Anyone who spends anytime on public transport in Melbourne will recognise the power of the smartphone. The endless sea of heads bent over tiny screens  reading / texting /  gaming / tweeting.  If only someone could harness the power of these attention demanding devices for the public good?

In this month’s journal watch Dr Melissa Stoneham explores the potential of smartphone applications in public health.

Dr Melissa Stoneham writes:

Leading up to the Festive Season, I received a call on my mobile from Santa. Seriously, the caller ID actually read “Santa”. Of course living by the old adage of “if you don’t believe, you won’t receive” I took the call. However, I soon realised, to my disappointment, that my kids had installed a Santa app on my phone.

Mobile phones – what did we ever do before them? According to a 2013 survey, 88 per cent of Australians have a smartphone. The same survey identified that the mobile phone is clearly about more than standard calling and texting, finding that 87 per cent of respondents used their phones to access information online, 76 per cent were visiting websites or searching online, 72 per cent were using their mobile phone for entertainment purposes and a further, 69 per cent were emailing on their mobile phone.
So when a recent journal article looking at the content of smoking cessation apps was published in the American Journal of Preventive Health, I was interested to find out more. The study, led by Lorien Abroms Assistant Professor from the George Washington University, examined the content of the 47 iPhone apps for smoking cessation that were distributed through the online iTunes store from June 2009.

The research team was particularly interested in the degree to which popular smoking-cessation apps adhered to established best practices for smoking cessation and the extent to which these apps were being used by the public.

Amazingly, when searching for smoking cessation apps, the team identified 414 quit-smoking apps. A decision was made to limit the content analysis to the top 50 most popular English-language apps for each operating system. The final sample consisted of 47 apps for the iPhone and 51 for the Android giving a total of 98 apps.

The apps were coded into categories according to the primary approach it used toward smoking cessation. Categories included calculator, hypnosis, rationing, calendar/tracker, informational and lung health tester, which claimed to measure lung health or lung capacity by having the user blow into the microphone of their phone. A “game” app provided a game for quitting smoking.

They found that calculator apps were the most common category, representing almost 39 per cent of all apps, followed by hypnosis apps (17.3%); rationing apps (15.3%); trackers (12.2 %); informational apps (6.1%); games (3.1%) and lung health testers (2.0%).

Although these apps were found to have some strengths, including being specific to smoking and being interactive, the researchers concluded that several basic evidence-based practices were missing from the vast majority of apps. Omissions included referrals to a Quit line (no apps) and recommending approved medications (4.1% of apps). Overall, the authors suggested that as a whole, despite the recent expansion of smartphone platforms and the increase in the availability of apps for cessation, popular apps still lacked many elements that are generally recommended for quitting smoking.
Charged with this information, I went looking for such an app at the Apple Store. Without too much trouble, I found the Tobacco-Free Teens app, developed by MD Anderson Foundation at the University of Texas. The app targets middle and high school students around the world.
Equipped with colourful animated teen characters and cool tunes, the app – available for iOS platform – targets those who have never smoked, those wanting to quit, those having trouble quitting and those not interested in quitting. The app includes gaming activities that reinforce smoking-cessation tips tailored for the teenage audience.

In one game the user’s task is to tap away various temptations to smoke which are depicted as objects, that rapidly move around the smartphone screen. Another game challenges users to match two pair of cards that contain memorable images of smoking consequences including yellow teeth, bad breath and stained fingers.

Given the growing popularity of smartphones and emerging evidence which indicates that quit-smoking text messaging programs on mobile phones can increase quit rates, providing effective smoking-cessation apps seems to be a sensible investment for public health.

The use of Smartphone apps and text messaging could be one strategy, amongst others, to encourage individuals to make healthy lifestyle choices. With increasing pressures on health care providers, in terms of both time with clients and the ability to provide a comprehensive list of advice, mobile phones could fill a gap in providing timely and relevant public health messages as well as preventing people from taking up unhealthy behaviours such as smoking. With more than two-thirds of the world’s population now owning a mobile phone, this is surely an area of growth for public health advocates.


Article: A Content Analysis of Popular Smartphone Apps for Smoking Cessation. Lorien C. Abroms, J. Lee Westmaas, Jeuneviette Bontemps-Jones, Rathna Ramani and Jenelle Mellerson. American Journal of Preventive Medicine 2013, Vol 45; Issue 6; Pages 732-736.


About JournalWatch
The Public Health Advocacy Institute WA (PHAIWA) JournalWatch service reviews 10 key public health journals on a monthly basis, providing a précis of articles that highlight key public health and advocacy related findings, with an emphasis on findings that can be readily translated into policy or practice.

PHAIWA is an independent public health voice based within Curtin University, with a range of funding partners. The Institute aims to raise the public profile and understanding of public health, develop local networks and create a statewide umbrella organisation capable of influencing public health policy and political agendas. Visit our website at

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