Exploring the Relationship Between Sunscreen Use and Screen Time in American High School Students

Objectives: To determine the association between reported non-school screen time (i.e. phones, televisions, gaming devices, etc…) and sunscreen usage among American high school students grades 9-12.Materials and methods: Data from the Youth Risk Behavior Surveillance System (YRBSS), administered by the Centers for Disease Control and Prevention to high school students across the United States in 2019 were utilized. The cross-sectional analysis focused on high school students in grades 9-12 from public and private schools. Self-reported sunscreen usage and screen time were the primary outcome and exposure, respectively. Prevalence ratios (PR) for poor sunscreen usage associated with excess screen time were estimated using modified Poisson regression models, controlling for sex, age, and race/ethnicity. Effect modification by sex was assessed, considering potential differences in non-school screen time behaviors between boys and girls. Results: In both adjusted and unadjusted models, we found that the prevalence of poor sunscreen use among students reporting excess screen time was somewhat higher compared to those not reporting having excessive screen time (PR=1.12, 95% CI: 1.08, 1.16). Adjustment for age, sex and race/ethnicity did not change this result (P=1.12, etc). When stratifying by sex to assess possible effect modification, the PR was estimated to be 1.14 (95% CI 1.05, 1.23) for males and 1.10 (CI 95% 1.02, 1.18) for females. Conclusion: There is a weak cross-sectional association between excess non-school screen time and poor sunscreen use among American high school students grades 9-12. This association is independent of sex, age and race/ethnicity.