Fagerström Test for Nicotine Dependence (FTND)

1.How soon after you wake up do you have your first cigarette?
2.Do you find it difficult to refrain from smoking in places where it is forbidden, e.g. in church, the library, the cinema?
3.Which cigarette would you hate most to give up?
4.How many cigarettes do you smoke per day?
5.Do you smoke more often during the first hours after waking than during the rest of the day?
6.Do you smoke even if you are so ill that you are in bed most of the day?

0/6 completed

Notes

Bands as in the Malaysian CPG (2025): 7–10 highly dependent, 4–6 moderately dependent, below 4 minimally dependent. The CPG uses the test to assess the level of nicotine dependence, with exhaled carbon monoxide to verify smoking status.

The cigarettes-per-day item does not pick the NRT gum strength. The CPG gives 2 mg gum below 20 cigarettes a day and 4 mg from 20 upward, but this item groups 11–20 together, so ask the actual number.

Smokers whose first cigarette comes within 30 minutes of waking may do better putting the nicotine patch on just before sleep, so the level peaks on waking (CPG).

The CPG calls this the Modified Fagerström Test for Cigarette Dependence — the same six items and scoring. It is written for cigarettes; vapers need a different tool.

Sources

Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–1127.
Dependence bands: Akademi Profesor Malaysia. Clinical Practice Guidelines on Treatment of Nicotine Dependence and Tobacco Use Disorder 2025, Appendix 3.
Malay version: Anne Yee HA, Ng CG, Rusdi AR. Validation of the Malay version of Fagerstrom test for nicotine dependence (FTND-M) among a group of male staffs in a University Hospital. Malaysian Journal of Psychiatry. 2011;20(1).