Smartphone applications for health consumers: the example of smoking

Abstract

The smartphone uptake is dominating the mobile phone handset market globally. Smartphones’ advanced computational and storage abilities, as well as their proximity to the consumers, have introduced one of the most fascinating science fiction ideas (an advanced personal computer in one’s pocket) into reality, with more functions than ever imagined. Smartphones have replaced many things in our lives; with a smartphone, one no longer needs a map in a new city, a timetable for public transport, an Internet cafe, or a paper-based “to-do” list. They also have changed how we interact socially through the wide range of text, audio, and video applications (apps) that can be used anytime and anywhere. Moreover, smartphones have recently gained wide popularity in the domain of health self-management, including health monitoring, screening, and diagnosis, as well as delivering behavioral health management programs. Currently, app stores offer thousands of health-related apps targeting health consumers that are mostly low quality and have exaggerated claims of effectiveness, with very limited evidence of efficacy. Although the large number of these apps is an indicator of their popularity, there is also very limited information about who use them and the health consumers’ need for them. On the other hand, smartphones’ large popularity and their global reach to a huge consumer base of various age and gender groups make them a powerful marketing tool to promote various products cost-effectively. Moreover, the underdeveloped regulations for apps—which come from the fact that app stores are in a developmental stage—and their absence in public policy monitoring provide chances for promoting illicit products or those under advertising bans such as tobacco products. Therefore, in addition to smartphones’ ability to promote healthy behaviors, they can also be used to promote harmful ones. For example, app stores also have dozens of apps promoting tobacco use, illicit substance use, and anti-immunization messages. Thus, smartphone apps can positively or negatively impact public health policies and initiatives. However, there is also a lack of information about the policies and regulations related to apps. This thesis investigated various aspects of quality, policies and regulations, feasibility, and efficacy related to smartphone technology’s interaction with health, using tobacco and smoking as an example. This is an important public health topic relevant to the variety of uses for smartphones, as smartphone apps can be used to promote harmful and banned substances globally, to help smokers quit and improve their health (e.g., as a health promotion tool), and as cross-country health research tools to investigate their feasibility and efficacy. The results of this thesis provided, for the first time, various issues regarding quality and regulation, as well as evidence of the feasibility and efficacy of smartphones as a cross-country health promotional tool.