A Process Evaluation of the Skin Cancer Prevention Act (Tanning Beds): A Survey of Ontario Public Health Units

  • Jessica Reimann
  • Jennifer E. McWhirterEmail author
  • Andrew Papadopoulos
  • Kim Bergeron
  • Susan Flynn
  • Loraine Marrett
  • Thomas Tenkate
  • Cheryl F. Rosen
  • Cate Dewey
Original Paper


Evidence of the dangers of indoor tanning and its popularity, including among youth, led the Government of Ontario to pass the Skin Cancer Prevention Act (Tanning Beds) (SCPA) in 2014. This legislation includes prohibiting the sale of indoor tanning services to individuals under 18, requiring warning signs be posted, and other safety regulations. We collected information from Ontario Public Health Units to conduct a process evaluation of the SCPA to: understand legislation implementation; assess available evidence about compliance, inspection, and enforcement; and, note barriers and facilitators related to inspection and enforcement. Data was collected March–April 2018. All 36 Ontario Public Health Units were invited to participate in an online questionnaire about the SCPA. Questions covered complaints, inspection, and enforcement, and used both close- and open-ended questions. Participants from 20 Public Health Units responded to the questionnaire; a response rate of 56%. These agencies reported 485 facilities offer indoor tanning. Since 2014, there have been 242 infractions by tanning facility owner/operators related to the SCPA, with most being uncovered during non-mandatory routine inspections (n = 234, 97%), rather than mandatory complaint-based inspections (n = 8, 3%). Most infractions were related to warning signs (n = 201, 83%). No charges were issued for any infractions. Instead, providing education (n = 90, 62%) and issuing warnings (n = 33, 23%) were the most common enforcement strategies. SCPA amendments are needed, including mandatory, routinely scheduled inspections. In addition to providing education, fines may improve compliance. More resources are required for inspection and enforcement of the SCPA.


Skin Cancer Prevention Act Indoor tanning Enforcement Inspection Compliance 



We would like to thank those who participated in our questionnaire and members the Ontario Sun Safety Working Group for their input on data collection and questionnaire development.

Author Contributions

Author tasks were as follows: Study concept and design: JR, JEM, AP, KB, SF, LM, TT, CFR, CD. Acquisition, analysis, and interpretation of data: JR, JEM, CD. Drafting of the manuscript: JR, JEM, AP, CD. Critical revision of the manuscript for important intellectual content: JR, JEM, AP, KB, SF, LM, TT, CFR, CD. All authors have reviewed and approved the final version of the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jessica Reimann
    • 1
  • Jennifer E. McWhirter
    • 1
    Email author
  • Andrew Papadopoulos
    • 1
  • Kim Bergeron
    • 2
  • Susan Flynn
    • 3
  • Loraine Marrett
    • 4
  • Thomas Tenkate
    • 5
  • Cheryl F. Rosen
    • 6
  • Cate Dewey
    • 1
  1. 1.Department of Population Medicine, Ontario Veterinary CollegeUniversity of GuelphGuelphCanada
  2. 2.School of Rehabilitation TherapyQueen’s UniversityKingstonCanada
  3. 3.Cancer Care Prevention, Canadian Cancer SocietyTorontoCanada
  4. 4.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  5. 5.School of Occupational and Public HealthRyerson UniversityTorontoCanada
  6. 6.Dermatology CentreToronto Western HospitalTorontoCanada

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