FTND: Fagerstrom Test for Nicotine Dependence

6-item measure of nicotine dependence severity for smoking cessation planning. ≈ 2 min to complete. Free with attribution.

addiction 6 items ≈ 2 min Updated 2026-05-06

Score FTND below → Download printable PDF View source paper (DOI)
What is FTND? FTND (Fagerstrom Test for Nicotine Dependence) is a validated instrument used to assess 6-item measure of nicotine dependence severity for smoking cessation planning.. It is used in 6-item measure of nicotine dependence severity for smoking cessation planning.. It comprises 6 items. Administration takes about 2 min.

What is FTND?

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

Clinical context: when FTND is used

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.

Score FTND

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.

How FTND is scored

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.

FTND score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–2Low dependenceSelf-help
3–4Moderate dependenceConsider NRT
5–6High dependenceCombination NRT + counseling
7–10Very high dependenceIntensive treatment

How to score FTND: a step-by-step worked example

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.

Step 1 — Score each item

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.

#ItemExample responseScore
1How soon after you wake up do you smoke your first cigarette?31-60 minutes1
2Do you find it difficult to refrain from smoking in places where it is forbidden?Yes1
3Which cigarette would you hate most to give up?Any other0
4How many cigarettes per day do you smoke?11-201
5Do you smoke more frequently during the first hours after waking than during the rest of the day?No0
6Do you smoke even when you are so ill that you are in bed most of the day?Yes1

Step 2 — Add up the scores

Add up all the item scores you noted in Step 1.

1 + 1 + 0 + 1 + 0 + 1 = 4

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 4 falls between 3 and 4Moderate dependence

Step 4 — What does this mean clinically?

Moderate dependence. Consider NRT

A score is one input alongside history and examination. FTND supports clinical judgment — it does not replace it.

Score FTND with your own answers above →

FTND psychometric properties

Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.

Limitations & common pitfalls

How FTND compares to other addiction scales

If FTND doesn't fit your context, related instruments in addiction include:

ScaleMeasuresItemsTime
AUDIT10-item WHO screening tool for hazardous alcohol consumption and dependence.10≈ 3 min
AUDIT-C3-item brief version of AUDIT for quick alcohol screening in clinical settings.3≈ 1 min
CAGEClassic 4-item screening test for alcohol problems.4≈ 1 min
DAST-1010-item brief screener for drug use problems excluding alcohol and tobacco.10≈ 3 min
PHQ-9Severity of depression9≈ 3 minutes
GAD-7Severity of generalized anxiety7≈ 2 minutes
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8
Glasgow Coma ScaleLevel of consciousness after head injury3

Frequently asked questions about FTND

What does FTND measure?

FTND (Fagerstrom Test for Nicotine Dependence) is a validated instrument that assesses 6-item measure of nicotine dependence severity for smoking cessation planning.. Its primary clinical use is 6-item measure of nicotine dependence severity for smoking cessation planning..

How long does FTND take to complete?

FTND typically takes ≈ 2 min to administer. Time can vary slightly depending on whether it is self-administered or clinician-led.

How many items are on FTND?

FTND contains 6 items. Items are summed to produce a total score.

What is a high FTND score?

Scores of 7–10 fall in the "Very high dependence" band. Intensive treatment

What is a low FTND score?

Scores of 0–2 fall in the "Low dependence" band. Self-help

How reliable is FTND?

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.

Is FTND free to use?

FTND is free to use with attribution. Free to use with citation

What is the source paper for FTND?

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.

Can FTND replace clinical judgment?

No. FTND is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

FTND is supported by the following peer-reviewed sources: