Associations of demographic, health, and risk behaviors with tattooing in a population-based cross-sectional study of ~ 18,000 US adults

Little is known about current characteristics of individuals with tattoos. We quantified the prevalence of tattooing and associations of demographic, health, and risk-behavior factors with tattooing. We computed adjusted prevalence ratios (PR) of tattooing in a population-based analysis of 18,687 Utah adults ages 18 years and older from the 2020–2021 Behavioral Risk Factor Surveillance System survey. The prevalence of tattooing was 26% among women and 22% among men, with the highest prevalence among those ages 25–29 years (women: 45%; men: 34%). Tattoo prevalence was higher among individuals with less than a college degree and those without religious affiliation. Tattoo prevalence was higher among indviduals with current tobacco use (women: PR = 2.89 [95% confidence interval (CI): 2.60, 3.20]; men: 3.39 [2.98, 3.86]), e-cigarette use (women: 2.44 [2.21, 2.69]; men: 2.64 [2.37, 2.94]), and heavy alcohol use (women: 2.16 [1.93, 2.43]; men: 1.89 [1.63, 2.19]). Tattoo prevalence was lower among individuals receiving a flu vaccine (women: 0.84 [0.76, 0.92]; men: 0.75 [0.67, 0.84]) or COVID-19 vaccine (women: 0.65 [0.54, 0.79]; men: 0.75 [0.61, 0.92]). Tattoo prevalence was higher among women and individuals under age 30 years. Several risk behaviors were associated with tattooing. Tattoo studios/conventions may present opportunities for partnership with tobacco cessation, alcohol reduction, and vaccination public health initiatives.