QuitGenius (YC W18) raises $2M to help people quit smoking | Hacker News Reader

QuitGenius (YC W18) raises $2M to help people quit smoking

techcrunch.com

44 pointsnafizh60 comments

> Since launch Quit Genius has grown to 300,000 registered users, with over 20,000 people officially smoke-free in the app (which Quit Genius defines as having not smoked for over 28 days).

I'd be interested to know how "smoke-free" time is established. Are users self-reporting that they have or haven't smoked with the app? And 28-days of not smoking is great, but it feels dishonest to call that "smoke-free".

> Healthy employees save the company money and are more productive, and Quit Genius thinks it can not only help employees get healthier but give employers a way to track that progress.

Dystopian.

> Smoking costs 45,400 lives, $16.2B in a year, study finds [1]

It is the largest single expense to employers and to the [Canadian] healthcare system. It is not dystopian to want to track smokers on their journey away from smoking - it's the only way we know if we're getting better at helping them quit.

28 days is a good measure of smoke free. By that time, you are through the nicotine withdrawal of about 72 hours, which I think is the biggest cause of relapse. After that, you need to resist the social and habitual pressures, and that is wholly up to the individual. Some people can go 20 years resisting these pressures, others collapse in a few days. So 3 weeks is a fair balance, I think.

[1] http://www.cbc.ca/news/business/smoking-economic-cost-1.4357...

> It is not dystopian to want to track smokers on their journey away from smoking - it's the only way we know if we're getting better at helping them quit.

The dystopian bit is that they give your personal data to your employer. Was this really unclear to you? I'm confused at why else you would try to derail that point.

It's dystopian for employers to track their employee's healthcare goals and track their success meeting them. I, personally, don't want HR to send the company an email congratulating me on losing 5 pounds, or for them to bring me to their office to talk to me about how I had 5 drinks on Friday and that's binge drinking and outside company policy.

> I, personally, don't want HR to send the company an email congratulating me on losing 5 pounds, or for them to bring me to their office to talk to me about how I had 5 drinks on Friday and that's binge drinking and outside company policy.

Who's suggesting this? A bit presumptuous to go from tracking "thing that definitely kills people [smoking]" to "things that are bad but not that bad [drinking, unhealthy eating]". Quite the slippery slope that thinking tracking smoking will lead to tracking everything.

The step from tracking zero things to tracking one thing may be larger then the step from tracking one thing to tracking (almost) everything.

First, it's not a slippery slope, because there is a simple and logical progression for it, and examples in other fields - seatbelt laws, for example. Also, the article itself mentions tracking alcohol use and weight.

Why would you track smoking? Because the company pays more for insurance. So, it makes sense to track other things that are indicators for worse health outcomes, also causing higher insurance payments.

> seatbelt laws

What are you saying here? You've lost me. Seatbelts are good and the laws we have in place are there to keep ignorance about them from spreading (ie. if you've never gotten in an accident, why would you wear a seatbelt?). So I definitely agree that we slipped on this slope for a good reason.

The reason seatbelt laws exist is not because they are intrinsically good, or to prevent ignorance. They exist because it is expensive to pay for someone that has slammed through a windshield and requires intensive care. They passed in large part through the argument that putting them in place would lower insurance rates. That's where a lot of the money lobbying for their use came from.

They also passed so that the automakers wouldn't be forced to put airbags into cars.

> seatbelt laws, for example

I was all up with agreeing with you until this point - but I honestly find it quite incredible that there are still people that think seatbelts are a bad thing.

I'm not saying seatbelts are bad, I'm saying the reason the laws exist is in part based on a combination of NHTS data opened up with Reagan's move to regulate federal drinking laws and the idea that mandatory seatbelts would lower insurance costs.

It's an example of one thing being tracked moving down the line to something that the majority of people opposed also being tracked and legislated.

Companies already do this using things like Virgin Pulse.

> It is the largest single expense to employers and to the [Canadian] healthcare system.

I've read numerous times that smokers are actually a net gain for a healthcare system, assuming the same system pays for the whole life of the patient.

The majority of medical costs are incurred by a small minority of patients, usually at the very end of their lives. Smokers die earlier and faster, usually without the slow and expensive deterioration many healthier patients will go through.

So squirrel suit fliers must be a huge discount then.

For countries with public health systems, retiree squirrel-suit fliers are the ideal -- they die cheaply, and have finished paying taxes and started taking pensions.

