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Fagerström Nicotine Dependence Test

Complete the Fagerström Test for Nicotine Dependence (FTND), a validated 6-item questionnaire. Scores: 0-2 low, 3-4 low-moderate, 5 moderate, 6-7 high, 8-10 very high dependence. Guides NRT dosing and cessation strategy.

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Complete the validated 6-item FTND. Scores predict quit difficulty and guide NRT and medication selection.

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Why: Complete the validated 6-item FTND.

How: Scores predict quit difficulty and guide NRT and medication selection.

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For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.

The Fagerström Test for Nicotine Dependence (FTND) is a validated 6-item questionnaire. Scores: 0-2 low, 3-4 low-moderate, 5 moderate, 6-7 high, 8-10 very high dependence. It guides NRT dosing and cessation strategy. Q1 (time to first cigarette) and Q4 (cigarettes per day) are the most predictive questions.

6
Questions
0-10
Score range
40+
Years validated
50+
Countries

Sources: Fagerström K-O (Addiction), WHO, Clinical guidelines.

Key Takeaways

  • • Q1 (time to first cigarette) is the most predictive question
  • • Scores 5+ strongly benefit from NRT
  • • Scores 7+ need combination therapy (NRT + Rx)
  • • FTND guides medication selection and dosing

Did You Know?

🔢 Q1 and Q4 are scored 0-3 — most predictive of dependence
📊 Cronbach's α = 0.68 — high reliability
💡 Smoking within 5 min of waking = severe dependence
🌍 1-800-QUIT-NOW offers free support 24/7
📈 Combination therapy triples success vs willpower alone
🎯 HSI uses only Q1 and Q4 — correlates 0.90 with full FTND

How Does the Fagerström Test Work?

Q1 & Q4 (0-3 points each)

Time to first cigarette and cigarettes per day. These weighted questions predict quit difficulty

Q2, Q3, Q5, Q6 (0-1 point each)

Difficulty refraining, morning preference, heavy morning smoking, smoking when ill.

Total Score

Sum of all 6 questions = 0 to 10. Higher = more severe dependence, more intensive treatment needed.

Expert Tips

Scores 0-4: Behavioral support may be sufficient; NRT can still improve success
Scores 5-6: 21mg patch or combination NRT strongly recommended
Scores 7+: Combination NRT + Chantix or Wellbutrin — consult your doctor
1-800-QUIT-NOW — free coaching, support, and resources 24/7

Score Interpretation Table

ScoreLevelNRT Recommendation
0-2LowOptional
3-4Low-ModerateConsider 14-21mg patch
5-6Moderate21mg patch or combo
7-10HighCombo NRT + Rx

Frequently Asked Questions

What is the Fagerström Test?

The FTND is a validated 6-question instrument that assesses nicotine dependence intensity. It predicts quit difficulty and guides NRT and medication selection. Used clinically for 40+ years.

What do Fagerström scores mean?

0-2: Low dependence. 3-4: Low-moderate. 5-6: Moderate. 7-10: High dependence. Higher scores indicate more severe withdrawal and need for intensive treatment.

Which questions matter most?

Q1 (time to first cigarette) and Q4 (cigarettes per day) are scored 0-3 and are the most predictive of dependence severity.

Should I use NRT based on my score?

Scores 5+ strongly benefit from NRT. Scores 7+ often need combination therapy (NRT + prescription medication) for best quit success.

Is the Fagerström test validated?

Yes. Used clinically for 40+ years with 1000+ validation studies. High reliability (Cronbach's α = 0.68). Validated in 50+ countries.

When should I take the Fagerström test?

Before setting a quit date to choose the right strategy, or in clinical settings for treatment selection and medication dosing.

Key Statistics

0.68
Cronbach α reliability
2x
NRT doubles quit success
3x
Combo therapy vs willpower
1000+
Validation studies

Official Data Sources

⚠️ Disclaimer: The Fagerström Test is a validated screening tool, not a diagnostic instrument. Your score provides guidance for treatment selection but should be discussed with a healthcare provider for personalized quit planning. If you experience severe withdrawal or mental health concerns when quitting, consult a doctor.

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