Background Pro-smoking applications (app) provide information about brands of tobacco products, where to buy them, and encourage their use. It is unclear in which countries these apps are being downloaded, or whether app stores play a role in promoting or regulating these apps, particularly those that appear to target children.
Method The lifetime popularity of 107 pro-smoking apps was investigated, using a third-party app metrics service that aggregates data from app stores about app download popularity by country. Apps were deemed popular if at any time in their lifespan they achieved a top 25 ranking overall across all apps, or a top 25 ranking in any particular category of apps, such as ‘educational games’.
Results Fifty-eight pro-smoking apps reached ‘popularity’ status in Apple and Android stores in one or more of 49 countries, particularly Italy, Egypt, Germany, Belgium and the USA. The daily downloads in each country ranged from approximately 2000 to 80 000. The Apple store featured five of the pro-smoking apps in various categories, and two apps were featured by the Android market. Two pro-smoking apps in the Apple store were extremely popular in the ‘Educational Games’ and ‘Kids’ Games’ categories.
Conclusions Pro-smoking apps were popular in many countries. Most apps were assigned to entertainment and games categories, with some apps specifically targeting children through placement in categories directed at children. App stores that feature pro-smoking apps may be in violation of tobacco control laws.
- Advertising and Promotion
- Global Health
- Tobacco Industry
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Smartphone applications (app) stores are global markets that any smartphone user can access in virtually any country where an internet connection is available. Our study conducted in 2012 found 107 pro-smoking smartphone apps in the Apple app store and Android market (recently renamed Google Play).1 Android users downloaded 25 billion apps by mid 2012; up from 10 billion downloads in 2011.2 ,3 As of February2012, it was estimated that more than 11 million users had downloaded pro-smoking apps from the Android market alone.1 Pro-smoking apps may violate Article 13 of WHO Framework Convention on Tobacco Control (WHO FCTC), which bans direct and indirect advertising and promotion of tobacco products in all media including the internet. The availability of apps under various store categories, including ‘Games’ and ‘Entertainment’, could readily expose children to this pro-smoking content and potentially increase the risk of smoking initiation.1
Developers can publish apps in a range of categories designed to classify apps, for example, as games, entertainment or lifestyle. However, no information about the locations of the users downloading these apps is available. To estimate the number of downloads, app publishers consider their rank in the app stores. Apps that occupy the top position in the relevant category or the overall rankings are downloaded most frequently.4
Distimo, an app-tracking company, monitors daily rankings in the app stores on a country-by-country basis.5 It found that to rank among the top 10–25 in the USA, an app needed between 45 000 and 80 000 downloads per day. To reach the top 25 in the games and entertainment categories, an app needed from 7000 to 25 000 daily downloads.4 ,5 To rank among the top 10 or 25 in Australia, the UK, Germany, France and Italy, an app required only 4000 to 18 000 daily downloads.4 ,5 In most countries, an app needed approximately 3000 daily downloads to achieve a top 50 ranking.4 ,5 This shows that being in the top 25 indicates that the app is getting high download volume. Additionally, being in the top 25 increases the app exposure and visibility, which stimulate further downloads.6
In this paper, we aim to identify the countries where pro-smoking apps are most popular. Additionally, we investigate whether the app stores featured a pro-smoking app in a given month. ‘Featured’ means an app was included on an app store list of selected or highlighted content, such as lists of the most popular free apps, of the apps that generate the most revenue, or of the apps that are staff picks. We also examined apps that had a high rank in app store categories that appeal to children, such as ‘Kids’ Games’ and ‘Educational Games’.
Several app-tracking companies aggregate the daily rankings in the Apple and Android stores. One such service, Appannie, supports searching for an individual app, its lifetime ranking, and the countries and categories in which it has been highly ranked.7 This service also shows the date on which app stores have promoted a specific app by featuring it in any category.
In February 2012, we searched the Apple app store and the Android market for pro-smoking apps, using the keywords ‘smoke’, ‘cigarette’, ‘cigar’, ‘smoking’ and ‘tobacco’. We defined pro-smoking apps as ‘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’.1 The identified 107 apps (the list of the identified apps can be found at http://spphr.net/2/psl.html)1 were then checked using the Appannie service to determine which had ever reached a top 25 ranking as of February 2012 and which countries were being reached by pro-smoking apps. We used the top 25 criterion to identify the most popular apps in individual countries. This criterion was assessed independently for all countries. Thus, an app in the top 25 of a given category in two or more countries was not necessarily downloaded at the same rate. Country rankings depend on the size of their app market and the total number of app downloads. We then ranked the countries by the number of pro-smoking apps that reached the top 25. Additionally, we identified any pro-smoking apps featured by stores in November 2012. We also investigated differences in the number of pro-smoking apps in the top 25 in countries with high and low smoking prevalence.
Of the 107 pro-smoking apps, 58 ranked in the top 25 (in various categories and overall rankings) in 49 countries during their lifetime.
