Despite increasing warnings about the connection between indoor tanning and skin cancer, Pittsburghers seem to take a shine to their tanning salons.

A new study by San Diego State University says Pittsburgh has the second-highest concentration of tanning salons in the nation, right behind Charleston, W.Va.

It comes at the same time as a new report this week from the International Agency for Research on Cancer that raised the danger of indoor tanning to the same level as other carcinogens, and said melanoma risk goes up by 75 percent in women who start using tanning beds before age 30.

Having a lot of tanning salons in an overcast city like Pittsburgh is probably not a surprise. The San Diego study showed that we have 27.8 tanning salons for every 100,000 residents, compared to a national average of about 12 per 100,000.

Joni Mayer, the director of San Diego State's Controlling Indoor Tanning in Youth project, said the study counted 93 tanning salons in an area that included a three-mile radius around the city, far more than the 34 McDonald's and 25 Starbucks.

And while Pittsburgh's ranking doesn't prove people here use tanning salons more than others, it's a likely assumption, Dr. Mayer said, because her group has found that the closer someone lives to a salon, the more likely she is to visit it.

Other findings: teenagers who use salons are more likely to have parents who use them, too, and those who get indoor tans are also less likely to use sunblock outdoors, so that they can get a double whammy of ultraviolet light exposure.

Maria D'Achille, 23, of Penn Hills, has heard all the cancer warnings, but she still uses indoor tanning, although not quite as much as when she was younger.

She began using salons as a way to get a tan before the prom and other big events, then started visiting more frequently, and now, after hearing the skin cancer warnings, has scaled back again.

But at Edinboro University, where she attends college, indoor tanning remains popular, Ms. D'Achille said, and is even gaining a following among some young men.

It's not just the results that attract her, she said, but the peacefulness of her time on the tanning bed. "Sometimes it's the best 20 minutes of your day."

Dr. Robin Gehris, a pediatric dermatologist at Children's Hospital of Pittsburgh of UPMC, said it's a habit that the young woman might pay for later.

One reason she advises families against indoor tanning, Dr. Gehris said, is that some studies show intermittent exposure to ultraviolet light carries a greater risk of skin cancer than steady exposure to the sun.

She acknowledged that the risk of melanoma, the most dangerous type of skin cancer, is both genetic and environmental, "but when young people come to me and they are already worried about abnormal moles, for instance, I say, 'Well, you can't do anything about that, but the one thing you can control is your exposure to the sun, so why would you voluntarily go out there and do that?' "

Dr. Adrian Ormsby, a pathologist at Henry Ford Hospital in Detroit who co-authored one study showing a connection between indoor tanning and melanoma, said the only way to absolutely prove the link would be to follow people for decades, because "you can get a dangerous dose of UV radiation when you're 18 or 19, but it may not manifest itself until you're past 50."

The San Diego State group also has rated Pennsylvania low on its regulation of tanning salons because it has no restrictions on their use by youths under 18. In addition, there are 22 states with no tanning laws whatsoever, including West Virginia.

Dan Humiston, president of the Indoor Tanning Association, a trade group, was especially upset by the new cancer study that raised an alarm over indoor tanning. The media's reaction to the report has been overblown, because "all they basically said was that any of the dangers you would associate with outdoor tanning can be associated with indoor tanning."

Mr. Humiston argued that indoor tanning is safer than sun exposure because it can be better controlled. "We can substantially if not completely reduce the risk of overexposure," he said.

San Diego's Dr. Mayer disagreed. One problem, she said, is that the UV radiation emitted by tanning salon machines varies widely, sometimes even within the same salon.

There is also evidence that young people who use tanning beds can become addicted to the practice, Children's Dr. Gehris said. One study showed that when people who frequently used tanning salons were given substances that blocked their brains' pleasure receptors, they no longer enjoyed the experience.

"I get a lot of parents who say, 'Can my teens tan before the prom? Is that OK?' and I say, 'No, unless you're going to let them smoke before the prom, too, because they're both addictive behaviors.' "

But for people like Ms. D'Achille, that may not make much difference.

"It worries you, but I don't know ... it does make you feel better. You just look better. I mean, everything has so many risks. If [cancer] happens, it happens."