Twenty-eight percent of teenage girls and 7 percent of boys reported using tanning booths three or more times, the nationally representative study found. Forty-seven percent of girls aged 18 and 19 reported use that frequent.
"Teenagers may think they look good now, but the sad part is that by the time they reach 60, their skin will look like a leather bag and they'll be paying a dermatologist to try to reverse the damage," said Dr. Ted Daly, director of pediatric dermatology at Nassau University Medical Center in New York, who was not involved in the study.
The study and an accompanying editorial appear in the September issue of Archives of Pediatrics & Adolescent Medicine, published Monday.
The Case Western Reserve University researchers analyzed data from 6,903 white teens who answered questions in a separate national survey on adolescent health in 1996.
Indoor tanning was most popular in the Midwest, where sunny weather is limited, and the South, where heat and humidity might make outdoor tanning uncomfortable.
The study's lead author, Case Western researcher Catherine Demko, said there's evidence that indoor tanning might contribute to the risk for malignant melanoma, the most serious kind of skin cancer.
Indoor tanners also were more likely to smoke, drink or use marijuana than paler adolescents, the researchers said.
"Tan skin beats a healthy vampire glow every time," said Dr. Robert Dellavalle, a Denver dermatologist. He wrote an accompanying editorial proposing a $20 tax per tanning session for kids under 18, which he said might help curb demand and increase funds for more skin cancer awareness campaigns.
"Since youth represents an especially critical period during which UV radiation increases skin cancer risk, altering tanning behavior of minors is a prime target of skin cancer prevention efforts," Dellavalle said.
Many teens are attracted to tanning booths because salons promote them as being safer than natural sunlight, which isn't true, Daly said.
"An occasional visit to the tanning booth may not be so bad, but teens should not go on a weekly basis or over the long-term," he said.
Magda Spisak, 18, a student at Harper College in suburban Chicago, said she used to go to tanning booths every few weeks — not because she thought it was safe but because "it's the fashion right now."
She said she stopped recently because it dried out her skin and because she worried about skin cancer.
Torea Frey, 19, a Northwestern University student, said she used tanning salons frequently when she was a high school cheerleader, but stopped when she quit cheerleading and no longer thought it was necessary to be tan. She also worried about a family history of skin cancer.
"I live in Oregon, so there's not much sun to be had," said Frey, of Portland. "It was just kind of the thing that everyone on the team did, so I did it, too."
The Indoor Tanning Association, which represents owners of tanning booths and salons, criticized the study and editorial and disputed any connection between deadly skin cancer and tanning beds.
Dan Humiston, association president, said recent studies have suggested that many teens may have a vitamin D deficiency, which can be caused or aggravated by a lack of adequate sun exposure.
Ultraviolet rays interact with chemicals on the skin to produce vitamin D.
But experts say the amount of UV exposure required for vitamin D benefits is far less than the average tan-seeking teen spends in sunlight or in tanning salons.