Heaviness of Smoking Index (HSI)
Assess your nicotine dependence with the validated Heaviness of Smoking Index (HSI) test. Two quick questions measure time to first cigarette and daily quantity for a 0-6 score with low, medium, or high dependence classification.
About This Calculator
The Heaviness of Smoking Index (HSI) Calculator helps you quickly assess your nicotine dependence level using a validated two-question screening tool. Developed from the Fagerstrom Test for Nicotine Dependence (FTND), the HSI is widely used in clinical settings, smoking cessation programs, and research to categorize smokers by their level of dependence.
The HSI questionnaire asks two questions: how soon after waking you have your first cigarette (a strong indicator of physical dependence) and how many cigarettes you smoke per day. Each answer is scored from 0 to 3 points, and the combined score (0 to 6) classifies dependence as low, medium, or high. Higher scores indicate greater nicotine dependence and may require more intensive cessation support.
Regional Notes
India: India has one of the highest tobacco use rates globally, with approximately 267 million tobacco users. The government runs the National Tobacco Control Programme (NTCP) and offers free quit support through QUITLINE (1800-11-2356). The Cigarettes and Other Tobacco Products Act (COTPA) regulates smoking in public places.
United States: The US FDA regulates tobacco products and funds state quitlines. The Affordable Care Act requires insurance plans to cover smoking cessation counseling and FDA-approved medications. The Tips From Former Smokers campaign has helped millions quit.
United Kingdom: The UK has comprehensive tobacco control policies including plain packaging, high taxes, and an annual Stoptober campaign. NHS Stop Smoking Services provide free one-on-one and group counseling. The UK aims to be smoke-free by 2030.
Frequently Asked Questions
What is the Heaviness of Smoking Index (HSI)?
The Heaviness of Smoking Index (HSI) is a validated two-question screening tool that measures nicotine dependence. It uses the time to first cigarette after waking and the number of cigarettes smoked per day to calculate a dependence score from 0 to 6, which is classified as low (0-2), medium (3-4), or high (5-6) dependence.
How is the HSI score calculated?
The HSI score is the sum of two component scores. Time to first cigarette: within 5 minutes (3 points), 6-30 minutes (2 points), 31-60 minutes (1 point), or after 60 minutes (0 points). Cigarettes per day: 31 or more (3 points), 21-30 (2 points), 11-20 (1 point), or 10 or fewer (0 points). The maximum total score is 6.
What do the HSI score levels mean?
HSI scores are classified into three levels: Low dependence (0-2 points) indicates minimal nicotine dependence; Medium dependence (3-4 points) indicates moderate nicotine dependence where cessation support may be beneficial; High dependence (5-6 points) indicates strong nicotine dependence where professional medical help and pharmacotherapy are strongly recommended for successful quitting.
Is the Heaviness of Smoking Index used by doctors?
Yes, the HSI is widely used in clinical settings and population surveys to quickly assess nicotine dependence. It is derived from the Fagerstrom Test for Nicotine Dependence (FTND) and is commonly used by healthcare providers, smoking cessation clinics, and researchers to determine the appropriate level of intervention for smokers.
Can I quit smoking if my HSI score is high?
Yes, even with a high HSI score, quitting smoking is possible. A high score indicates stronger nicotine dependence, which may require additional support such as nicotine replacement therapy (patches, gum, lozenges), prescription medications (varenicline, bupropion), counseling, or smoking cessation programs. Consult a healthcare provider to create a personalized quit plan.
How many people smoke cigarettes in India, the US, and the UK?
In India, approximately 267 million adults (over 28% of the population) use tobacco products, with about 100 million cigarette smokers. In the United States, around 28 million adults (11.5%) smoke cigarettes. In the United Kingdom, about 6 million adults (13%) smoke cigarettes. Smoking rates have declined in all three countries due to public health initiatives.
What smoking cessation resources are available in India, the US, and the UK?
In India, the National Tobacco Control Programme (NTCP) and QUITLINE (1800-11-2356) provide free cessation support. In the US, 1-800-QUIT-NOW connects callers to state quitlines offering free counseling and nicotine patches. In the UK, the NHS offers free Stop Smoking Services, and the Smokefree National Helpline (0300 123 1044) provides telephone support.
Is the HSI calculator free to use?
Yes, this HSI calculator is completely free to use with no registration required. Your answers are not stored or shared. You can also share your results via the URL, which saves your input selections.