Article Text

Research paper
Pro-smoking apps for smartphones: the latest vehicle for the tobacco industry?
  1. Nasser F BinDhim,
  2. Becky Freeman,
  3. Lyndal Trevena
  1. 1School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2Ministry of Higher Education, Saudi Arabia
  1. Correspondence to Nasser F BinDhim, School of Public Health, Sydney Medical School, Rm 125, Lvl 1, Edward Ford Building A27, University of Sydney, Sydney, NSW 2006, Australia; nbin6641{at}uni.sydney.edu.au

Abstract

Background Smartphone use is growing exponentially and will soon become the only mobile phone handset for about 6 billion users. Smartphones are ideal marketing targets as consumers can be reached anytime, anywhere. Smartphone application (app) stores are global shops that sell apps to users all around the world. Although smartphone stores have a wide collection of health-related apps they also have a wide set of harmful apps. In this study, the availability of ‘pro-smoking’ apps in two of the largest smartphone app stores (Apple App store and Android Market) was examined.

Method In February 2012, we searched the Apple App Store and Android Market for pro-smoking apps, using the keywords Smoke, Cigarette, Cigar, Smoking and Tobacco. We excluded apps that were not tobacco-related and then assessed the tobacco-related apps against our inclusion criteria.

Result 107 pro-smoking apps were identified and classified into six categories based on functionality.42 of these apps were from the Android Market and downloaded by over 6 million users. Some apps have explicit images of cigarette brands.

Conclusions Tobacco products are being promoted in the new ‘smartphone app’ medium which has global reach, a huge consumer base of various age groups and underdeveloped regulation. The paper also provides two examples of app store responses to country-specific laws and regulations that could be used to control the harmful contents in the app stores for individual countries.

  • Advertising and Promotion
  • Tobacco industry
  • Prevention
  • Global health

Statistics from Altmetric.com

Background

In 2011, the number of mobile phone subscriptions reached 5.9 billion, nearly 2.5 times higher than the total worldwide internet subscriptions of 3.1 billion (of those 3.1 billion internet users, 1.2 billion used mobile-broadband).1 A smartphone is a mobile phone handset with advanced hardware and software capabilities that enable it to perform complex functions similar to those of laptop computers. Its function as a mobile phone handset (which is closest to the consumer and on hand when needed) makes the smartphone potentially the ideal health promotion and self-help programme delivery vehicle and the ideal marketing target as consumers can be reached anytime, anywhere. Smartphone users are increasing exponentially and, in the near future, all mobile phone handsets will be smartphones.2

The ‘Apple App Store’ and ‘Android Market’ are global virtual application (app) stores. They are the only sources for users of the Apple iOS system (the system which runs on the iPhone, iPod touch and iPad) and the Android system (now used by many mobile phone handset manufactures such as HTC, Motorola and Samsung) to find and download apps for their devices. In 2012, Apple customers downloaded 25 billion apps, up from 15 billion in 2011.3 ,4 The Android Market reached 10 billion app downloads by mid-2011.5

Smartphones now account for 37% of all mobile phone handsets in Australia,6 36% in the UK7 and 35% in the USA.8 ‘Ofcom’, a UK telecommunications regulator, conducted a study on smartphone usage in the UK and found almost half of the teenagers (47%) now own a smartphone.9 Moreover, 37% of adults and 60% of teens report being ‘highly addicted’ to smartphones.9 The Nielsen Company analysed mobile phone usage data among teens in the USA for the second quarter of 2010 (April 2010—June 2010) and found that teen mobile phone subscribers increased their app download frequency from 26% to 38% in 1 year.10 This growing trend of app use on smartphones is a powerful marketing tool that can reach adults and teenagers easily and cost-effectively.

Taking into account that these app stores are in a developmental stage and facing a massive growth in app users and developers, their content regulation policies are also likely to be under constant revision to try minimising the promotion of harmful content.

Although the app stores now have hundreds of health-related apps, the effectiveness, quality and accuracy of most are not validated. Furthermore, apps that encourage harmful health behaviours such as smoking are also available in the app stores. This is particularly important since we know that exposure to pro-smoking messages can increase smoking among adolescents.11 ,12 A study by Gidwani et al found that pro-smoking content on television has a dose–response relationship with young people taking up smoking.11 Moreover, a review examining what is known about the pro-smoking content in various media channels found that exposure to favourable media images about smoking provided youth with direct reinforcement for smoking and encouraged smoking initiation.12 However, no studies have attempted to evaluate the pro-smoking content in the app stores.

