between 2011 and 2013; almost half (47.1%, CI: 43.6, 50.5%) reporting they ‘strongly agreed’ and 40.3% (CI: 43.6, 50.5%) reporting they ‘agreed’ in 2013 (87% total).

Table 11. Reported importance of ‘protecting myself from too much sun and/or skin cancer’

2011 2013 Significant

trend?

Mean 95% CI Mean 95% CI

Overall 4.0 3.9 4.1 4.3 4.2 4.3 Yes ↑

Males 3.9 3.8 4.4 4.2 3.4 4.0 Yes ↑

Females 4.2 4.1 4.2 4.4 4.3 4.4 Yes ↑

16-24 year olds 4.2 3.8 4.4 3.9 3.7 4.2 No ↓

Mean (1-5 from strongly disagree to strongly agree) and SD standard deviation (range of mean).

Mean rating scores (1-5) are presented in Table 10 above. In the whole sample, and in men and women, there was a significant increase in reported importance of protecting themselves from the sun (Table 10 and Figure 7). There was no significant change between 2011 and 2013 in 16-24 year olds.

Although not shown clearly in Figure 7 below, women also rated significantly more highly than men in both 2011 and 2013.

Figure 8. Reported importance of ‘protecting myself from too much sun’, in 2011 and 2013

1.0

2.0

3.0

4.0

5.0

Overall Males Females 16-24 year olds

Me

an r

atin

g

Q3: Protecting myself from too much sun is important to me (1=strongly disagree, 5=strongly agree)

2011

2013

**significant

** ** **

20

5.4 Reported sunbed use

Q4. Which of these best describes your sunbed use?1

1Responses:

Never used sunbeds and never intend to Have used sunbeds in the past and may in future

Never used sunbeds but may do in the future Have used sunbeds in the past and will continue to do so in future Have used sunbeds but will not in future

Results for the whole sample: Overall, nearly three quarters (74%) in 2011 and over two thirds (69%) in 2013 of people reported ‘never used sunbeds and never intend to’ (see Table 11); this was a slight, but significant decrease. The second most commonly reported action was ‘have used sunbeds but won’t in future’ (around 20% of the sample in both 2011 and 2013). There was a small but significant increase from 2011 to 2013 in those reporting ‘have used sunbeds in the past and will continue to do so in the future’; increasing from around 1 to 3%. Table 12. Sunbed use in 2011 and 2013, whole sample

Overall 2011 2013 Significant

trend? Sunbed use % 95% CI % 95% CI

Never used and never intend to 74.0 70.5 77.4 68.9 65.3 72.6 Yes ↓

Never used sunbeds but may do in the future 1.5 0.7 2.3 1.9 0.8 3.0 No ↑

Have used sunbeds but will not in future 19.7 17.1 22.2 22.4 19.5 25.3 No ↑

Have used sunbeds in the past and may in future 3.7 2.5 4.9 4.3 2.9 5.7 No ↑

Have used sunbeds in the past and will continue to do so in future 1.2 0.5 1.9 2.6 1.5 3.6 Yes

↑

Of those who reported an intention to use sunbeds in the future by answering either ‘have used sunbeds in the past and may in future’ or ‘have used sunbeds in the past and will continue to do so in future’, the most common age of these respondents was 25 – 44 years, with the exception of 2013 where those aged 65+ reported this most frequently (Table 12).

Table 13. Age of respondents who reported they ‘have used sunbeds in the past and may in future’ and ‘have used sunbeds in the past and will continue to do so in future’ in 2011 and 2013

2011 2013

Age Frequency % Frequency %

Have used sunbeds in the past and may in the future

16 - 24 11 27.3 8 18.8

25 - 44 19 46.8 20 45.0

45 - 54 7 18.2 7 15

55 - 64 2 3.9 5 11

65+ 2 3.9 14 10

TOTAL 41 100 43 100

Have used sunbeds in the past and will continue to do so in the future

16 - 24 3 24 5 21.3

25 - 44 9 64 5 21.3

45 - 54 2 12 4 14.9

55 - 64 0 0 4 17

65+ 0 0 7 25.5

TOTAL 13 100 26 100

21

Comparing results for men and women

Sunbed use in men and women is reported in Table 13. Significantly fewer women reported ‘never used sunbeds and never intend to’ compared to men in both 2011 and 2013 (Figure 8). There was also a significant decrease in reports of ‘never used sunbeds and never intending to’ among women only between 2011 and 2013. Conversely, significantly more women reported ‘have used sunbeds but wouldn’t in future’ compared to men in both years, and this proportion increased significantly between 2011 and 2013 (from 25% to 31%) in women only.

