Who Gets Tattoos? Demographic and Behavioral Correlates of Ever Being Tattooed in a Representative Sample of Men and Women WENDY HEYWOOD, BA(HONS), KENT PATRICK, PHD, ANTHONY M.A. SMITH, PHD, JUDY M. SIMPSON, PHD, MARIAN K. PITTS, PHD, JULIET RICHTERS, PHD, AND JULIA M. SHELLEY, PHD PURPOSE: Despite recent increases in the popularity of tattooing, little is known about the prevalence and characteristics of adults who have ever been tattooed. We investigated demographic and behavioral correlates of ever getting tattooed in an adult population. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 8656 men and women ages 16–64 years in Australia. RESULTS: A total of 14.5% of respondents had ever been tattooed, and 2.4% of respondents had been tattooed in the year before the interview. Men were more likely than women to report a tattoo, but the high- est rates of tattooing were found among women in their 20s (29.4%). Men and women ages 20–39 were most likely to have been tattooed, as were men with lower levels of education, tradesmen, and women with live- out partners. Tattooing was also associated with risk-taking behaviours, including smoking, greater numbers of lifetime sexual partners, cannabis use (women only) and ever having depression (men only). CONCLUSIONS: Tattooing has increased in popularity during the past decade. Yet tattoos still appear to be a marker for risk-taking behavior in adults. Ann Epidemiol 2012;22:51–56. Ó 2012 Elsevier Inc. All rights reserved. KEY WORDS: Epidemiology, Prevalence, Risk-Taking, Tattooing. INTRODUCTION In recent years, tattooing has dramatically increased in popularity among both men and women. Once the domain of gangs, prisoners, and specific subcultures, tattoos are now regularly seen on celebrities, athletes, and middle-class young people. Given this growth in popularity, it is likely the prevalence and characteristics of those who have been tattooed have changed in the past decade. Most empirical research on tattooing to date has focused on either adolescents or prisoners. Studies in these popula- tions have mainly reported the prevalence of tattoos (1–13) and motivations for getting them (14). In a number of studies authors have also reported tattooing and body piercing to be associated with risk-taking behavior. Among adolescents, tattooing has been associated with drug (4, 12, 15–17) and alcohol use (4, 17, 18), increased levels of sexual activity (12, 15, 17), suicide ideation (15), and illegal/violent behaviour (12, 16). It has even been suggested that clinicians should use tattooing as an indicator for further investigation into risk-taking behavior in adolescents (12, 15–18). Surprisingly, little research in the recent past has focused on tattooing in adults. A study using random digit dialling in the United States in 2004 surveyed 500 men and women ages 18–50 years (response rate 33%). Overall, 24% of respondents had tattoos, with those who were younger, lower paid, had spent time in prison, used alcohol or drugs, and had achieved lower levels of education reporting the highest levels of tattooing (19). Two large national studies have previously reported on the prevalence of tattooing in Australian adults. In 1998 a random survey of more than 10,000 Australian subjects aged 14 years and older found that 10.1% had ever been tat- tooed and 2.2% had been tattooed in the past 12 months (response rate 34%–55%). The authors also reported greater rates of tattooing among younger men and women and among injecting drug users (20). The Australian Study of Health and Relationships surveyed more than 19,000 men and women ages 16–59 years in 2001–2002 and found 12.6% of respondents had ever been tattooed, with 2.5% of the sample being tattooed in the year before the survey From the Australian Research Centre in Sex, Health & Society (ARCSHS), La Trobe University, Melbourne, Australia (W.H., K.P., A.M.A.S., M.K.P., J.M.S.); Sydney School of Public Health, University of Sydney, Sydney, Australia (J.M.S.); School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia (J.R.); and School of Health and Social Development, Deakin University, Melbourne, Australia (J.M.S.). Address correspondence to: Wendy Heywood, BA(HONS), Australian Research Centre in Sex, Health & Society, La Trobe University, 215 Franklin Street, Melbourne, Victoria, Australia, 3000. Tel.: þ61 3 9285 5282; Fax: þ61 3 9285 5220. E-mail: w.heywood@latrobe.edu.au. The study was funded by the NHMRC (grants 234409 and 487304). Received June 14, 2011. Accepted October 3, 2011. Ó 2012 Elsevier Inc. All rights reserved. 1047-2797/$ - see front matter 360 Park Avenue South, New York, NY 10010 doi:10.1016/j.annepidem.2011.10.005