Whether actually true or not, tobacco companies have definitely used this argument in lobbying against anti-smoking public health efforts, particularly in Eastern Europe.

Of course at best this argument assumes that you are looking at cost for a comparable standard of care, not cost for comparable health outcomes.

> Of course at best this argument

To me, this deflects from the main question of whether it is true or not. Or in other words, whether those quoting the "costs" of smoking (as a justification for further anti-smoking measures) are using dishonest propaganda. Also known as lying.

> To me, this deflects from the main question of whether it is true or not.

It points out that the question the claim addresses is different then that addressed by the opposing claim (and different than the policy concern that is usually beoing addressed.)

Which means its truth is orthogonal, rather than opposed, to the truth of the other claim.

Lost productivity is a huge cost for smoking (to say: we lose out on the fruits of labor, particularly of some great people). But then most smokers don't just quickly die of cancer, but do have much larger incidents of heart disease, which can pressure the healthcare system.

Plus the same government is paying for pensions / social security so there's a "double dip" of savings when they die earlier.

There are some funny cost sources in there. Tobacco enforcement? OK, but I mean, that's not the cost of tobacco, that's the cost of your distaste for tobacco. Lost productivity and lost years of life? Yes, I suppose it's true that you don't get to benefit from my productivity when I'm dead, but that's kind of an odd way to look at it.

In fact, yes, smokers do die sooner, which is why they actually cost less:

https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748...

I understand that people don't like smoking, but that doesn't excuse the loose way that organizations throw around numbers about this topic.

It's instructive to watch the way people reason when they're convinced they've got the moral high ground. There's almost nothing they won't say.

> I understand that people don't like smoking, but that doesn't excuse the loose way that organizations throw around numbers about this topic.

And they never give a source so a person can fact check the numbers.

Luckily, in this case we know we're reading dishonest propaganda, since they make no mention of the revenue side of it.

> It's instructive to watch the way people reason when they're convinced they've got the moral high ground. There's almost nothing they won't say.

Preach brother.

I know this is anecdotal, but I‘ve taken about 8 years and 10 attempts to successfly quit smoking. On half of those attempts, I made it past the 28-day mark, even past five months on one attempt before relapsing. Physical withdrawal is easy, staying on top of your mind is much harder. I’m at 2+ years now. I‘d say a year of not smoking is a meaningful predictor of not relapsing. 28 days shows you‘re making a serious effort.

It takes longer than 72 hours to clear out nicotine from the body. 4 days for the saliva but upto a year it can be measured in hair samples. Not counting the repair/reorganization the body requires to function again.

28 days is probably a good measure.

>> Healthy employees save the company money and are more productive, and Quit Genius thinks it can not only help employees get healthier but give employers a way to track that progress.

> Dystopian.

Yup, but we've long crossed that bridge. We can only suggest that quality employees take a zero tolerance policy towards these invasive employers. I'm afraid we are not going to be able to rely on regulation to stop these practices since anything anti-smoking (or anti-terrorism or anti-CP) can only be seen by most as a benefit. It's a slower form of prohibitionism. People can only see one side of the smoking debate. Similar thing happened with alcohol age. "Can't get a job unless you follow these rules" is very similar to "can't get funds unless you follow these rules". Choice against "good" is disallowed one way or another.

> Yup, but we've long crossed that bridge.

I think young generation simply doesn't care. Dystopian is something normal, natural for them. It is only older people that will struggle with it, but once they die, there will be whole new world, where freedom will be an extremist concept.

What???? Who told you that? What kind of proof do you have? It seems to me that it's just some meaningless sentence just to make empathy with dystopian views of the world, but without any real reflection in the real world.

This is just anecdotal. It is my observation of the world. It could be much different than yours and I hope it is.

I see this a lot in young people. They trust the cloud and privacy isn’t a big deal. That attitude will not change until something bad happens on a large scale that wakes the masses.

Simple example is when German intelligence service even before the start of the war was compiling details of Polish intelligentsia, cultural, social or political elites. So when they invaded Poland they knew where to look for Poles who could be a danger to the Reich in the newly acquired territories. And they executed them. One by one to destroy national identity. Now if back then something like Facebook existed, their job would have been much easier. This is what scares me, because when in future politicians decide that people of my views need to be "removed", that would be very easy to do. Just run a query against social media database and send kill squads.

