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You’d think that skin cancer survivors would be hyper-vigilant about wearing sunscreen and staying out of the sun, but not always: More than 27 percent of people who’ve had melanomas removed say they don’t use sunscreen—and 2.1 percent have actually gone to a tanning salon recently, according to new findings presented earlier this week at the annual meeting of the American Association for Cancer Research.

Researchers analyzed data from the Center for Disease Control’s 2010 National Health Interview Survey, an annual, nationally representative survey of people in the U.S. that asks questions on a wide range of health topics. What they were looking for in particular: participants’ self-reported history of melanoma, as well as how that corresponded to their sun protection and indoor tanning habits.

Of the adults in the survey, 171 had a prior history of melanoma and 26,949 didn’t. “Using this very robust data source, we were able to determine that melanoma survivors in general do a better job on staying out of the sun, using sunscreen, and so on—but we still could be doing much better,” says study author Anees B. Chagpar, MD, an associate professor in the department of surgery at Yale University School of Medicine. Of the non-melanoma survivors, 35.4 percent of people said that they never use sunscreen. When you look at the flip side of that—how many people say they always use sunscreen—melanoma survivors also do better than people who haven’t had any of the serious skin cancers removed (32 percent versus 17 percent). But here’s the scariest part: When you control for other demographic factors like race and age, people who’d had melanoma were no less likely to say they’d visited a tanning salon in the last year than people who hadn’t had the disease.

“Truthfully, that blew my mind,” says Chagpar. “All of this really does raise the question of: Are there some behaviors like tanning that just may be habits that are very difficult to break?”

Whether or not indoor tanning is addictive, it is certainly dangerous—particularly for melanoma survivors, who are nine times more likely to get a subsequent melanoma, says Chagpar. While this group needs to be particularly proactive, people who haven’t had skin cancer in the past certainly aren’t off the hook when it comes to staying safe.

“The fact that over a third of people in general never wear sunscreen is problematic,” says Chagpar. “This study really sends a message to both groups that we really could be doing a much better job in terms of protecting ourselves from the harmful rays of the sun and certainly the harmful rays of indoor tanning salons.”

In addition to never, ever indoor tanning, you should apply SPF—the higher, the better—whenever you’ll be outdoors for an extended period of time, says Chagpar. You’ll also need to reapply it every few hours, and it’s a good idea to wear hats, long sleeves, and a long skirt or pants (if you can bear it).

“These are common sense public health messages that wev’e been sending for a long time,” says Chagpar. “I think this is simply a wakeup call that we know these answers, we just could be doing a better job of actually following them.”

More From Women’s Health:
Tanning Beds: Skin Cancer Kills
What’s Your Skin Cancer Risk?
The New Skin Cancer Fighter

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