A page in a section entitled "FACT AND FICTION" on the website www.indigosun.co.uk, for a chain of tanning salons. The page related to a study into the link between sunbed use and the risk of developing skin cancer.
Text stated, "A study from the UK shows: No link between tanning sessions and an increased risk of skin cancer. Press Release. Sunbeds cause skin cancer - is this really the case? It is a widely held belief that the use of sunbeds increases the risk of developing skin cancer. But now a large-scale study carried out by the University of Leeds in the UK is showing how the opposite is in fact true ... The study showed no evidence of a link between sunbed use and an elevated risk of skin cancer".
SunbedbanUK, who believed the study referenced had been used out of context, challenged whether the ad misleadingly suggested that there was no link between sunbed use and the risk of developing skin cancer.
Indigo Sun Retail Ltd said that the ad was based on a report published by Leeds University, and provided a copy of the report. They said that the report stated that no evidence had been found between sunbed use and melanoma risk.
Indigo Sun said their website posed the question of whether there was a link between sunbed tanning and an increased risk of skin cancer and that the ad merely put forward the case that there was no link based on the report by the University of Leeds. They said their claim was made based on many previous large-scale studies which came to the same conclusion. They said that although those studies included many European countries, the Leeds report was more relevant for their customers because it was UK-based. They said the report was not a blip, but that it should be borne in mind that all reports on this subject emphasised the difficult nature of the subject due to factors affecting the results such as sun exposure, skin type, age, moles and recall bias.
In response to the complainant's belief that the report had been used out of context, Indigo Sun said that that suggestion was not credible because any reasonable person would conclude from a large study that no evidence of a link to an elevated risk existed, although other studies had different outcomes. In order to further substantiate their claim, they provided three additional studies which they said demonstrated that there was no evidence of a link between sunbed-use and skin cancer.
The ad stated that a study had shown no link between tanning sessions and an increased risk of skin cancer. The study would therefore need to relate directly to that claim and to be sufficiently robust in demonstrating the lack of such a link in order to substantiate the claim.
The ASA noted that the Leeds report, and the other studies provided, all focused specifically on melanoma, but not other types of skin cancer. We noted that malignant melanoma was the least common of the three main types of skin cancer, and considered that the studies did not relate to the claims made in the ad.
The Leeds report was a discussion of several papers in the form of a letter to the Editor of a journal. Because we were unable to assess the data in full from the trials referenced in that paper, we did not consider it was adequate substantiation for the claims in the ad. Furthermore, we identified limitations in the additional studies, some of which were acknowledged by the authors, which meant we were unable to draw firm conclusions from them. One of the studies stated that the results could have been affected by recall bias and selection bias in the control group. It went on to state that regular sunbed use was harmful in terms of developing non-melanoma skin cancers, with significant morbidity and health costs. Another study acknowledged that the true impact of sunbed exposure was uncertain, and that the increase in sun exposure and sunbed use in Caucasian populations over the previous 20 years may have a significant effect on the melanoma risk in the years to come.
We also understood that various UK organisations such as the NHS and Cancer Research UK advised that UV rays emitted from sunbeds increased the risk of developing skin cancer, both malignant melanoma and non-melanoma.
Given the lack of robust evidence, the limitations identified in the studies, the fact that they did not relate to the claims made in the ad, and the omission of information about official advice that contradicted the claims, we concluded that the claims in the ad had not been substantiated and were misleading.
The ad breached CAP Code (Edition 12) rules
Marketing communications must not materially mislead or be likely to do so.
Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means. (Misleading advertising), 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation), 13.3 (Exaggeration) and 12.1 12.1 Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease. (Medicines, medical devices, health-related products and beauty products).
The ad must not appear again in its current form. We told Indigo Sun Retail Ltd to ensure that their advertising did not mislead as to the link between sunbed-use and skin cancer.