Where There’s Smoke, There’s Profit

A Yale startup joins the field of tobacco cessation products | “These apps ... provide people with a virtual support system”

Ben Paynter

Jim Peters, a 50-year-old tractor dealership owner near Livingston, Tex., has been chewing tobacco since the age of 10. So when he decided to get serious about kicking the habit last January, he downloaded a $180 app called Craving to Quit developed by goBlue Labs, a startup out of Yale University. “I’d gladly pay that much money to stop and be done with it,” Peters says.

Roughly 70 percent of the 43.8 million Americans who smoke say they want to quit, yet only 6 percent succeed each year, according to the Centers for Disease Control and Prevention. GoBlue is one of a number of tech startups vying for a piece of what Mintel Group says is a $1 billion market for tobacco cessation products. “These apps are helpful in that they provide people with a virtual support system,” says Emily Krol, a health analyst at Mintel. Just 1 percent of quitters currently use mobile apps, but more than 30 percent have expressed interest, according to the research firm.

GoBlue claims its software can help users give up nicotine in as little as 21 days using meditation techniques derived from Buddhism. Founder Judson Brewer, who is also the medical director of the Yale Therapeutic Neuroscience Clinic, says that by using specialized MRI machines his research team has identified a region of the brain that is activated by feelings of anxiety. Individuals trained to perform mindfulness exercises to develop an awareness of feeling and sensations in real time can reduce activity in the cerebral area, thereby curbing cravings. In 2011, Brewer put his discovery to the test in a four-week randomized clinical trial involving 88 participants; 36 percent quit smoking using his method, nearly double the number that did so using a protocol designed by the American Lung Association. The first group also had markedly lower rates of relapse four months on.

Last year, Brewer set up an office inside an incubator jointly supported by Yale and Connecticut Innovations, a state-backed investment program. He then lined up about $500,000 in funding from Bridge Builders Collaborative, an angel fund with Juniper Networks Chairman Scott Kriens and Boston Market founder Scott Beck among its partners. Profit isn’t the only thing driving Brewer, however. “Hopefully I will die by a sniper bullet paid for by tobacco companies,” says the 39-year-old psychiatrist. “I would be glad to go out that way because it meant I made an impact on people quitting smoking.”

Released in December 2012, Craving to Quit features a daily cigarette counter and a Want-O-Meter, a dial-like gauge to track the intensity of a craving. There’s also audio exercises to “surf the urge,” rather than give in to it. Users can tap into an online community where others using the app post tips and insights and Brewer personally answers questions. Within a few years, Brewer foresees selling add-ons such as a portable EEG device that plugs into a smartphone, so that smokers can monitor their own brain activity. Each session would be graded by an algorithm to assess progress.

“What we are excited about with goBlue is the ability to see your brain-flow state in real time and to be able to train yourself to be living in the present moment,” says Charlie Hartwell, operating partner at Bridge Builders Collaborative. For his part, Brewer envisions lots of other uses for the software, such as tailoring it to golfers and other athletes so they don’t choke when under pressure, or to help vets with post-traumatic stress.

The marketplace for nicotine cessation apps has more than quadrupled since 2009. Roughly 400 offerings have been downloaded an estimated 1.4 million times per month, says Lorien Abroms, an associate professor of prevention and community health at George Washington University, who recently did a study of the 50 most popular smartphone apps. “It’s like land grab in the app store,” says Abroms, who notes that many offerings were developed by gamemakers, with little grounding in hard science.

In January, goBlue cut the price of its app to $49.99. Despite the move, it’s been downloaded fewer than 100 times, according to Socheata Poeuv, the company’s chief executive officer. Brewer says he’s not troubled by the tepid reception, since his target customers aren’t consumers, but insurers, public health agencies, and corporate wellness programs. His main rival, Voxiva, in 2011 launched Text2Quit, a service that offers everything from counseling to trivia via text message. The service, which is free and has had about 50,000 subscribers, sends out suggestions to call quit lines or use nicotine replacement therapies like gums or patches for more support. “The theory behind Text2Quit is more is better,” says Abroms, who helped design the program. Overall, it’s the incessant electronic “nudge” that seems to be most effective, she says.

Simplicity may be one key to success. Since starting Craving to Quit, Peters has cut his tobacco use in half, but put off his quit date several times. “I haven’t taken the opportunity to fully use all the features,” he says.

The bottom line GoBlue is counting on its scientific credentials to set it apart from the many startups vying for the $1 billion smoking cessation market.


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