6-item measure of nicotine dependence severity for smoking cessation planning. ≈ 2 min to complete. Free with attribution.
FTND (Fagerstrom Test for Nicotine Dependence) is a validated clinical instrument used to assess 6-item measure of nicotine dependence severity for smoking cessation planning.. It is most often used for 6-item measure of nicotine dependence severity for smoking cessation planning.. The instrument contains 6 items. Typical administration time is ≈ 2 min.
Source / attribution: Free to use with citation
6-item measure of nicotine dependence severity for smoking cessation planning. FTND is part of standard practice in this setting because it provides a structured, replicable assessment that can be tracked over time and compared across patients or visits.
Like all screening or assessment instruments, FTND is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 6 items below to see your FTND score and interpretation.
Each item is scored on a 4-point scale (0–3). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
Sum all 6 items with weighted scoring. Total range 0-10. Higher = greater dependence.
Scoring notes: Sum all 6 items with weighted scoring. Total range 0-10. Higher = greater dependence.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–2 | Low dependence | Self-help |
| 3–4 | Moderate dependence | Consider NRT |
| 5–6 | High dependence | Combination NRT + counseling |
| 7–10 | Very high dependence | Intensive treatment |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | How soon after you wake up do you smoke your first cigarette? | 31-60 minutes | 1 |
| 2 | Do you find it difficult to refrain from smoking in places where it is forbidden? | Yes | 1 |
| 3 | Which cigarette would you hate most to give up? | Any other | 0 |
| 4 | How many cigarettes per day do you smoke? | 11-20 | 1 |
| 5 | Do you smoke more frequently during the first hours after waking than during the rest of the day? | No | 0 |
| 6 | Do you smoke even when you are so ill that you are in bed most of the day? | Yes | 1 |
Add up all the item scores you noted in Step 1.
1 + 1 + 0 + 1 + 0 + 1 = 4
Find the row in the interpretation table whose range contains your total:
Total = 4 falls between 3 and 4 → Moderate dependence
Moderate dependence. Consider NRT
A score is one input alongside history and examination. FTND supports clinical judgment — it does not replace it.
Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.
If FTND doesn't fit your context, related instruments in addiction include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| AUDIT | 10-item WHO screening tool for hazardous alcohol consumption and dependence. | 10 | ≈ 3 min |
| AUDIT-C | 3-item brief version of AUDIT for quick alcohol screening in clinical settings. | 3 | ≈ 1 min |
| CAGE | Classic 4-item screening test for alcohol problems. | 4 | ≈ 1 min |
| DAST-10 | 10-item brief screener for drug use problems excluding alcohol and tobacco. | 10 | ≈ 3 min |
| PHQ-9 | Severity of depression | 9 | ≈ 3 minutes |
| GAD-7 | Severity of generalized anxiety | 7 | ≈ 2 minutes |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
| Glasgow Coma Scale | Level of consciousness after head injury | 3 | — |
FTND (Fagerstrom Test for Nicotine Dependence) is a validated instrument that assesses nicotine dependence severity for smoking cessation planning. It is designed for clinicians, medical students, evidence-synthesis researchers. It takes about 2 min to complete, and the 6 items are summed to produce a total score.
FTND typically takes about 2 min to administer. The exact duration varies a little depending on whether it is self-administered or completed with a clinician. Its brief format is part of what makes it practical for routine clinical use and for repeat administration when tracking change over time.
FTND contains 6 items. Item scores are summed to produce the total. Scores run from 0 to 10, grouped into 4 interpretation bands from ‘Low dependence’ up to ‘Very high dependence’.
On the FTND (total score 0–10), scores of 7–10 fall in the ‘Very high dependence’ band — interpreted as: Intensive treatment. The full ladder is: 0–2 — Low dependence: Self-help.; 3–4 — Moderate dependence: Consider NRT.; 5–6 — High dependence: Combination NRT + counseling.; 7–10 — Very high dependence: Intensive treatment. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–2 fall in the ‘Low dependence’ band: Self-help. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
FTND has reported Cronbach's α of 0.61 in validation samples and test–retest reliability of 0.73. Predicts withdrawal severity and treatment outcomes. In practical terms, a Cronbach’s α around 0.61 indicates modest internal consistency (the items hang together well), and a test–retest reliability of 0.73 means scores are well when the scale is repeated without real clinical change.
FTND is free to use with attribution — clinical, educational, and research use is permitted provided the original source is credited. If you publish results or reproduce the scale, include the citation to the source paper.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence. British Journal of Addiction, 86(9), 1119-1127. This is the original publication for the FTND — the reference to cite when reporting results.
No. FTND is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of nicotine dependence severity for smoking cessation planning — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
FTND is supported by the following peer-reviewed sources: