Interview conducted by April Cashin-Garbutt, BA Hons (Cantab)
Please could you give a brief introduction to Australia’s ban on tobacco advertising?
Australia adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2005. This includes a ban on all forms of tobacco advertising including on the internet.
According to Article 1 of the framework, tobacco advertising is defined 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.”
How many other countries have a similar ban on tobacco advertising?
The WHO FCTC is currently adopted by 173 countries. Article 13 of the treaty requires all ratifying nations to adopt a comprehensive ban on tobacco advertising, but it is up to each individual country to determine how strictly Article 13 guidelines are interpreted.
Exceptions are limited to those that, due to constitutional limitations, are unable to adopt total ban. Australia is the global leader in adopting a truly comprehensive ban as it is the only nation to implement plain packaging.
Please could you explain how some smartphone apps have recently been promoting smoking?
Some of the apps are explicitly showing different brands of tobacco products and others use images that resemble known brands. The apps show pro-smoking messages either inside the app or in the app download page.
In our paper we added that, “Pro-smoking apps can be found under numerous retailer categories and keywords in the app stores from “Health and Fitness” to “Entertainment,” “Games” and Lifestyle”. This potentially exposes these apps to a range of age groups. These apps also could reach teens and children easily due to their high quality graphics and availability under the “Game” and “Entertainment” categories in the app stores.
The increased number of teen users of smartphones and their increasing app usage could put them in danger of taking up smoking through pro-smoking apps that not only show that smoking is “cool” in a cartoon game, but provide a chance to explore the available cigarette brands and even simulate the smoking experience with high quality apps that are available for free.”
How did your recent research define “pro-smoking” content?
Our definition of ‘pro-smoking’ content included any app that explicitly provided information about brands of tobacco, where to buy them, images of tobacco brands or cigarettes, and apps that might encourage smoking behaviour by providing smoking trigger cues “e.g. smoking simulation apps that show a cigarette on the screen and ask the user to light it and smoke it”.
How many pro-smoking smartphone apps exist?
Our search in February this year identified 107 apps, 42 of them in Android Market recently known as “Google Play” and downloaded by an average of 11 million users.
Under which retail categories are these pro-smoking apps sold?
They are distributed under many categories including ‘Lifestyle’, ‘Games’, ‘Entertainment’, ’Personalisation’ and ‘Health & Fitness’.
Who are the main users of these apps?
We cannot tell for sure, but some of them potentially appear to target adolescents and children as they are rated suitable for them.
How do the pro-smoking apps violate Australia’s and other countries’ bans on Tobacco advertising?
For those Apps that are explicitly promoting tobacco brands through brand imagery and the use of trademarks, this could be a direct violation of Australian tobacco advertising laws. The difficulty lies in knowing if the tobacco industry is behind these Apps or if private citizens are promoting these brands without tobacco industry consent. In this case, the tobacco industry has not taken adequate steps to prevent others from using their trademarks. Given how highly prized these trademark’s are by the tobacco industry this seems a curious omission.
For other apps, they may violate the law by recommending or encouraging the smoking behavior, which is also a violation under the Federal Tobacco Advertising and Promotion Act.
Do the app stores have the technological infrastructure to block the sale of the apps in accordance with the local laws?
Yes, in our paper we have explained how app stores have the infrastructure to control the availability of any app in any country. We also provided two examples of how Apple app store has responded to local laws in China & Saudi Arabia.
What do you think the future holds for these pro-smoking apps?
Our findings are to highlight an emerging global trend of promoting restricted products such as tobacco in a new media platform. As the app stores have the infrastructure to respond to local laws, it is now in the individual countries’ hands to enforce local legislation.
Do you have any plans for further research into this topic?
Our main research project aims to explore the feasibility and effectiveness of Smartphone health apps to empower health consumers and to bring evidence-based information to this new media platform. We are currently focusing on developing an interactive smoking cessation app that may help smoker in their quitting journey. The app will be evaluated for effectiveness in a randomised control trial.
Where can readers find more information?
About Nasser BinDhim Becky Freeman and Lyndal Trevena
Nasser Dhim is a pharmacist. who has completed his master of health informatics degree at the University of Sydney in early 2011, and started his PhD degree at the public health school. He is amateur software developer with around 10 years experience in web services development, and he has started designing smartphone apps since 2009. He recently won the health informatics society of Australia Award for health app challenge 2012. He is currently focusing on developing reusable health app templates that can be used for various health conditions and smartphone health research projects. His main research interest is utilising web or smartphone technology to empower health consumers.
Dr Becky Freeman has worked in the field of tobacco control for more than 10 years. She is an early career researcher at the School of Public Health, University of Sydney. Her main research interests are tobacco control and the public health implications of new media. She was awarded her PhD, titled Tobacco control 2.0: Studies on the relevance of online media to tobacco control, in July 2011. Prior to pursuing her research interests, Freeman held tobacco control positions in Canada with both government and not-for-profit organisations. In 2004, she was selected from a pool of international applicants for the Director position of Action on Smoking and Health (ASH) in New Zealand. Since moving to Australia in 2006, Freeman has established herself as an authority on the potential of the Internet to circumvent tobacco advertising bans. She was the first researcher to publish papers on tobacco product promotions through the online social media websites YouTube and Facebook. Freeman is the Associate Editor of New Media for the international journal, Tobacco Control.
A/Prof Lyndal Trevena As a key member of the Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED) and an active general practitioner, Dr Trevena's main research interest is the application of evidence in general practice, particularly in evidence-based clinical decision-making. She continues to develop and evaluate a number of decision tools and clinical practice guidelines which assist clinicians and patients to individualise population-level research into practice. Much of this work has been in cancer and other disease prevention. More detail about this research program can be found at http://www.psych.usyd.edu.au/cemped/
She is particularly interested in preventive primary care strategies in disadvantaged groups & has worked with homeless people low literacy groups and more recently in low income country settings.