Population and age-group trends in weekend sun protection and sunburn over two decades of the SunSmart programme in Melbourne, Australia

Summary Background  In response to the high skin cancer burden in Australia, the multicomponent, community-wide SunSmart programme has worked since 1988 to reduce excessive sun exposure. Objective  To examine trends in key sun-protection behaviours and sunburn for the Melbourne population from 1987 to 2007, and examine for the first time patterns of change among age groups. Methods  Representative cross-sectional weekly telephone surveys of weekend sun protection and sunburn were conducted over 11 of the summers in the period 1987–88 to 2006–07. Trends were analysed for the population and for age groups, adjusting for ambient temperature and ultraviolet radiation, which are environmental determinants of sun-related behaviour and sunburn. Results  The general pattern of trends suggests two distinct periods, one with rapid improvement in behaviours (more sunscreen use, less unprotected body exposure and less sunburn) from 1987–88 to 1994–95, and the second from 1997–98 to 2006–07 with fewer changes in behaviours noted. The age-group analyses showed a similar pattern of change over time across groups, with a few notable exceptions. Conclusions  The similarity of the pattern of trends among age groups suggests that external influences including the SunSmart programme’s activity had a relatively similar impact across the population. Sun-related behaviours continue to be amenable to change. More recent relative stability with some declines in sun protection suggests further intensive campaigns and other strategies may be needed to maintain previous successes and to achieve more universal use of sun protection.