What we know about the ‘app stores’

App stores provide app developers or publishers with a subscription that allows them to publish their apps in the app stores. When a developer is ready to submit an app, he/she has to provide information including the app name, a description of the app to be used in the advertisement, a price for the app if the developer decides to sell it and in which store category the app will be published.13 ,14 The app stores, however, provide no specific criteria for the category selection, and the app developer can nominate the category they prefer. The developers also can specify in what countries they want their app to be published.13 ,14

In the Android Market only, users can also see the number of downloads for each app in a range rather than the actual downloads number. For example, if an app downloads number is 1000–5000 this means that this app was downloaded by a minimum of 1000 unique devices and is growing to reach 5000 downloads. Once the app reaches 5000 downloads the range will change to 5000–10 000. According to the Android Market, these numbers refer to ‘the total number of unique users that have ever installed this app.’15

This shows that both Android and Apple app stores have an advanced infrastructure that can be used to control the app content if required.

This study aimed to identify and describe the pro-smoking content in the Apple App Store and Android Market. We provide two regulation examples for app stores in response to individual countries’ local laws.

Method

In February 2012, we searched the Apple App Store and Android Market for pro-smoking apps, using the keywords Smoke, Cigarette, Cigar, Smoking and Tobacco. To simulate user behaviour, we conducted the search using real smartphone devices and built a list of the identified apps, then extracted their data from the app stores’ websites. We excluded apps that were not tobacco-related such as apps that used the word ‘smoking’ or ‘smoke’ to convey another meaning (eg, ‘smoked food’) and then assessed the tobacco-related apps against our inclusion criteria. These were apps that (1) were in the English language and (2) had pro-smoking content. Our definition of ‘pro-smoking’ content included any app that explicitly provided information about brands of tobacco, where to buy tobacco products, images of tobacco brands or cigarettes, and apps that might encourage smoking behaviour by providing smoking trigger cues, for example, smoking simulation apps that show a cigarette on the screen and ask the user to light it and smoke it. We extracted the app names, publisher names, the app description ‘advertisement’ and, in the Android Market, the number of app downloads in an access database. We then downloaded the included apps to identify the general themes of these apps based on their functionalities in order to categorise them. We also analysed the app advertisement content for its claims about the app's ability to aid in smoking cessation alongside the stated purpose of the app. The collected data were then verified independently by two researchers against the inclusion criteria and the app functionality categories.

To test inter-coder reliability, a sample of 20 apps from both stores was randomly selected and two researchers coded them against the inclusion criteria and categorisation. κ Statistical tests were conducted to measure inter-coder agreement for both inclusion criteria and app categorisation. Inter-coder reliability tests showed good reliability at κ 0.78 for app inclusion and 0.76 for app functionality categorisation. Disagreements were then discussed and resolved.

Results

The initial keyword search returned a total of 40 pages of ‘results’ in the Android Market and eight pages in the Apple App Store, equivalent to approximately 1400 apps (1000 in the Android store and 400 in Apple). Of these, 299 apps were tobacco-related and 283 of these were in English. The English-language tobacco-related apps were assessed against our definition of pro-smoking. We identified 107 pro-smoking apps, 42 apps in the Android Market and 65 in the Apple App Store. We found six themes based on app functionality, directly overlapping with our categories to create the following typology: (a) ‘Tobacco Shop/Brands’: apps that contained information about where to buy cigars or cigarettes, information about the brands, helping users to build their favourite cigar or cigarette list, or a combination of these functions; (b) ‘Smoking Simulation’: apps that simulated the smoking behaviour (eg, virtual electronic cigarettes that users can inhale and exhale, games where users can pass a cigarette to the game characters); (c) ‘Wallpaper’: apps that change the phone wallpaper or the theme to one that contains images of cigarettes or smoking people; (d) ‘Cigarette Battery’: apps that change the battery icon to a burning cigarette shape; (e) ‘Pro-smoking Advocacy’: apps that oppose antismoking policies and gather support for pro-smoking advocacy (eg, pro-smoking advocacy group apps); and (f) ‘Cigarette Rolling Info’: provide information and multimedia illustration on how to roll a cigarette in different shapes. Examples of each category are given in box 1. Of the 107 apps, 48 were ‘Smoking Simulation’, 42 ‘Tobacco Shop/Brands’, nine ‘Cigarette Battery’ apps, six ‘Wallpaper’, one ‘Pro-smoking Advocacy’ and one ‘Cigarette Rolling Info’.

Box 1

Pro-smoking app examples.

We review below example applications (apps) of each category.

  • Tobacco Shop/Brands apps

    • Cigarettes: Android app that lists famous cigarette brands and products with images, their specifications and their availability in various countries.

    • Cigar smoker: Apple app for iPhone, ipod touch and iPad (figure 4) provides information about various cigar brands, tips, video reviews and allows users to take photos of their favourite brands and share them on social media.

