AI and quitting addictions: how I quit the “Quit with Bella” app and stayed a smoker
I got really excited about Microsoft’s Quit with Bella. As an on and off smoker of 30 years (that hurts to write down), I felt that the time was right to say goodbye to this habit for good. The combination of wanting to quit and an above average interest in artificial intelligence technologies led me to Quit with Bella. Released just over a year ago in January 2018, Quit with Bella is an artificially intelligent assistant in the form of a mobile app developed by the UK company Solutions 4 Health. It uses Microsoft’s Bot Framework and Cosmos DB as its base technologies. It can now be downloaded for both iOS and Android devices. The application uses a knowledge base developed by top experts to guide the users through the process of quitting smoking. After an initial questionnaire, through continuing dialogue with the user, the app offers 24/7 support in the form of chat conversations. My expectations were high, my dedication was firm and the adventure began three weeks ago. This is what unfolded over 3 weeks.
My background as a smoker
Like many people, I started smoking as a teenager, at the age of seventeen. I’ve never been a heavy smoker: never smoked more than a half a pack, at most a pack a day. I have quit multiple times in my life, sometimes for years, but always got back to the habit. I have gone “cold turkey” at times, tried using NHS’s quitting smoking service (which included personal help appointments) as well as nicotine replacement therapy (NRT) in the form of nicotine patches. Smoking seems to be my number one stress management aid and I’m very aware of how bad it is for me.
The process and meeting Bella
I downloaded the app onto my iPhone 7+ on the very day I decided to quit smoking. The app is free and easy to get going. I was asked a series of questions regarding my age, my profession and my smoking habits. Nothing surprising there. The questions were asked and answered in the form of a chat, except for the basic identifiers such as name, login details, address, age, and gender which were filled out in a pop up form. Bella’s avatar is a slim woman of about 30, with white skin, auburn hair and she seems to be wearing a white nurse’s gown.
There are no alternative choices offered for other avatars, people of different ages, skin colours or genders. I started the chat dialogue and I was really excited at first. It was, after all, my first blossoming relationship with a virtual “robot.”
Not so personalised…
My first surprise was how superficial the questions were. I have filled out smoking questionnaires before and an essential indicator is a person’s level of addiction. A version of these questions did indeed show up: the number of cigarettes smoked daily, how long after waking up in the morning is my first cigarette smoked, number of previous quitting attempts, whether it’s uncomfortable for me to attend events where I can’t smoke — etc… The answers to these standard questions usually provide a good understanding of how addicted a smoker is and they are widely used by the NHS and other consultants. I felt that the app format and the 24/7 availability of Quit with Bella would allow for much deeper questions and better data gathering. I literally felt that I should be sharing more information about my smoking habits and triggers. Surely this quitting assistant can only be as helpful if it really knows you and your habit and gets detailed data to do that? Maybe those questions would come later? Nope.
Bella started pushing
At some point of the initial getting acquainted with Bella, I disclosed that I have used nicotine replacement therapy in the past, in the form of nicotine patches. That got her flying. From that point on Bella became a channel minded drug pusher.
She was offering up patches of different kinds over and over again. Based on my smoking profile (moderate smoker) I was offered level 2 patches, those were the ones Bella was recommending repeatedly.
Where things went wrong
I stuck with Bella. Dedicated to quitting smoking, armed with nicotine patches and and AI assistant, I was cruising along nicely. While I was a nice and obedient quitter, Bella and I got along just fine. I got daily trivia about how healthy I was going to become and nice compliments about how great I was doing. I was checking in regularly and felt mighty proud of myself. Then life happened. Things were heating up at home and work and I began to stress. I lasted about a week before I began to tear off the nicotine patches after a few hours and went for a puff or two outside. I yelled and cried at Bella who was asking me through push notifications questions about how I was doing. She gave long winded answers to whatever I was saying, but her comments never seemed personalised at all. She offered up more patches and some videos about how awesome NRT is. With her it seemed to be all about the selling of the patches. The app’s developers claim that using Quit with Bella is like talking to a real person. What real person would respond to a desperate outbursts of “I wish I could smoke” with “I’m so excited for you”? To “I’m SMOKING AGAIN! Help!” (sic) with a long paragraph of generic advice, including things like “put the money you used to spend on cigarettes into a jar and watch it mount up”?
Things were not looking good. My AI assistant was acting like a dumb robot, even though a kind one. She was no match for someone with cigarette cravings. I stared at her cold, blue eyes and felt angry and betrayed. At that point I didn’t feel like joining the “Quit with Bella Community”, an option on the app that was offered up multiple times. I knew I had that option from getting to know the app. I didn’t need an app for a support group with strangers. I’ve never been an “online group therapy” person, that’s been quite obvious since I gained weight in every Facebook diet group I ever checked out. It was time for a break-up.
The quitting of quitting
Things were going downhill. Everyone familiar with addiction knows that the “I’ll just have one cigarette” thought is the boarding call for full blown smoking. I found myself avoiding Bella who kept flashing on my screen with notifications asking how I am doing. I was doing OK as a smoker, but that was not the goal of this all, was it.
At some point I logged in again to say hello and finally got it through to her that I was smoking again and she offered up a higher dose of nicotine patches. Drug pushing again, my dealer was relentless. Then for reasons unknown all the sudden I was not able to send messages again. The app was up and running, I could get into settings, but I was not able to type in the comment field. I rebooted my phone, closed and reopened the app, deleted and re-downloaded the app and the chat window was frozen in the same place where I was supposed to pick a new NRT product. It seems like Bella too gave up on me.
What I learnt — I hope Bella learnt something too!
Quitting smoking is never as easy as not buying that next pack of cigarettes. Smoking, like all addictions usually has its deep roots in a personal need for a fix. Many people can quit for a day, a week, or a month, but if their need is unmet, they will pick up the habit again. NRT can help, yes, as can all kinds of support, live or AI based.
Quit with Bella doesn’t take into consideration that quitting smoking is a different experience for everyone and pushing messages or products might not be enough, or it might even be off-putting. I accidentally committed to using NRT in the app and it seemed to be almost impossible to get off that path. Without creating a different login I was unable to get Bella’s AI mind off the NRT route before the app stopped working for me. She might not be a drug pusher to everyone, but she was sure was one for me. Quit with Bella needs to go much deeper into the smoker’s mind to find their reasons for smoking, their personal needs and triggers. Responses should be more personalised, even if that means collecting more personal data. Finally, the app needs to be made more robust, with a quicker launch and less freezes.
Will I quit smoking? I’m absolutely sure. Will I quit with Bella? Most certainly not.
Bogi Szalacsi is a Senior Associate with infoNation, based in London. You can contact her at firstname.lastname@example.org and follow her on Twitter: @infoNation5.