Sun protection behaviours

Ultraviolet (UV) radiation from the sun is both a beneficial source of vitamin D and the major cause of skin cancer in Australia[1]. Sun protection behaviours are needed to balance the risk of skin cancer from exposure to UV radiation while maintaining adequate levels of vitamin D. Unlike sunlight and heat, we can’t see or feel UV radiation and there can still be significant UV radiation on cold or cloudy days. The UV Index is a measure of the intensity of the sun’s UV radiation, which varies by time of day, time of year and geographic location[2].

Given the broad geographic range of Australia, each state and territory has unique UV and weather environments. This may influence the risk of experiencing sunburn, and also the sun protection behaviours that people implement[2].

Whenever the UV Index is 3 or higher, the Cancer Council Australia recommends sun protection behaviours to help prevent damage to skin and reduce the risk of cancer by being SunSmart. Sun protection behaviours are also recommended when the UV Index is below 3 if spending an extended period of time outdoors, or near reflective surfaces such as snow. While the current SunSmart recommendations are to use SPF50 or higher sunscreen, at the time of collection the recommendation was SPF30 or higher[3].

The sun protection behaviours collected in this survey include:

• using SPF30 or higher sunscreen
• wearing a broad brimmed hat or cap with a back flap
• staying in the shade
• wearing clothing or swimwear that covers at least three quarters of arms and/or legs
• wearing sunglasses.

Individuals’ skin type and skin sensitivity to sun exposure can influence sun protection behaviours and associated health risks[4]. The Sun protection behaviours survey asked respondents how sensitive their skin was to burning and tanning. One in four (24.6%) people aged 15 years and over in Australia reported they would ‘just burn and not tan’ after 30 minutes of sun exposure, and one in three (32.9%) people would ‘burn first then tan afterwards’.

Over half (57.4%) of Australians reported they would burn after 30 minutes of sun exposure. People living in Tasmania (63.4%), SA (62.6%) and the ACT (61.5%) were more likely to report burning after 30 minutes of sun exposure compared to all Australians (57.4%).

Using sunscreen is important to reduce the risk of skin cancer, especially when used in conjunction with other sun protection behaviours. Cancer Council Australia recommends that sunscreen should be applied regularly on days when the UV index is forecast to be 3 or above[3].

Between November 2023 and February 2024, almost two in five (38.1%) people aged 15 years and over used sunscreen on most days in the last month. Females were more likely than males to wear sunscreen on most days (48.8% compared to 27.0%), across every age group.

People aged 65 years and over were less likely to use sunscreen on most days than those aged 35–44 years (27.4% compared to 45.5%); however, they were also less likely to be in the sun during peak UV times in the last week (51.1% compared to 65.2%).

Females aged 35–44 years were more likely to use sunscreen on most days than males the same age (60.0% compared to 31.8%).

Between November 2023 and February 2024, Australians were less likely to use sunscreen on most days in the last month if they were:

• born in Australia (36.2% compared to 41.8% of those born overseas)
• living in Outer Regional and Remote Australia (34.8% compared to 39.8% of those living in Major Cities)
• unemployed (32.6% compared to 41.0% of those who were employed)
• living in areas of most disadvantage (32.5% compared to 44.3% of those living in areas of least disadvantage).

Over a quarter (26.6%) of people who reported they would ‘have nothing happen’ to their skin after 30 minutes of sun exposure used sunscreen on most days, compared to 43.6% of those who ‘just burn and not tan’ after 30 minutes of sun exposure.

One in two (49.2%) people in the ACT used sunscreen on most days in the last month, higher than the proportion of all Australians (38.1%). Just over one in three people in Queensland (35.3%) and SA (35.4%) used sunscreen on most days, lower than the national proportion (38.1%). Females were more likely than males in every state and territory to use sunscreen, with the exception of NT where the difference was not significant.

Sun protection recommendations during peak UV times aim to help to prevent damage to skin and reduce the risk of cancer by being SunSmart[3]. For this survey, the peak UV time for states and territories was from 11am–3pm for NSW, Victoria, SA, Tasmania and the ACT. Queensland, WA and the NT do not have daylight savings and therefore peak UV times were from 10am–2pm.

Six in ten (60.6%) Australians spent more than 15 minutes outdoors during peak UV times in the past week during November 2023 to February 2024. Males were more likely to spend time outdoors in peak UV times than females (64.8% compared to 56.6%).

Of those who were outside in the sun during peak UV times for more than 15 minutes in the last week, on their most recent time exposed to sun:

• 63.7% wore sunglasses
• 55.6% stayed in the shade
• 51.0% wore a broad brimmed hat or cap with a back flap
• 49.4% used SPF30 or higher sunscreen
• 38.4% wore clothing or swimwear that covered at least three-quarters of legs and
• 34.7% wore clothing or swimwear that covered at least three-quarters of arms.

While SunSmart recommendations include five key sun protection behaviours which align with those listed above[3], not everyone reports implementing all the behaviours. However, half (53.9%) of Australians who were recently exposed to the sun during peak UV times implemented three or more sun protection behaviours on their most recent exposure.

