Why Don’t They Want to Wear Sunscreen? an Observational Study of Anti-Sunscreen Messaging on TikTok

Introduction The incidence of melanoma among younger patients is increasing. This demographic often turns to social media for information and connection. This observational study aims to quantify the prevalence of anti-sunscreen sentiments on TikTok and analyze their content and communication style. Methods Videos tagged #nosunscreen on TikTok were collected in July 2024. Reviewers gathered video characteristics such as username, user profile (individual or organisation), date posted, captions, length, number of followers, likes, views, shares, and comments, presence of sponsorship, and filming location. User demographics were noted. Reviewers also noted communication styles and other video characteristics such as the use of audio memes or music. Users’ opinions about not wanting to wear sunscreen were collected and analysed. Spearman’s correlation coefficient, Chi-squared test, and Phi coefficient were calculated between variables. Results 321 English language TikToks were selected. The majority (38%) were posted in 2023. Average video length was 25 seconds. Mean number of followers was 90,053 (SD 324,640). Mean number of views, likes, and comments was 73,121 (SD 408,245), 5,250 (SD 31,772), and 51 (SD 203), respectively. Only 12 videos included product sponsorship. Female (78%) predominance was observed and 19% showed a person belonging to a visible ethnic minority. 45% of videos used music and 30% used audio memes. 32% were filmed outdoors, mostly the backyard or the beach. In 44% of videos, a sunburn was shown. Almost half of the videos (41%) provided explicit sunscreen sentiments. Common reasons for not wearing sunscreen included personal preferences, trends, perceived natural sun exposure benefits, sunscreen being viewed as unnecessary and/or harmful, alternative forms of sun precaution, and the desire to tan. 42% of videos conveyed sarcasm and/or irony. Anti-sunscreen stances were strongly associated with a lack of regret for not wearing sunscreen (p<0.001). Conclusion TikTok videos tagged with #nosunscreen highlight the alarming prevalence of anti-sunscreen sentiments.