From Clinic to Capitol: Tips for Building Grassroots and Legislative Support For Anti-Tanning Policies in Your State

Dermatologists are considered the first line of defense when it comes to educating the public about the dangers of unprotected exposure to ultraviolet (UV) light. While many of us have a unique opportunity to reach our patients daily about the importance of UV avoidance in our individual practices, public awareness efforts on this issue encompass a much broader sweep. The reality is that we are up against an indoor tanning industry that’s armed with both commercial and financial might. This may render our mission to educate patients and the public at large a greater challenge, but a more urgent one as well.

Outside of the office, one venue where dermatologists are becoming more involved on the issue of indoor tanning in particular is at the level of local and state government. Though it is not an easy task to shepherd legislation through state assemblies, it is nonetheless an area where our clinical standing can have some influence. Ahead I will offer some reflections on both legislative and grassroots efforts from my own experience in my home state of Pennsylvania, with the hope that it may provide some insight on how you can get involved in your state.

Building Relationships That Matter

As you set off to achieve action on curbing indoor tanning, one of the most important factors that will help you gain focus of the issue is to recognize what you specifically are trying to accomplish. For instance, a complete ban of indoor tanning would be ideal but not feasible. Thus, it’s important to first identify how you can achieve realistic, but meaningful action. Based on the laws we’ve already seen passed, you can either pursue strengthened parental will go to a committee. The health committee might be the best place for it to land, but this will vary by state. Wherever your proposal turns up, this would is the best time begin educating members of the legislature and take the pulse of the group as to where key members stand. That is partially why it is crucial to have a bill sponsor with some sway, either in her or his own party or on individual committees.

As these events play out, begin thinking about the specific language you wish to include in the bill. Determine what exactly you’re hoping to achieve and what you’re willing to compromise on, versus what you will remain steadfast on. For example, consider questions that will help you gain a strong sense of the bill’s core elements. These might include:

• Do you want an under 18 ban vs. parental consent?
• Do you want to require licensing or registration of all commercial tanning salons?
• What type of penalties are you looking for with the bill?
• What agency do you envision being the enforcing body?

The answers to these questions will depend on the way your state’s bureaucracy is structured. After all, melanoma may not be a partisan issue, but public policy is very partisan. Any time that you’re dealing with a legislative effort, partisan politics become a major factor. For instance, a well-intentioned “white hat issue” bill can be derailed for any number of reasons ranging in substance. Sometimes the opposing party will obstruct the bill and use that position as a means to leverage support for another issue or bill that’s important to them.

Whatever the reason might be for holding up the bill, don’t get too bogged down by the inevitable frustration of the process. Wading into the murky waters of partisan politics may not be desirable, however, surveying the philosophical divides and coalitions within the party systems is nonetheless a wise endeavor because it keys you in to the rhythms of politics and may instruct you on how and when to strike on an issue. Savory or not, there are nuances to how government functions that require attention if you expect to accomplish meaningful action on an issue that means something to you.

Timing is another crucial element and unspoken factor of the political process. It’s never easy to read when is the right time to introduce a bill or press it through committees, but it’s worth noting that without the right timing even a good bill with a lot of support can fail. That’s why it is essential to influence key individuals at critical times for a bill. For instance, for bills that start in a committee, it’s important to have influence on the committee chair. Even if a bill has broad support from the committee members, the chair is ultimately responsible for deciding if the bill comes up for a vote at all. After that process is over, your relationship with the House and Senate majority leaders will be key. Whether the bill comes up for a vote or lands in another committee may depend on your relationships with those key figures. And if the bill should ever come to a vote, the most essential component is having influenced key members along the way.

Grassroots Support and Other Tools

Influencing the political process can broken into three categories. The first is direct influence of members of the legislature, which I’ve just addressed. The other two wings of the process reside outside the capitol building and involve efforts to put pressure on members to support a piece of legislation. The first of these is public influence, which encompasses many forums of media to foster public outcry for the cause. In addition to newspaper editorials and press conferences, social media can be very powerful tool in this regard, as well. Powerful though these outlets can be, to reach a point at which these efforts can gain real traction requires the third wing of political influence: Grassroots.