Table 14. Sunbed use in males and females between 2011 and 2013

Males and females 2011 2013 Significant trend? Sunbed use % 95% CI % 95% CI

Never used and never intend to Males 84.4 79.7 89.1 82.5 77.2 87.8 No ↓

Females 66.3 61.5 71.1 57.4 52.6 62.3 Yes ↓

Never used but may do in future

Males 1.8 0.6 3.1 2.7 0.8 4.7 No ↑

Females 1.3 0.3 2.4 1.2 0.1 2.3 No ↓

Have used but will not in future

Males 12.4 9.1 15.7 12.7 9.3 16.1 No ↑

Females 25.0 21.4 28.7 30.7 26.3 35.1 Yes ↑

Have used and may do in future

Males 1.4 0.3 2.4 2.6 1.1 4.1 No ↑

Females 5.4 3.4 7.4 5.8 3.6 8.1 No ↑

Have used and will do in future

Males 1.2 0.0 2.5 2.7 1.1 4.3 No ↑

Females 1.2 0.3 2.0 2.4 1.1 3.7 No ↑

Figure 9. Sunbed use in males and females in 2011 and 2013

0

10

20

30

40

50

60

70

80

90

Males Females Males Females

2011 2013

%

Never used and never intend to

Never used but may do in future

Have used but will not in future

Have used and may do in future

Have used and will do in future

Significant differences between sexes for ‘never used’, ‘have used won’t again’ and ‘have used may again’ in 2011 and 2013

22


Sunbed use in 16-24 year olds was similar to patterns in the overall sample, with over 70% reporting that they had ‘never used sunbeds and never intend to’, around 10% reporting they ‘have used sunbeds but will not in future’, and a small proportion reporting that they ‘have used sunbeds in the past and will continue to do so in future’ (Table 14). There were no significant changes between 2011 and 2013 in this age group.

Table 15. Sunbed use in 2011 and 2013 in males and females


trend?

% 95% CI % 95% CI

Never used and never intend to 73.7 64.9 82.6 71.8 61.6 82.0 No ↓

Never used but may do in future 4.0 0.1 8.0 5.1 0.1 10.1 No ↑

Have used but will not in future 10.1 4.1 16.1 9.0 2.5 15.5 No ↓

Have used and may do in future 9.1 3.3 14.9 7.7 1.6 13.7 No ↓

Have used and will do in future 3.0 -0.4 6.5 6.4 0.9 12.0 No ↑

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5.5 Reported frequency of sunburn

Q4. Thinking back over this summer, how often did your skin tend to go red or get sunburn in strong sunshine?

1

1Responses:

Always Rarely

Usually Never

Sometimes

Results for the whole sample Around half of the sample reported that their skin had ‘never’ gone red or been burned in strong sun in the previous summer in both 2011 (52%) and 2013 (51%). Around 23-26% reported this had happened ‘rarely’ and about 17%-18% reported this happened ‘sometimes’ (Table 15). In both 2011 and 2013 only very small proportions reported that this ‘usually’ (4-5%) or ‘always’ (2-3%) happened and there were no significant differences observed between 2011 and 2013 in this whole sample. Table 16. Reported frequency of sunburn in strong sunshine over previous summer overall

2011 2013

Significant trend? % 95% CI % 95% CI

Always 2.5 1.6 3.4 2.2 1.3 3.1 No ↓

Usually 4.9 3.7 6.2 3.6 2.4 4.8 No ↓

Sometimes 17.7 15.5 20.0 16.8 14.5 19.1 No ↓

Rarely 22.8 20.4 25.3 26.0 23.3 28.8 No ↑

Never 52.0 49.0 54.9 51.4 48.2 54.5 No ↓

Comparing results for men and women Patterns of results by gender in 2011 were very similar to the whole sample (see Table 16) with half reporting their skin had ‘never’ gone red or been burned in the previous summer. There were no significant trends between 2011 and 2013 in women. However, significantly more men reported ‘rarely’ going red or getting burnt in 2013 than in 2011 (29% vs. 21%) and slightly less (significantly less), reported ‘never’ going red or getting burnt in 2013 than in 2011 (46% vs. 53%). There were no significant differences between men and women in either 2011 or 2013 for any responses.