And now they’d just send a drone after they obtained your gps coordinates. The labor of hunting classes of people down has dropped dramatically.

Fortunately, I believe invasiveness of that type is illegal under HIPAA.

Kinda. For the state I live in, it is believed that if it's just for "image" appeal it may not be considered a privacy concern [0]. So if you worked for QuitGenius in TX and part of their image is non-smoking, they may have such a requirement. But for affecting insurance premiums, nope (federal HIPAA violation). I think this is reasonable. Other states have laws that don't allow the employer to restrict off-duty legal activities. I personally appreciate Texas's approach to employer freedom until it becomes a problem. They take the same approach towards municipalities wrt smoking laws (i.e. statewide ban in many types of public places that were a problem then defer to local voters for others).

0 - https://www.texasemployerhandbook.com/2013/01/smoking-discri...

> Dystopian.

Damn straight. Step tracking, smoking tracking, what's next, analysis of what I had for lunch with a "reward deduction" if I choose a cheeseburger over a salad?

Boss calls you into the office: “jimmy, I thought we agreed you would cut down on the red meat?”

>I'd be interested to know how "smoke-free" time is established. Are users self-reporting that they have or haven't smoked with the app? And 28-days of not smoking is great, but it feels dishonest to call that "smoke-free".

Well, they're not actually claiming "mission accomplished" after 28-days smoke-free -- they continue to help people stay smoke-free on an ongoing basis. But 28 days seems like a challenging and reasonable milestone to me.

(Disclaimer: I invested in QuitGenius)

Exactly. Why does quitting smoking have anything to do with employment? Is this solely because of how health insurance usually works in the US? I'm so tired of apps wanting to give my data to other people.

"Smoking employees cost $6,000 a year more, study finds"

https://www.nbcnews.com/healthmain/smoking-employees-cost-6-...

>A startling part of the calculation was just how much less productive smokers really are. “Though all employees are occasionally unproductive in one way or another, research suggests that smoking status negatively impacts productivity separately and apart from lost work time due to smoking breaks and absenteeism,” Berman’s team wrote.

>“This is because nicotine is a powerfully addictive drug. Although cigarettes satisfy a smoker’s need for nicotine, the effect wears off quickly. Within 30 minutes after finishing the last inhalation, the smoker may already be beginning to feel symptoms of both physical and psychological withdrawal. (Much of what smokers perceive as the relaxing and clarifying effect of nicotine is actually relief from their acute withdrawal symptoms.)”’

Absolutely dirty. There is nothing productive about adding this layer of tension between employers and employees.

Sure, people are going to stop smoking, but the change isn't coming from within. I'm certain this will only breed contempt.

These days it just seems crazy to trust some random SV company that's likely to be acquired by a huge company with questionable privacy ethics in a couple years with sensitive data that traditionally has been used to price discriminate in health insurance.

I went to their website looking for some acknowledgement that they take this problem seriously and didn't see it. Even worse, the article says that they envision a future collaborating with employers to track employee programs. There's just no way I would be able to feel comfortable sharing this kind of information with a company that has this business model.

The question is found on all health insurance applications as far as I'm aware -- "Have you used tobacco in the past 6 months".

I'm under the impression that the question is not optional and that it's perfectly legal for insurers to price discriminate based on the answer to it (understandably and justifiably so IMO). I'm not sure, but I'd also assume that being dishonest when answering the question would technically put you at risk of having claims denied on that basis -- or, at the very least, having your rates raised retroactively since it presumably would indicate that you belong in a higher risk (and premium) pool...

Is my layman's understanding wrong?

The fact that these companies can discriminate based protected human attributes like age or gender doesn't make sense in this day and age.

The fact that you assume that age and gender don't make a difference in this age of big data, doesn't make sense.

So does race do we include that? So do other factors like politics. Should we say if you are black you should pay more? A trump fan gets to pay less until he leaves office.

We create groups based on anything to assign costs to other people.

Everyone should be paying the same general rate with personal factors like accident history, or tickets.

I wish them, and everyone they're trying to help, all the best.

I quit years ago and it was one of the best things I've done. There were only three mantras in my head when I quit "get through the first 48 hours" then "get through two weeks" then "don't fuck it up".

It's hard to quit smoking, but only in the short term. It's much harder to live as a smoker over a lifespan. Remember that.