Females were more likely than males to implement three or more sun protection behaviours (58.1% compared to 50.4%).

Between November 2023 and February 2024, people who spent more than 15 minutes outdoors in peak UV times in the last week were more likely to implement three or more sun protection behaviours if they:

• would ‘just burn and not tan’ after 30 minutes of sun exposure (62.1% compared to 40.2% of those for whom ‘nothing would happen’)
• were living in Outer Regional and Remote Australia (60.1% compared to 52.7% of those in Major Cities)
• had a Bachelor degree or above (59.2% compared to 46.1% of those whose highest educational attainment was Year 11 or below)
• were living in areas of least disadvantage (55.6% compared to 49.7% of those living in areas of most disadvantage).

Too much exposure to UV radiation from the sun can result in sunburn. Sometimes the damage to the skin is not evident until hours later. If there is long exposure with a high UV index, it is possible to have blisters with second and third degree burns[5].

One in fourteen (6.9%) people aged 15 years and over reported getting sunburnt in the week prior to the survey, during November 2023 to February 2024. Younger people were more likely to experience sunburn, with 15.2% of people aged 15–24 years experiencing sunburn compared to 2.0% of people 65 years and over.

Males were more likely to be sunburnt than females (7.9% compared to 6.0%). This was particularly true for those aged 25–34 years, where 12.0% of males experienced sunburn compared to 6.4% of females.

Australians who were more likely to experience sunburn in the last week between November 2023 and February 2024 include those:

• born in Australia (8.2% compared to 4.2% of those born overseas)
• living in Inner Regional Australia (8.7%) compared to those who live in Major Cities (6.6%) or Outer Regional and Remote Australia (5.7%)
• employed as sales workers or labourers (11.8% and 10.2%) compared to 4.9% of managers.

Tasmanians were more likely to experience sunburn in the last week compared to all Australians (11.3% compared to 6.9%). In Queensland, males were more likely to have experienced sunburn in the last week than females (10.5% compared to 5.5%).

Attitudes towards getting a suntan through sun exposure are one of the biggest barriers to more people adopting sun protection behaviours[6].

Almost one in ten (9.4%) Australians attempted to get a suntan in the last twelve months. Females were more likely to attempt suntanning than males (11.5% compared to 7.1%).

Australians who were more likely to attempt suntanning include those who:

• would either ‘burn first then tan afterwards’ or ‘not burn at all, just tan’ after 30 minutes of sun exposure (13.1% and 11.7%) compared to 4.2% of those who would ‘just burn and not tan’
• were living in Major Cities (10.6%) compared to those living in Outer Regional and Remote areas (4.1%)
• were born in Australia (11.2%) compared to those born overseas (5.7%)
• were living in areas of least disadvantage (13.4%) compared to those living in areas of most disadvantage (8.3%).

When compared to all Australians, people living in NSW were more likely to attempt suntanning (10.9% compared to 9.4%) and people living in the NT were less likely (4.2% compared to 9.4%).

Skin cancer risk increases with a history of sunburn and tanning, and getting sunburnt earlier in life may be a particularly important risk factor[7]. Younger Australians aged 15–24 years reported different sunburn and tanning behaviours compared to older Australians. Compared to people aged 65 years and over, people aged 15–24 years were more likely to:

• be outdoors for 15 minutes or more during peak UV times in the last week (66.1% compared to 51.1%)
• experience sunburn in the last week (15.2% compared to 2.0%)
• attempt suntanning in the last 12 months (20.6% compared to 3.3%).

Of those who were outdoors in peak UV times, young Australians were less likely to implement three or more sun protection behaviours than those aged 45–54 years (39.4% compared to 61.6%).

There were also differences between the behaviours of younger males and females aged 15–24 years, with young females more likely to:

• attempt suntanning (26.0% compared to 15.3%)
• implement three or more sun protection behaviours (46.2% compared to 33.2%).

Despite this, a similar proportion of males and females aged 15–24 years were sunburnt in the previous week.

1. Cancer Council, ‘Vitamin D’, https://cancer.org.au/cancer-information/causes-and-prevention/sun-safety/vitamin-d; accessed 19/08/2024.
2. Cancer Council, ‘UV Index’, https://cancer.org.au/cancer-information/causes-and-prevention/sun-safety/uv-index; accessed 19/08/24.
3. Cancer Council, ‘Be SunSmart’, https://cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart; accessed 19/08/2024.
4. Cancer Council Victoria, ‘Skin cancer’, https://www.cancervic.org.au/cancer-information/types-of-cancer/skin_cancers_non_melanoma/skin-cancer-overview.html; accessed 19/08/2024.
5. Better Health Channel, ‘Sunburn’, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sunburn; accessed 19/08/2024.
6. Cancer Council, ‘Why we need to end the trend’, https://cancer.org.au/end-the-trend/why-we-need-to-end-the-trend; accessed 19/08/2024.
7. Cancer Council, ‘Risk factors/epidemiology’, https://cancer.org.au/about-us/policy-and-advocacy/prevention/uv-radiation/related-resources/risk-factors-epidemiology; accessed 19/08/2024.