How the Fagerström Test for Nicotine Dependence Works
The Fagerström Test for Nicotine Dependence (FTND) is a brief, 6-item questionnaire developed by Heatherton, Kozlowski, Frecker, and Fagerström in 1991 as a revision of the original Fagerström Tolerance Questionnaire. It is the most widely used standardized self-report instrument for estimating how physically dependent a cigarette smoker is on nicotine. Each item is scored 0, 1, 2, or 3 points, and the six item scores are added together for a total that ranges from 0 (very low dependence) to 10 (very high dependence). This calculator asks the same six questions used in the published instrument and sums your answers automatically.
The six FTND items and their scoring weights
- Time to first cigarette (0-3 pts): within 5 minutes = 3, 6-30 minutes = 2, 31-60 minutes = 1, after 60 minutes = 0. This is the single strongest predictor of biochemically measured nicotine dependence.
- Difficulty refraining in forbidden places (0-1 pt): answering "yes" scores 1 point.
- Cigarette hated most to give up (0-1 pt): naming the first cigarette of the day scores 1 point.
- Cigarettes smoked per day (0-3 pts): ≤10 = 0, 11-20 = 1, 21-30 = 2, ≥31 = 3.
- Smoking more in the morning (0-1 pt): answering "yes" scores 1 point.
- Smoking while ill in bed (0-1 pt): answering "yes" scores 1 point.
Interpreting your total score (0-10)
- 0-2 points: Very low dependence.
- 3-4 points: Low dependence.
- 5 points: Medium dependence.
- 6-7 points: High dependence.
- 8-10 points: Very high dependence.
Higher totals generally correspond to more severe nicotine withdrawal symptoms and are commonly used by clinicians as one factor, alongside smoking history and prior quit attempts, when discussing whether higher-dose or combination nicotine replacement therapy (NRT) or prescription medication may help a quit attempt.
Important disclaimer
This calculator is for educational and informational use only. It reproduces a published screening questionnaire but does not replace a clinical evaluation. Use your score as a starting point for a conversation with a doctor, pharmacist, or smoking-cessation counselor about the quitting approach that fits your situation.