Table 17. Reported frequency of sunburn in strong sunshine over previous summer, comparing males and females

2011 2013

Significant trend? % 95% CI % 95% CI Always

Males 3.6 1.9 5.3 2.4 1.0 3.8 No ↓

Females 1.7 0.7 2.7 2.0 0.8 3.2 No ↑

Usually

Males 5.1 3.1 7.0 3.1 1.8 5.2 No ↓

Females 4.8 3.2 6.5 3.7 2.1 5.3 No ↓

Sometimes

Males 18.1 14.7 21.6 19.2 15.6 22.8 No ↑

Females 17.4 14.5 20.4 14.8 11.8 17.8 No ↓

Rarely

Males 20.5 16.8 24.1 28.8 24.6 32.9 Yes ↑

Females 24.6 21.3 28.0 23.7 20.1 27.3 No ↓

Never

Males 52.7 48.2 57.3 46.2 41.6 50.8 Yes ↓

Females 51.4 47.5 55.3 55.7 51.5 59.9 No ↑

24


As was observed in men only, there was a significant increase in the number of 16-24 year olds who reported they had ‘rarely’ gone red or burnt their skin the previous summer, and a corresponding decrease in those who reported ‘never’ having gone red or burnt their skin (Table 17).

Table 18. Reported frequency of sunburn in strong sunshine over previous summer among 16-24 year olds

2011 2013 Signif?

% 95% CI % 95% CI

Always 1.0 -1.0 3.0 2.6 -1.0 6.2 No ↑

Usually 10.1 4.1 16.1 9.0 2.5 15.5 No ↓

Sometimes 23.2 14.8 31.7 21.8 12.4 31.2 No ↓

Rarely 19.2 11.3 27.1 33.3 22.6 44.0 Yes ↑

Never 46.5 36.5 56.5 33.3 22.6 44.0 No ↓

25

5.6 Reported personal incidence of sunburn in the UK

Q5: How many times did you get sunburn in the UK this summer? 1Responses:

I didn’t get sunburned (‘None’) Six to ten times

Once or twice More than ten times

Three to five times

Results for the whole sample There were no significant trends in reported personal incidence of sunburn in the UK between 2011 and 2013. While

around 40% of people reported ‘I didn’t get sunburned’ in both 2011 and 2013, around half reported that they had

been burned ‘once or twice’; 47% in 2011 VS 50% in 2013. Just 9% of people reported being burned ‘three to five

times’ in 2011 and 6% in 2013 (Table 18). Around 5% of people reported being burned at least 6 times in 2011 and

this figure was similar (4%) in 2013.

Table 19. Reported incidence of personal sunburn in the UK, overall


trend? % 95% CI

% 95% CI None 38.4 34.3 42.6 40.8 36.4 45.2 No ↑

Once or twice 47.2 43.0 51.4 49.7 45.2 54.2 No ↑

Three to five times 9.0 6.5 11.4 5.8 3.7 7.9 No ↓

Six to ten times 2.2 1.0 3.5 2.1 0.8 3.3 No ↓

More than ten 3.2 1.7 4.7 1.6 0.5 2.8 No ↓

Comparing results for men and women Results by gender were very similar to the whole sample. The only significant trend observed was in women only - there was a significant decrease in those reporting being burned more than ten times (Table 19). Only one significant difference between men and women was observed in 2011, with slightly more men than women reporting being burned ‘six to ten times’.

Table 20. Reported incidence of personal sunburn in the UK, comparing males and females


trend? % 95% CI

% 95% CI None

Males 37.5 31.1 43.9 42.9 36.7 49.1 No ↑

Females 39.1 33.7 44.5 38.7 32.4 44.9 No ↓

Once or twice

Males 42.9 36.3 49.4 45.3 39.1 51.6 No ↑

Females 50.3 44.7 55.9 54.2 47.8 60.6 No ↑

Three to five times

Males 11.2 7.0 15.3 6.5 3.4 9.6 No ↓

Females 7.4 4.5 10.3 5.0 2.2 7.8 No ↓

Six to ten times

Males 4.9 2.1 7.8 2.4 0.5 4.4 No ↓

Females 0.3 -0.3 1.0 1.7 0.0 3.3 No ↑

More than ten

Males 3.6 1.1 6.0 2.8 0.8 4.9 No ↓

Females 2.9 1.0 4.8 0.4 -0.4 1.2 Yes ↓

26


There were no significant differences in reported personal incidence of sunburn in the UK

between 2011 and 2013 in 16-24 year olds (Table 20). Over half reported they had been burned ‘once or twice’

(around 57% in 2011 and 56% in 2013). The second most commonly reported incidence of sunburn was ‘none’ (26% in

2011 and 27% in 2013; this difference was not significant). In both years around 10% (9% in 2011 and 12% in 2013)

reported being burned ‘three to five times’. In 2011 4% of people reported being burned ‘six to ten times’ and in

2013 this was 2%. In 2011 and 2013 4% of 16-24 year olds reported being burned ‘more than ten’ times.

