Fagerstrom Test for Nicotine Dependence Calculator

Assess the intensity of your physical addiction to nicotine using the validated FTND questionnaire.

🚬 Do you currently smoke?

🎉 Great news! You are not nicotine dependent. Keep it up!
Within 5 minutes3 pts
6–30 minutes2 pts
31–60 minutes1 pt
After 60 minutes0 pts
Yes1 pt
No0 pts
The first one in the morning1 pt
Any other0 pts
10 or fewer0 pts
11–201 pt
21–302 pts
31 or more3 pts
Yes1 pt
No0 pts
Yes1 pt
No0 pts
—
Total FTND Score (out of 10)
0246810

What is the Fagerstrom Test for Nicotine Dependence (FTND)?

The Fagerstrom Test for Nicotine Dependence is a validated questionnaire designed to assess the intensity of a person's physical addiction to nicotine. It was originally developed as the Fagerstrom Tolerance Questionnaire (FTQ) by Karl-Olov Fagerstrom in 1978. In 1991, Todd Heatherton and colleagues revised it to create the current version — the FTND.

The FTND provides an ordinal measure of nicotine dependence specifically related to cigarette smoking. It consists of 6 questions covering three core domains:

  • Quantity of cigarettes consumed per day
  • Compulsion to use — difficulty refraining, timing of first cigarette
  • Dependence level — smoking when ill, morning smoking patterns

The test is commonly used by physicians to assess the intensity of physical addiction to nicotine, particularly when documenting indications for prescribing medication for nicotine withdrawal therapy.

Fagerstrom Test Scoring

Each Yes/No question scores 1 or 0 points, while multiple-choice questions score from 0 to 3 points. The total FTND score ranges from 0 to 10.

Score Level of Dependence
0–2 Very low dependence on nicotine
3–4 Low dependence on nicotine
5 Medium dependence on nicotine
6–7 High dependence on nicotine
8–10 Very high dependence on nicotine

The higher the total score, the more severe the physical dependence on nicotine.

How to Use This Calculator

Begin by answering the initial question: "Do you currently smoke?". If your answer is "No," the test is not applicable — you are not nicotine dependent. If your answer is "Yes," the 6-question FTND questionnaire will appear. For each question, choose the option that best describes your smoking behavior. Once all questions are answered, click "Calculate FTND Score" to see your total score and dependence level interpretation.

Health Effects of Smoking

Cigarettes are highly addictive because they contain nicotine. Cigarette smoking is associated with many serious health problems, including:

  • Lung cancer and other cancers (throat, mouth, esophagus, bladder)
  • Chronic obstructive pulmonary disease (COPD)
  • Heart disease and stroke
  • Reduced fertility and pregnancy complications
  • Weakened immune system
  • Premature aging and skin damage

Regardless of how long you have smoked, quitting smoking can significantly improve your health. Within 20 minutes of stopping, your heart rate begins to drop. Within 12 hours, carbon monoxide levels in your blood return to normal. Within 1 year, your excess risk of coronary heart disease is half that of a smoker's.

Limitations of the FTND

While the FTND is widely used, it has some limitations:

  • It measures only physical dependence, not psychological or behavioral aspects
  • It is designed specifically for cigarette smokers and may not apply to other forms of nicotine use (e-cigarettes, smokeless tobacco)
  • Self-reported answers may be subject to recall bias

This tool can never replace professional medical advice. If you are concerned about nicotine dependence, please consult a healthcare professional.