I have more advice and micro tactics, but I feel like listing them all would only pollute the message above.

Just get through the first 48 hours.

You can do it.

This seems to me like this should be a non-profit. This company's revenue growth is misaligned with their customer's goals. Total success would be for the company to have 100% churn from successful rehab, the better they are at what they do the higher their churn rate should be. I guess this is a common issue in the health industry, an area that I haven't the slightest clue about.

Depends on the revenue model. They could give you lifetime access for a one-time payment, and then the more you need their services the less money they make. Particularly if it includes any kind of labor like support costs or reviewing your case.

Mobile, can't link now, but the Obamacare expansion required covering rehab centers, and the industry exploded, and tons of bad actors are doing literally this. There are even cases of centers next to drug dens with staff acting as suppliers/runners

I apologise for no link, but quick googling will find the stories.

Simpler solution that actually works: buy one of these miracle devices (timer box) and just taper off your smoking. Make decisions that are in your best long term interest when you aren't in a weak "I must have a smoke now" mode.

I admit I use it for a different kind of smoke (legal in California, yay), and for that, no need to completely quit, just keep usage reasonable without having to constantly fight with temptation.

I don't own stock in the company, but I heartily recommend it. https://www.amazon.com/gp/product/B00JGFQRN4/ref=oh_aui_deta...

FWIW this is not the right way to think about quiting smoking. It might work for some people, although i'd bet only temporarily unless the root problem somehow goes away.

This solution still has people believe they want to smoke and that it's something they enjoy (it will de-stress them, etc). These core beliefs have to be addressed IMO. Only until the user does NOT want to smoke and sees smoking as not only not being a benefit to them but also a harm to them, have they successfully quit smoking.

Not sure how this app works, though.

Well I've quit smoking multiple times, the first time in 1990 and then after a few relapses that each lasted a few months, in the time since.

I still want to smoke. I see no reason that will ever go away. It is enjoyable and relaxing -- during the time I am smoking and soon afterward. But it makes me unhealthy and generally feel like crap overall, so I choose not to anymore.

But I do know that during my relapses, this box would have fixed the problem quick. I just have short term weakness, and if a whole pack is sitting there, I will smoke it pretty quickly. If I could easily taper it off (and this device allows that) it would have been easy. (I've actually done the equivalent, but it required someone to hold onto my cigarettes and dole them out...the box automates that)

This reminds me of Weight Watchers ($WTW). The idea is crazy - people will pay for advice and some instructions I guess. $WTW is a $5B company now.

Aren't they paying for community / accountability?

Oftentimes the value the user gets is a bit tangental to the concrete product.

Advice, instructions, and a social group centered around the advice & instructions! Bill Ackman lost a lot of money underestimating the value of the latter.

Does it bother anyone else that this is a phone app only? Why can't it be a normal web app? One of the bad habits people have is being glued to their phones. And the permissions it requires seem pretty skeptical as well.

Frontage and already harvesting for my phone number? Good idea. With email I can at least mark you as spam or report you, much harder to unsubscribe or report my cellnumber abuser.

Truly a "Genius" idea.

I don't know how necessary this is with electronic cigs now. I know many people that have switched to e-cig, slowly reduced nicotine and have quit altogether.

Stopping smoking is not all it’s cracked up to me.

The show Silicon Valley hinted at this when Bachman tries to pitch an app to crowdsource geolocating smokers.

First, yes smoking is bad, but all the health benefits of stopping have been completely absorbed by the unhealthy food that is sold / made available.

In fact, the second largest smoking company, RJ Reynolds, used to be called RJR Nabisco. A ton of snack food executives got there start from the world of smoking.

Second, there is a community level to this as well. It used to really bother me how many people at work smoked. I would walk past the designated smoking area and see 30 of them hanging out. Then I realized that there is something about smoking that brings people together (one of which is being forced to gather in a designated area), and perhaps in this era of individualism, loneliness, and anonymity that is a greater good.

For more on RJR Nabisco, I suggest this great book from the 80’s:

Barbarians at the Gate: The Fall of RJR Nabisco https://www.amazon.com/dp/0061655554

I bet in another context you’d happily point out which logical fallacies you just used for points 1 and 2.

I used to think like you - while I was still addicted.

In fairness these safe snack foods being marketed as powerbars or meal replacement will be outlawed or restricted in the future for the same reason smoking is now.

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