Table 21. Reported incidence of personal sunburn in the UK among 16-24 year olds


trend? % 95% CI % 95% CI

None 26.4 14.1 38.7 26.9 14.5 39.4 No ↑

Once or twice 56.6 42.8 70.4 55.8 41.8 69.7 No ↓

Three to five times 9.4 1.3 17.6 11.5 2.6 20.5 No ↑

Six to ten times 3.8 -1.5 9.1 1.9 -1.9 5.8 No ↓

More than ten 3.8 -1.2 9.1 3.8 -1.6 9.3 No

27

5.7 Reported personal incidence of sunburn outside of the UK Q5: How many times did you get sunburn outside of the UK this summer?

1Responses:

I didn’t get sunburned (‘None’) Six to ten times

Once or twice More than ten times

Three to five times

Results for the whole sample There were no significant trends in reported levels of sunburn outside of the UK between 2011 and 2013. A high proportion of people reported ‘I didn’t get sunburned’ outside of the UK in both 2011 (65%) and 2013 (71%). About a quarter of people reported that they had been burned ‘once or twice’ outside the UK: 28% in 2011 and 25% in 2013. 5% in 2011 and only 3% in 2013 reported they had been burned ‘three to five times’, with around 1-2% reporting they burned ‘six to ten times’. In 2011 1% reported being burned ‘more than ten times’, reducing to less than 1% in 2013 (Table 21). Table 22. Reported personal incidence of sunburn outside of the UK, overall

2011

2013 Significant

trend? % 95% CI % 95% CI

None 65.3 61.3 69.3 70.7 66.6 74.8 No ↑

Once or twice 27.6 23.8 31.4 24.7 20.9 28.6 No ↓

Three to five times 4.5 2.7 6.2 2.9 1.4 4.4 No ↓

Six to ten times 1.5 0.5 2.5 1.2 0.2 2.2 No ↓

More than ten 1.1 0.2 2.0 0.4 -0.2 1.0 No ↓

Comparing results for men and women Patterns were very similar to the overall sample when examining men and women separately (see Table 22). No significant differences were observed between men and women in either 2011 or 2013. Table 23. Reported personal incidence of sunburn outside of the UK, comparing males and females


trend?

% 95% CI % 95% CI

None

Males 63.8 57.5 70.2 70.8 65.1 76.6 No ↑

Females 66.3 61.1 71.6 70.6 64.8 76.4 No ↑

Once or twice

Males 25.9 20.1 31.2 37.7 24.2 51.2 No ↑

Females 28.9 23.8 33.9 25.6 20.0 31.2 No ↓

Three to five times

Males 5.7 -0.8 12.1 5.8 -0.8 12.3 No ↑

Females 3.2 1.2 5.2 2.8 0.8 4.9 No ↓

Six to ten times

Males 2.2 0.3 4.1 1.6 0.3 3.2 No ↓

Females 1.0 -0.1 2.1 0.6 -0.2 1.5 No ↓

More than ten

Males 1.9 0.1 3.5 0.1 0.03 1.9 No ↓

Females 0.0 0.0 0.0 0.0 0.0 0.0 No

28


Overall patterns were similar to that of the whole sample with no significant changes observed from 2011 to 2013 (Table 23). Table 24. Reported personal incidence of sunburn outside of the UK among 16-24 year olds


trend? % 95% CI % 95% CI

None 54.7 40.9 68.6 59.6 45.8 73.4 No ↑

Once or twice 37.7 24.2 51.2 30.8 17.8 43.7 No ↓

Three to five times 5.7 -0.8 12.1 5.8 -0.8 12.3 No ↑

Six to ten times 1.9 -1.9 5.7 3.8 -1.6 9.3 No ↑

More than ten 0.0 0.0 0.0 0.0 0.0 0.0

29

Appendix

Survey response by year

Year 2003 2004 2005 2006 2008 2009 2010 2011 2013

TOTAL 3680 3547 3010 1178 1087 957 1082 1116 1003

n % n % n % n % n % n % n % n % n %

Male 1613

44 1551

44 1376

46 532

45 490

45 448

47 500

46 474

42 460

46

Female 2067

56 1996

56 1634

54 646

55 509

55 509

53 642

54 642

58 543

54

16-24 339

9 289

8 251

8 118

10 90

8 81

7 87

8 99

9 78

8

25-44 1307

35 1269

36 1038

34 352

30 354

33 298

27 342

32 358

32 305

30

45-64 1127

31 1084

31 946

31 395

34 353

32 318

29 336

31 351

31 340

34

65+ 907

25 905

26 775

26 313

27 290

27 260

24 317

29 308

28 280

28

Trends in awareness and behaviour relating to UV and sun ...Results for reported sun protection...

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Transcript of Trends in awareness and behaviour relating to UV and sun ...Results for reported sun protection...