The uptake of smartphones is growing exponentially around the globe.1 ,2 Their use by health consumers and healthcare professionals is increasing.1–4 Smartphone technology particularly impacts on health policy via two new challenges: (1) smartphone app stores can act as mass global media channels to augment or undermine public health efforts and (2) smartphone apps are portals to a multitude of health interventions with unprecedented proximity to health consumers. This paper discusses the issues related to smartphone apps regulations, safety, privacy and quality.

Regulation

Apps promoting harmful behaviours such as smoking and illicit drug use have previously been identified.5–7 In the case of ‘pro-smoking’ apps, they violated international and local public health laws in many countries, not only through promotion to adults but also by targeting children directly and indirectly.5 ,6 The major stakeholder that can play an immediate and significant role in the regulatory process are the app stores, as they are operating as business entities under, and obligated to abide by, local and international laws.

Providentially, in April 2014, Apple updated its app age rating policy and introduced a new section guiding the process of publishing apps that target children (figure 1).8 In the new policy, Apple provides a table indicating how their rating relates to other media rating standards, such as the ‘Entertainment Software Rating Board’ and ‘Pan European Game Information’.8 However, unlike ratings for video games that are covered by the two previous standards, smartphone apps may include audio, video, books and software combined within one item. Therefore, assessing app content based on video game criteria is potentially problematic, especially for health-related content, as the previously mentioned standards do not also have health-specific rating criteria. Although Apple store policy has a ‘medical/treatment variable’ to its age rating criteria (figure 1 …