A World Wide Web–based survey of nonmedical tattooing in the United States

To the Editor: In the United States, recent surveys suggest an increasing prevalence of non-medical tattooing in younger age cohorts compared to surveys performed only a few years earlier 1. Given the high use of the internet by young adults, we sought to estimate the current national prevalence of non-medical tattoos using a widely disseminated on-line health assessment system called HowsYourHealth.org2 open to researchers. This system asks individuals to answer questions about their health status, symptoms, concerns, management of chronic diseases, health care experiences, and self-care. During the period from September-November, 2008 we posted two additional questions on the website for respondents aged 14–69 years: (1) Have you ever had a tattoo on any part of your body? and (2) How old were you when you had your tattoo? A total of 452 respondents from 43 states responded. Using the survey data, we examined the prevalence of being tattooed by age and gender. We then compared health, social environment, and behavioral risk factors obtained from the survey between those who reported having had tattoo and those who had not tattooed. We used logistic regression and evaluated the potential confounding effects due to other factors. The prevalence of having a tattoo shows strikingly different age patterns. In contrast to the relative stability of adult male tattooing (i.e., among men between the ages of 18–49 years a prevalence of 18% and 50–69 years a prevalence of 16%), tattoos in women aged 18–49 years (a prevalence of 29%) appeared to be roughly 5 times higher than women aged 50 to 69 years (a prevalence of 7%) (Chi-squared p95%, making this site a unique and inexpensive resource for researchers. With consent, individuals could be enrolled into epidemiologic studies. A recognized limitation of web-based surveys is that they only include those using the internet, and in the present study, the website for our study. The main advantage, however, is the efficiency with which such data can be ascertained in an era of high internet use. Our survey suggests a rise in non-medical tattooing among younger women in the USA.