  • Smoking Simulation apps

    • Hotsmoke: Smoking simulation app in the Apple App Store that allows the user to pick a cigarette box that resembles a wide range of famous brands in high quality 3D design (online supplementary image 3) and then smoke a cigarette virtually by holding the phone near the mouth and using the microphone. The user will be asked to inhale and exhale, the cigarette will burn faster with inhalation and smoke will show on the screen with exhalation; the user can shake the phone to drop the ash. The cigarettes also resemble the cigarettes of the brand the user selects. This app advertisement started with ‘Please enjoy the real smoking anytime in any indoor space including office and home!’ It also claims to help users quit smoking.

    • Puff Puff Pass: This app is a cartoon game where the user must click on game characters to order them to smoke and pass the cigarette to the other characters. The user collects points if he or she continues passing the cigarette in the same sequence at a fast pace. Users also can select the type of tobacco (cigarette, cigar and pipe) (figure 5).

    • MyAshtray: Apple app that simulates an ashtray where the user can click on it to open it and click inside it to drop cigarette or cigar ash or a cigarette butt (supplementary figure 8). After each few ashes drop, the app displays messages that encourage smoking behaviour, such as ‘Would be even better with a beer in your hand!’ This app also has a quit smoking help claim.

  • Wallpaper apps

    • Marlboro Red 3D Live Wallpaper: Android app that explicitly shows the famous Philip Morris brand Marlboro in attractive 3D images that show the pack from various angles so users can have it as a theme background for their phone (online supplementary image 1).

  • Cigarette Battery

    • Cigarette battery widget: Shows burning cigarette on the phone screen with the battery life percentage (supplementary figure 9).

  • Smoking Advocacy

    • CRA—Cigar Rights of America: Available in both Android Market and Apple App Store; its advertisement states that it is for a non-profit public advocacy to protect the freedoms of cigar enthusiasts. The objective is to focus on: opposing restrictive smoking bans, opposing taxation of cigars, government regulation of cigars and policy measures relating to cigars. App contains audio and video streaming for speech-related to the app objectives, news and events, and how to join or support the group (supplementary figure 10).

Although some ‘Smoking Simulation’ apps claim to be smoking cessation apps we included them as possible pro-smoking apps for the following reasons: some of them resemble some cigarette brands, they were published under the ‘entertainment’ category in the app stores, and virtual electronic cigarette apps, unlike E-cigarettes, do not deliver nicotine replacement and there is no evidence on the effectiveness of such smoking simulation methods. The pro-smoking apps were found in both stores under different retailer categories: ‘Health and Fitness’, ‘Entertainment’, ‘Games’ and ‘Lifestyle’.

In the Android Market

The pro-smoking apps were downloaded by a minimum of 6 225 786 users by February 2012 (table 1), an average of about 11 million users. The most downloaded app category was ‘Smoking Simulation’, which contained 10 apps downloaded by 6 157 700 users, followed by apps in the ‘Tobacco Shop/Brands’ category, which contained 15 apps downloaded by 32 580 users. Three apps contained images of known cigarette brands, two of them for Marlboro (figure 1) and the other one included images for many famous brands (supplementary figure 2). One app was to collect points for buying Marlboro cigarettes (figure 2). Four apps from the ‘Smoking Simulation’ category claimed that smoking simulation could help users to quit.

Figure 1

Screenshots of Android App show the brand Marlboro.

Figure 2

Android App to collect points for buying Marlboro cigarettes.

Table 1

Pro-smoking apps in the Android Market

The identified apps were distributed in seven Android Market retailer categories (table 2). Most apps were in the ‘Lifestyle’ and ‘Personalisation’ categories. The highest download numbers were found in the ‘Casual’ and ‘Entertainment’ categories, probably because they have smoking simulation apps which were also receiving the highest download numbers in the functionality categorisation.

Table 2

Pro-smoking apps distribution on Android Market retailer categories

Although the Android Market website has a content rating (Low Maturity, Maturity and High Maturity) for potential app users, we could not find the content rating on the device version of the app store easily. In addition, unlike the Apple app store, there is no warning message about age restrictions when users attempt to download an app that contains smoking or ‘High Maturity’ content references.

In the Apple App Store

The 65 pro-smoking apps were distributed among only four categories: ‘Tobacco Shop/Brands’, ‘Smoking Simulation’, ‘Cigarette Rolling Info’ and ‘Smoking Advocacy’ (table 3). Six of the smoking simulation apps claimed that the smoking simulation could help users to quit smoking. Although there were no exact images for cigarette brands in the Apple App Store, some smoking simulation apps contained images that resembled international brands with very minor modifications; most of them resembled Marlboro (supplementary figure 5) (additional coloured screenshots are available on: http://spphr.net/2/c_img.pdf).