In the Android market
Thirty-eight countries had at least one pro-smoking app reach the top 25 in at least one category. In 23 countries, at least one pro-smoking app held the top position in at least one category. As seen in table 1, countries where pro-smoking apps from the Android market were most popular were Italy, France, Egypt and Brazil. In countries with pro-smoking apps in top 25 rankings, pro-smoking apps were popular in five to eight retailer categories, primarily the ‘Casual’, ‘Games’, and ‘Lifestyle’ categories. An example of these apps, ‘Pocket Roller’ teaches users various ways to roll cigarettes (see online supplementary figure S1). The app reached the top 5 in the ‘Lifestyle’ category in France, the top 15 in Canada, and the top 23 in the UK. In November 2012, the Android market featured two pro-smoking apps in 23 countries, as shown in table 1.
In the Apple app store
In 49 countries, at least one pro-smoking app ranked among the top 25 in at least one category. In 21 countries, at least one pro-smoking app held the top ranking in at least one category. As seen in table 1, the countries where pro-smoking apps in the Apple app store were most popular were Egypt, Armenia, Israel, Italy and Belgium. In countries with pro-smoking apps in top 25 rankings, the pro-smoking apps were found in five to eight Apple app store apps categories. While the apps were most popular in the ‘Entertainment’, ‘Games’, and ‘Lifestyle’ categories, two pro-smoking apps (both have a smoking simulation function in which users can smoke virtually by inhaling and exhaling near the device's microphone) were highly popular in the ‘Educational Games’ and ‘Kids’ Games’ categories in Germany, Italy and the USA (see online supplementary figure S2). In 13 countries, including Italy, Germany, and the USA, at least one pro-smoking app reached the top 25 overall rankings. In November 2012, the Apple app store featured five pro-smoking apps (see online supplementary figure S3), including at least one in 12 countries, as shown in table 1. The store also featured the two pro-smoking apps popular in the ‘Educational Games’ and ‘Kids’ Games’ in 11 countries. Overall, in both stores, at least one pro-smoking app achieved a top 25 ranking in at least one category in 14 countries, including Italy, Egypt, Germany, Finland, Belgium and the USA.
We suspected that there would be significant differences in the number of apps that reached top 25 rankings between countries with high smoking prevalence (above the global average of 36%) and lower prevalence based on 2012 world health statistics.8 However, among the countries included in table 1, there was no significant difference in the number of apps that reached top 25 rankings (t (34)=−1.9, p=0.06).
This study found that pro-smoking apps have gained global popularity, with 58 ranked in the top 25 (in both specific categories and overall) in one or more of 49 countries during the study period (mostly in Italy, Egypt, Germany, Finland, Belgium and the USA). Differences between Apple and Android apps in countries might be due to the popularity of different smartphone devices in any given country.
With the exception of Indonesia and the USA, all the countries included have ratified WHO FCTC.9 We found that the pro-smoking apps were equally popular in countries with strict tobacco control regulations, such as a comprehensive ban on tobacco advertisements (eg, Australia, UK, Thailand and Turkey), and countries with fewer tobacco control regulations (ie, Indonesia).10 We found no relationship between smoking prevalence and the popularity of pro-smoking apps.
Patterns of uptake and use of smartphone apps are poorly understood, yet apps are increasingly popular and rapidly becoming a source of information, social interaction and leisure in many countries. It is likely that these patterns will continue to change as smartphone uptake increases globally. Public health authorities need to consider the potential risks these new, poorly regulated media could pose. Numerous studies have found that exposure to pro-smoking messages across a variety of media channels increases smoking initiation in adolescents.11–13
Most of the apps were assigned to entertainment and games categories, potentially exposing children, and two apps specifically targeted children through placement in child-related categories. Although we could not find sufficient information about the selection process for the featured apps in either the Apple app store or the Android market, both featured some pro-smoking apps in November 2012. App stores may violate Article 13 of WHO FCTC, which bans advertising and promotion of tobacco products in all media including the internet. Our analysis of the featured apps was only for a selected month; more apps could have been featured before or after that period.
Pro-smoking apps have reached many countries around the world. Although the overall top 25 most downloaded apps include few pro-smoking apps, there are 58 pro-smoking apps that rank in the top 25 within particular categories such as ‘Games’ and ‘Entertainment’. The app stores feature some pro-smoking apps, some of which are offered in categories intended for children. App stores may be in violation of tobacco control laws in some countries.
What this paper adds
This paper has provided evidence of the global reach of pro-smoking apps in the Apple app store and the Android market. It also supplied evidence of the role of the app stores in promoting pro-smoking apps.
This paper has introduced a new way to investigate the popularity of health-related apps globally and in specific countries using app-ranking services.
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Files in this Data Supplement:
- Data supplement 1 - Online supplement
Contributors All authors participated in the writing and editing of the article. NFB was responsible for study design, conceptual development, data collection, analysis and drafting of the manuscript. All authors read and approved the final manuscript.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.