Fagerstrom Test For Nicotine Dependence

Take the Fagerstrom Test for Nicotine Dependence (FTND) online. Answer 6 questions to assess your nicotine addiction severity from very low to very high dependence. Free self-assessment tool with charts and breakdowns.

Assess your nicotine dependence level

1. How soon after waking do you smoke your first cigarette?

2. Do you find it difficult to refrain from smoking in places where it is forbidden?

Yes No

3. Which cigarette would you hate most to give up?

The first one in the morning Any other

4. How many cigarettes per day do you smoke?

5. Do you smoke more frequently during the first hours after waking than during the rest of the day?

Yes No

6. Do you smoke even when you are so ill that you are in bed most of the day?

Yes No

About This Calculator

The Fagerstrom Test for Nicotine Dependence (FTND) is a widely validated 6-question self-assessment tool that measures the intensity of physical addiction to nicotine. Developed by Swedish psychologist Karl Fagerstrom in 1978, it evaluates cigarette consumption patterns, the compulsion to smoke, and the degree of dependence. This screening tool is used globally by healthcare professionals including doctors, nurses, and pharmacists to assess smoking addiction severity and guide cessation treatment.

The FTND questionnaire assesses two key scored dimensions: smoking timing and quantity. Questions 1 (time to first cigarette) and 4 (cigarettes per day) are scored from 0 to 3 points, while questions 2, 3, 5, and 6 are yes/no responses scored 0 or 1 point. The total score ranges from 0 to 10. A score of 0-2 indicates very low dependence, 3-4 low dependence, 5 moderate dependence, 6-7 high dependence, and 8-10 very high dependence. Higher scores typically indicate stronger physical dependence and predict greater difficulty quitting without support.

Regional Notes

India: With over 267 million tobacco users, the FTND is widely used in Indian tobacco cessation clinics and public health programs. The Indian government's National Tobacco Control Programme (NTCP) incorporates dependence assessment for tailored interventions. Tobacco use in India includes both smoking and smokeless forms.

United States: The FTND is used by healthcare providers under the Affordable Care Act and the CDC's Tips From Former Smokers campaign. The US Preventive Services Task Force recommends screening for tobacco use and offering cessation interventions. Nicotine replacement therapy is available over-the-counter.

United Kingdom: The NHS includes FTND assessment in its Stop Smoking Services. The National Institute for Health and Care Excellence (NICE) guidelines recommend FTND as part of smoking cessation pathways. Nicotine replacement therapy and prescription medications are available through the NHS.

Frequently Asked Questions

What is the Fagerstrom Test for Nicotine Dependence (FTND)?

The Fagerstrom Test for Nicotine Dependence (FTND) is a standard 6-question instrument developed by Karl Fagerstrom in 1978 for assessing the intensity of physical addiction to nicotine. It evaluates cigarette consumption, compulsion to use, and dependence. Scores range from 0 to 10, with higher scores indicating more severe nicotine dependence.

How is the FTND scored?

The FTND has 6 questions. Two questions (time to first cigarette and cigarettes per day) are scored 0-3, and four yes/no questions are scored 0 or 1. Total score: 0-2 very low dependence, 3-4 low dependence, 5 moderate dependence, 6-7 high dependence, 8-10 very high dependence.

What does a high FTND score mean?

A high FTND score (6-10) indicates stronger physical dependence on nicotine. Individuals with high scores may experience more intense withdrawal symptoms when quitting and may benefit from nicotine replacement therapy (NRT) or other cessation aids under medical supervision.

Can the FTND be used for e-cigarettes or vaping?

The original FTND was designed for cigarette smoking. Modified versions exist for electronic nicotine delivery systems. If you vape, the Penn State Electronic Cigarette Dependence Index may be more appropriate. This FTND calculator is validated for cigarette smokers.

Is the FTND used in India, US, and UK?

Yes, the FTND is used globally. In India, it is used in tobacco cessation clinics and public health research. In the US, healthcare providers use it to assess nicotine dependence under the Affordable Care Act. In the UK, the NHS recommends FTND for smoking cessation services. It is validated across all populations.

Who can administer the Fagerstrom Test?

The FTND is a self-report questionnaire that can be completed by individuals without professional assistance. In clinical settings, nurses, pharmacists, and physicians use it to assess nicotine dependence and determine appropriate cessation strategies and nicotine replacement therapy.

What are the limitations of the FTND?

The FTND focuses primarily on physical dependence and may not capture behavioral or psychological aspects of smoking addiction. It also does not assess social or environmental triggers. Clinicians often supplement FTND with other assessments for a comprehensive evaluation.

Can I quit smoking based on my FTND score?

Your FTND score helps determine the appropriate level of support needed for quitting. Higher scores suggest greater benefit from pharmacotherapy (nicotine patches, gum, lozenges, or prescription medications). Consult a healthcare provider in India (tobacco cessation clinics), US (1-800-QUIT-NOW), or UK (NHS Stop Smoking Services) for a personalized quit plan.