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Instrument: Fagerstrom Test For Nicotine

Dependence (FTND)
The Fagerstrm Test for Nicotine Dependence is a standard instrument for assessing the intensity of
physical addiction to nicotine. The test was designed to provide an ordinal measure of nicotine
dependence related to cigarette smoking. It contains six items that evaluate the quantity of cigarette
consumption, the compulsion to use, and dependence.

In scoring the Fagerstrom Test for Nicotine Dependence, yes/no items are scored from 0 to 1 and
multiple-choice items are scored from 0 to 3. The items are summed to yield a total score of 0-10.
The higher the total Fagerstrm score, the more intense is the patient's physical dependence on

In the clinic, the Fagerstrm test may be used by the physician to document indications for
prescribing medication for nicotine withdrawal.

The Fagerstrm Tolerance Questionnaire was developed by Karl-Olov Fagerstrm. This instrument
was modified to the Fagerstrm Test for Nicotine Dependence by Todd Heatherton, et al. in 1991.
The FTND is copyrighted by Taylor and Francis Ltd., but may be reproduced without permission, as
available from the source reference (Heatherton, et al., 1991).

Instrument Usage:
Clinical Research


Interview a smoker

Assess the level of dependence using the fagerstrom test.

Analyze the results based on level of dependence.
Why is it important to assess the level of dependence of a smoker?
What health teachings can be given to these clients?
Smokers Profile

Name: J.M. Pionilla

Age: 19 years old


1. 31 to 60 mins. -1
2. No -0
3. Any others -0
4. 10 or less -0
5. Yes -1
6. No -0

TOTAL SCORE: 2 (Very Low Dependence)

The smokers total score is 2. This means that the client has low dependence on
nicotine. This suggests that they may not need Nicotine Replacement Therapy (NRT),
although it is recommended that they still be monitored for withdrawal symptoms.

Nicotine dependence also called tobacco dependence is an addiction to tobacco

products caused by the drug nicotine. Nicotine dependence means you can't stop using
the substance, even though it's causing you harm.

Nicotine produces physical and mood-altering effects in your brain that are temporarily
pleasing. These effects make you want to use tobacco and lead to dependence. At the
same time, stopping tobacco use causes withdrawal symptoms, including irritability and

While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects of
tobacco result from other substances in tobacco. Smokers have much higher rates of
heart disease, stroke and cancer than nonsmokers do.

Regardless of how long you've smoked, stopping smoking can improve your health.
Many effective treatments for nicotine dependence are available to help you manage
withdrawal and stop smoking for good. Ask your doctor for help.