A study from the USA has provided further evidence that some people who tan excessively are tanning dependent.The study recruited 400 volunteers from an American university, who were asked to complete an online questionnaire that had been modified to identify tanning dependence (modified CAGE and DSM-IV-TR scales). The mean age of participants was 21 years, 75% were women and 66% were white. 'Despite extensive public health education about the risks of excessive exposure to ultraviolet radiation, some people continue to tan excessively. Similarities between excessive tanning and substance use disorders are increasingly being discussed. Both are particularly common in the young, associated with pleasurable reinforcing experiences such as relaxation and socialisation and represent health risk behaviours that continue despite health warnings. A possible mechanism, linking tanning to endogenous opioid release during ultraviolet radiation exposure, has been mooted.The concept of tanning dependence may be new to many GPs and may  help them provide health education for those who continue to tan excessively.'