Dec. 5, 2009 -- Keeping that healthy, sun-kissed glow year-round just got a little bit pricier. Health care legislation passed by the Senate last week calls for a new, 10 percent tax on the use of tanning beds. Analysts expect the tax to net $2.7 billion over the next decade.
Salon owners greeted the news like a gloomy weather report -- but no one thinks a few extra dollars is going to come between diehard tanners and their bronzing. Legislators in favor of the new tax cited health concerns. The industry itself, however, couldn't be healthier.
"I think tanning beds became popular in part because you could ... continue the tan all year long," said Kate White, editor-in-chief of Cosmopolitan magazine. "A tan makes you look sexy and glamorous, and thin, too."
In the past 30 years, indoor tanning has become hugely popular. A recent study by San Diego State University found that in some cities there are more tanning salons than McDonalds or Starbucks. Every day, 1 million people tan indoors. They spend $5 billion a year.
But indoor tanning does not come without controversy. This year, the World Health Organization classified tanning beds right up there with the sun as a definite cancer risk.
In a joint investigation with Cosmopolitan magazine, "20/20" visited tanning salons across the country with hidden cameras to see if employees would handle health risks with customers -- especially cancer.
Here's what one salon told us:
Q: I heard recently something about indoor tanning causing cancer -- is that something I have to worry about?
A: Well that's burning, it's the same as being outside. If you got a sunburn in here, it wouldn't be as bad as being outside.
"20/20"asked Chicago dermatologist Dr. Carolyn Jacob to review the hidden camera tapes. She said that getting a sunburn is bad no matter where you get it.
"20/20" and Cosmopolitan visited salons in five states and encountered similar misinformation when it came to serious risks.
Q: I've heard how you can get cancer from indoor tanning beds -- is that something I should be worried about?
A: Umm, I don't know -- it's up to the person. A lot of people go tanning ...
Q:Like, how often can I come, with my skin tone?
A: Um, It's up to you. You could come every day if you want, you just can't tan two times in one day. You could come every other day ...
Q: But it's safe to come every other day or every two days even if you're fair skinned?
A: Yeah ...
At one tanning salon, the clerk sets the tanning bed to run for more than twice the recommended length. Our tester questions her.
Q: ...[the] recommended exposure time for fair skin, says three minutes.
A: I mean that won't give you any coloring at all.
'I Didn't Even Think About It'
Jacob found the exchange disturbing.
"Well, that's frightening," said Jacob. "Firstly, she is showing her the bed and saying that, 'No, don't even bother with the three minutes, you won't get a tan. I'm going to put you in for more than double that time.' The other thing is, she told us she could come in every day for tanning -- that is really going to damage the skin much quicker, and if you can do that indefinitely and they're giving those as guidelines to the patients, it's very, very scary."
"The people that I see that still go tanning are in their late teens, early 20s. They know -- 'Well, I've heard it's probably not so good for my skin, but since I'm young, it's OK,'" said Jacob.
That's what 22-year-old Amanda Ahrens said to herself. She started using tanning beds at age 14. By age 19, she had melanoma, the deadliest form of skin cancer.
"I didn't even think about it," Ahrens said. "I looked good and I, you know, I got sort of addicted to that feeling that -- you know -- I look good."
Amanda and her mother would tan together before vacation. By age 17, Amanda was working in a tanning salon. She'd tan four to five times a week. One day she noticed a mole on her back that had changed over time. She had it checked out by her doctor.
"It was scary, 'cause they tell you, 'We found something. You need to come on in and we need to talk about it,'" Amanda recalled, choking back tears.
Amanda said she would never forget hearing the words, "We found melanoma."
"Of course I was scared to death. Its cancer, you know? That's scary," she said. "So that's hard to hear. I had to keep telling myself, 'I'm young, I can get through this. This is no problem.'"
The number of young women diagnosed with melanoma is 50 percent higher today than it was 30 years ago, and skin cancer is the most common type of cancer in young adults ages 25-29.
"Don't take your medical advice from someone who works at a tanning booth," said Jacob. "Ask your dermatologist."
Salons Tout Vitamin D Benefits of Indoor Tanning
"20/20" found that salons often played up the "benefits" of tanning. They claim it's good for you, healthy, because it's a source of vitamin D.
Salon No. 1: Tons of people do it for just vitamin D.
Salon No. 2 : It's actually healthy for you because it produces a lot of vitamin D and makes your bones strong.
Salon No. 3: Yeah, actually, the big thing now, if you go on like ABC.com or anything, there was this huge new thing, like have you ever heard of Dr. Oz? From like literally like five minutes you get 5,000 milligrams. So, he recommends people that don't get to go outside to tan, it's like the new thing. But, in moderation. Like, you couldn't go in the bed for 15 minutes, you know what I mean?
The salons are not alone in touting Dr. Oz's support of vitamin D. The industry's trade group highlights Oz on its Web site. So "20/20" decided to ask Dr. Oz directly.
"The tanning bed is a terrible idea for just getting vitamin D ... all the data that we're seeing continues to reflect an increased danger of lying in a tanning bed," Oz said. "And so it's very difficult for me to endorse this to anybody out there and I won't let my own kids go to tanning salons. If your goal is to get vitamin D which is a very admirable goal, take… [a vitamin] pill or go out and get real sun."
Daniel Humiston is the head of the Indoor Tanning Association and owns a chain of salons himself. It was news to him that Dr. Oz would not support indoor tanning.
"I'm surprised, because I know Dr. Oz has been a big advocate of ultraviolet light exposure, and the production of vitamin, as, as the way it re-, produces vitamin D," said Humiston. "And he's been a big, big advocate, advocate of that."
A few minutes of natural sun can't be duplicated, Oz said. Bu that's not what the tanning industry says. Humiston claims tanning beds are safer than the sun because you're less likely to burn in their controlled environment. And yet, despite warnings from top cancer experts, he insists there's no conclusive scientific proof that indoor tanning increases the risk of melanoma.
"The only thing I can say is that, you know, they've not always been right," Humiston said.
Then there's the issue of our first-time tanners being told they could come every day to tan.
"I would be discouraged if I heard that they were taking someone that just, just had never tanned before, and said they never tanned before, and they recommended beyond where they should be recommending," Humiston said.
Chang asked Humiston about young tanning salon employees giving false information and if the tanning industry should do something about all the misinformation.
"If it's as prevalent as what you, as what was, as what we're finding out through your investigation, you know, maybe we could do a better job," he said.
Amanda Ahrens wishes that she could take back the years she spent baking under tanning lamps.
"Tanning beds caused this and I had no idea," Ahrens said. "They tell you this may cause skin cancer, but do you really think it's going to? Of course not. So I, I learned that yes, it does."
Ahrens said now she never leaves the house without sunscreen and lives in fear that her cancer could return.
Chang asked Ahrens what she would say to young people who think there's no link between tanning beds and cancer.
"I show them my scar," Ahrensa said. "They just really don't know the true dangers involved with tanning beds ... and what it can do to you in the moment, as well as the rest of your life."
Watch the investigation on "20/20" Friday at 10 p.m. ET