Figure 3

Apple smoking simulation apps contained images that resembled international brands.

Figure 4

Screenshots of the App Cigar smoker.

Figure 5

Screenshots of the App Puff Puff Pass.

Table 3

Pro-smoking apps in the ‘Apple App Store’

Pro-smoking apps in the Apple store were found in five retailer categories, ‘Entertainment’ 32 (49.2%), ‘Lifestyle’ 25 (38.5%), ‘Games’ 4 (6.2%), ‘Health and Fitness’ 3 (4.6%) and ‘Reference’ 1 (1.5).

Discussion

The pro-smoking apps are available under multiple retailer categories, from ‘Health and Fitness’ to ‘Entertainment,’ ‘Games’ and Lifestyle’. This potentially exposes a range of age group to these apps. These apps could also easily attract teens and children due to their high quality graphics and availability under the ‘Game’ and ‘Entertainment’ categories in the app stores. Pro-smoking apps that show that smoking is ‘cool’ in a cartoon game, and provide a chance to explore the available cigarette brands and even simulate the smoking experience with high quality, free apps could potentially increase teen's risk of smoking initiation. However, there are no data available about who actually downloads these apps and further research in this area is needed.

The availability of pro-smoking content in the app stores appears to be violating Article 13 of WHO Framework Convention on Tobacco Control (WHO FCTC), which bans advertising and promotion of tobacco products in all media including the internet.16 Advertisement and promotion of tobacco products are defined in Article 1 of the FCTC as ‘any form of commercial communication, recommendation or action with the aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly’.16 Consequently, pro-smoking apps also violate the laws of the countries that have adopted tobacco advertising bans. In addition, if app developers use brand imagery belonging to tobacco companies without permission, then they are potentially in violation of copyright law: but, the tobacco company would have to issue legal demands that the app developer cease and desist.17

App stores have a moral and (arguably) a legal responsibility to ensure they have the infrastructure to comply with WHO FCTC and other laws restricting advertising of tobacco to minors. Although we were able to provide evidence of the Apple App Store response to local laws (box 2), we were unable to find any for the Android Market. The Android Market also has a less restrictive procedure regarding pro-smoking content than the Apple App Store and does not show a warning about the content before downloading the app.

Box 2 Examples of apple store response to individual countries local laws.

  • · Example 1: Encyclopedia De Chine (China)

  • An app called ‘ENCYCLOPEDIA DE CHINE (CHINA)’ available in both the Apple app store and the Android Market that features photos, news feeds, audio podcasts and videos about China was blocked by the Apple app store in China. The developer stated in the app description in the Apple app store: ‘Sorry, due to local laws, this app will no longer be available in China.’18 However, the developer did not mention anything about this issue on the app description in the Android Market.

  • · Example 2: Apps with adult content in Saudi Arabia

  • In an Apple store, when a developer attempts to submit an app, he or she has to answer the content rating questions and if the app contains adult content, a warning message will be displayed to the developer, stating: ‘Due to local laws, this app will not be sold in the following territories.’ One of the countries in the list is Saudi Arabia. Saudi Arabia has a no tolerance policy for adult content on the internet and has one of the most active internet censorship policies in the world.19 Very popular websites such as Facebook and YouTube have hundreds of blocked pages.

Conclusions

Pro-smoking content including explicit cigarette brand images is promoted in smartphone apps, which are reaching millions of users, including teenagers and children. App stores need to explore ways of regulating this content. Individual countries could also include monitoring of app stores when enforcing tobacco control policies, as the current technical infrastructure of the Apple and Android app stores could be used to apply local laws and regulations.

What this study adds

  • This paper reviews for the first time the existence of pro-smoking apps in smartphone ‘app’ stores. It identifies a new trend of promoting tobacco products in a new medium with global reach, a huge consumer base of various age groups and less strict regulation policies.

  • Some of the identified apps show explicit images of cigarette brands and others show images that resemble existing brands.

  • This paper also provides examples of how app stores might regulate content.

  • Our research findings could be used to re-evaluate the scope of existing tobacco advertising bans for virtual markets and to implement stricter policies for pro-smoking apps in the app stores.

References

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Supplementary materials

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Footnotes

  • Contributors All authors participated in the conceptual development, the study design, data coding, and the writing and editing of the article. NB was responsible for data collection, analysis and drafting of the manuscript. All authors read and approved the final manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it was published Online First. The spelling of Dr Nasser BinDihm's surname has been corrected to ‘BinDhim’.

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