Tattoos Mark Youths Prone to High-Risk Behavior

April 30, 2001

Youths with tattoos are much more likely than their peers to smoke cigarettes or marijuana, go on drinking binges, have premarital sex, get into serious fights, join gangs, skip school and get poor grades, say physicians at the University of Rochester's Children's Hospital at Strong in Rochester, N.Y. Pediatrician Timothy Roberts, M.D., a fellow specializing in adolescent medicine, presents the results April 28 at the annual conference of the Pediatric Academic Societies in Baltimore.

"Of course, there is nothing about the actual tattoo that causes this kind of behavior," says Roberts. "Getting a tattoo is simply an act of having ink put underneath one's skin, and there's nothing about the ink that affects people's behavior. Rather, people who get tattoos tend to be involved in high-risk behaviors. Kids with tattoos are often the kids who get into trouble as adolescents." The link was statistically significant even after researchers accounted for socioeconomic status and other differences between the children.

A tattoo provides a visible cue that the patient may be vulnerable to high-risk behaviors - information that should be very helpful to physicians, Roberts says.

"A tattoo should serve as a trigger for talking," says Roberts. "Many appointments with pediatricians last only a few minutes. When a doctor sees a tattoo on a teenager, instead of asking about their eating habits or whether they wear a safety belt, doctors can focus their questioning. 'Do you smoke? Do you drink? Are you having sex?' It allows a clinician to prioritize what to ask about during the visit."

Roberts himself sports a tattoo, a Celtic good-luck symbol that he got as a way of marking an important time in his life. He is currently in the Navy and treated scores of young men and women with tattoos before coming to Rochester. He decided to do some research on tattoos, but when he checked the medical literature he didn't find much data, so he decided to conduct his own study, funded by the federal Maternal and Child Health Bureau.

Roberts and Sheryl Ryan, M.D., assistant professor of pediatrics at the University of Rochester, analyzed information from a national sample of 6,072 adolescents that was collected in 1995 and 1996. Youths in the study ranged in age from 11 to 21 and were in junior high or high school. Overall, about 4.5 percent had tattoos, with risky behaviors much more prevalent among those with than without.

"I was more than a little surprised at the result," says Roberts, who had thought that people with tattoos were unfairly stereotyped. A few studies have indicated that people with tattoos might be at higher risk for certain behaviors, but Roberts says these analyses were often done in settings like prisons or juvenile detention facilities, where residents had obviously engaged in risky behavior of one sort or another.

While it's illegal for children under age 18 to be tattooed in New York State, and many states have guidelines regarding parental permission, Roberts says many youths get their tattoos from amateurs, friends, or even at tattoo parties. Some mention the idea to their parents first. Roberts advises parents of youths who want tattoos to talk to them about the permanence of a tattoo and how hard it is to remove it. He also says the request provides a chance to talk honestly with one's children.

"Having a tattoo is not the problem. If a child asks for a tattoo, the parent should recognize that as an opportunity to talk. It's a reason to spend some time with the adolescent, to ask some questions about their activities and help them think about the choices they are making.

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