BackgroundDigital health has become a heated topic today and smart homes have received much attention as an important area of digital health. However, most of the existing studies have focused on discussing the impact of smart homes on people or the attitudes of older people towards smart homes. Only few studies have focused on relationship between health-related risks and use of smart homes.AimsTo investigate the association between health-related risks and the use of smart homes, provide new recommendations to promote the implementation of digital health strategies and achieve health for all.MethodsWe used data from 11,031 participants aged 18 and above. The population was clustered based on five health-related risk factors: perceived social support, family health, health literacy, media use, and chronic diseases self-behavioral management. A total of 23 smart homes were categorized into three sub-categories: entertainment smart home, functional smart home, and health smart home. We analyzed demographic characteristics and utilization rate of smart home across different cluster.ResultsThe participants were clustered into three groups: low risk, meddle risk, and high risk. The utilization rate of smart home was the most popular in the low risk group (total smart home: 86.97%; entertainment smart home: 61.07%, functional smart home: 77.42%, and health smart home: 75.33%; p < 0.001). For entertainment smart home, smart TV had the highest utilization rate (low risk: 45.73%; middle risk: 43.52%, high risk: 33.38%, p<0.001). For functional smart home, smart washing machine (low risk: 37.66%, middle risk: 35.11%, high risk: 26.49%; p<0.001) and smart air conditioner (low risk: 35.95%, middle risk: 29.13%, high risk: 24.61%) were higher than other of this category. For health smart home, sports bracelet has the highest utilization rate (low risk: 37.29%, middle risk: 24.49%, high risk: 22.83%).ConclusionHealth-related risks are an important factor affecting the use of smart homes. Joint efforts of government and product manufacturers are needed to broaden the smart home market and promote the implementation of digital health strategies.