Here are some of the avenues I’ve found particularly helpful at the grassroots level:

1. Melanoma advocacy groups clinics. Advocacy groups that have access to patients and families who’ve had melanoma. These folks can tell a very powerful story. Within these groups are also a bevy of healthcare workers, from fellow physicians to oncology nurses, most of who are deeply committed to supporting good health policy. University or melanoma clinics also have many individuals and families that have dealt with melanoma in some capacity.
2. Schools and Other Educational Venues. Giving lectures at your local school to kids about the dangers or UV light and tanning can be very helpful. In addition, you can send information and handouts home to parents. In general, teachers and educators are usually strong advocates and interested in the safety of children. Therefore they can be strong allies in building support. Other educational venues include free screening tours, which allow you to see a large numbers of patients and garner grass root support. Moreover, it tends to invite media attention.
3. State and National Organizations. Partner with your trusted state and national organizations, including the American Academy of Dermatology or your state medical society. They have available tools to help design and send en masse grassroots alerts to the dermatologists in your state.
4. Your Practice. As a dermatologist, you have a captive audience: Your patients. People respect their individual physician, so having that influence is powerful. There are many ways you can reach patients, whether that’s mentioning it to each new patient or having an informative poster in your waiting room. If you have a patient that is responsive to the message—usually those that have been touched by melanoma in some way—you can encourage them to take action or perhaps write a letter that you plan to submit to your state assemblies.

Be Patient and Keep it Simple

Although any of these efforts—whether at the legislative or grassroots levels—are time-consuming, they are needed now more than ever. The Indoor Tanning Association and other similar groups such as American Sun Tanning Association have not let up on opposing restrictions on indoor tanning. In fact, they are actively trying to dispel our facts as myths. As dermatologists, we know the data and the reality. We see patients that have personal stories and we are the experts in the eyes of the public. In some ways, our commitment to this issue is like a reverse conflict of interest. We’re advocating essentially for less business in effort to facilitate good overall health. That’s part of the ethos of being a doctor. It’s not just about treating patients but spreading a good health message. Every major effort to successfully curb tanning has had dermatologists behind it, and that is why it is important to become as involved as you can, whether that’s influencing those within government or building support and increasing education to bolster the cause for action.

No matter which road you take in building support for the cause, it’s almost certain to be a grueling journey. But keep in mind that if you lose, you also win. That’s because every time you advance the issue and make it visible to lawmakers and others, you’ve created a conversation and boosted awareness. In a more pragmatic sense, if your bill is defeated, take solace in the fact that you’ve made inroads, that you know the territory more, and that when the timing is right it can find better success in the future. After all, many of the existing laws passed that restrict indoor tanning failed previously before finally getting over the hump.

The increasing number of states that are either introducing or passing laws is unlikely to trigger a “domino effect,” as we might wish, but nevertheless state legislators do look to other states sometimes to gain a sense of a the political climate. It is conceivable, then, that increased movement on the front of stricter tanning regulation across the board may place indirect pressure on politicians to see it as a viable issue on which they do not want to fall behind the curve in their own state. And remember that the worst thing about politics is also the best thing: If you are not happy with the current leadership, elections change that leadership. Sentiments can change and bring new political winds, which can provide renewed initiative and opportunity for action.

In the end, no matter how involved you become in any effort to clamp down on indoor tanning, never forget to examine the elements of a situation and identify conditions that are most favorable to action. This partially means tailoring your message to how it affects the individual lawmakers you are trying to influence and keeping that message simple. In other words, speak their language and make your cause relatable. Sometimes, a physician is not enough; some legislators may be more moved by hearing the testimonial of someone who’s been affected by melanoma from tanning. That’s why having a strong grassroots network is essential, as well.

Politics can be messy, but if you’re willing to do the legwork, the results may yield meaningful and substantive changes in the interest of better public health. Through the process it may be hard for us to separate emotion from strategy. Many of us are deeply passionate about this cause, and while that passion fuels our action, the actions themselves should be carefully considered. It may not always bring success when you want it or the way you envision, but success is possible. And that, ultimately, is why we should all be encouraged to participate in these efforts in our own states.