FTND: Fagerström Test for Nicotine Dependence

The six-item FTND describes cigarette-related nicotine dependence on a 0-to-10 scale. Survey Doctor assumes the person currently smokes cigarettes.

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Overview

The Fagerström Test for Nicotine Dependence (FTND) asks six questions about current cigarette-smoking patterns and produces a 0-to-10 total. Survey Doctor assumes the person currently smokes cigarettes; it does not collect an eligibility answer. The five displayed bands describe the questionnaire score. They do not diagnose a condition or select treatment.

Eligibility comes first.

The scope stays narrow.

History and scope

Heatherton and colleagues revised the eight-item Fagerström Tolerance Questionnaire into the six-item FTND in 1991. The revision removed two items and changed the scoring of two others.

The standard FTND is for current cigarette smokers. Scope matters. It does not assess vaping, cigars, pipes, or smokeless tobacco. Some study forms first ask whether a person currently smokes; Survey Doctor starts with the six scored questions.

Who may find it useful?

The FTND may be useful if you currently smoke cigarettes and want to:

  • Describe your smoking pattern with a brief questionnaire
  • Understand where your answers fall within the published score bands
  • Share structured information with a healthcare provider
  • Add context to a conversation about quitting

If you do not currently smoke cigarettes, the questions and score may not fit your nicotine use.

Score interpretation

Add the values from all six answers. The NIH Common Data Elements record supports the mixed 0-to-1 and 0-to-3 item values and the 0-to-10 sum. Its score record supplies the five ranges below.

ScoreDependence levelWhat the label describes
0-2Very low dependenceThe lowest range of the current-cigarette scale
3-4Low dependenceThe low range of the scale
5Moderate dependenceThe single-score moderate band
6-7High dependenceThe high range of the scale
8-10Very high dependenceThe highest range of the current-cigarette scale

A score of 5 is the moderate band, not a universal treatment cutoff. It is descriptive. No band determines whether someone should use medication, which medication might fit, or what dose to use.

The NIH score record calls 5 “Medium dependence.” Survey Doctor displays “Moderate dependence” for the same one-point band. Record the numeric score when comparing labels across systems.

Keep the number visible.

Bands do not prescribe.

The FTND is not a diagnostic test. A provider can interpret the result alongside your health, current smoking, previous quit attempts, other medicines, and preferences.

For a plain-language guide to the bands, see what your FTND score means.

What the six questions ask

The questionnaire covers:

  • Time from waking to the first cigarette
  • Difficulty not smoking where smoking is forbidden
  • Which cigarette would be hardest to give up
  • Cigarettes smoked per day
  • Whether smoking is more frequent soon after waking
  • Whether you smoke while ill in bed

Time to first cigarette and cigarettes per day each contribute 0 to 3 points. The other four answers contribute 0 or 1 point. The total combines all six responses.

Administration

The FTND can be answered as a written self-report or read aloud by a provider. It asks about current behavior, with no separate retrospective timeframe.

There is no fixed repeat schedule in the questionnaire. Once someone no longer smokes cigarettes, several questions no longer apply. That changes the task. A provider can choose a different measure when tracking abstinence, cravings, or other nicotine products.

Using the result in a quitting conversation

The score can summarize part of your current smoking pattern. It is not a treatment algorithm.

If you want to quit, share the result with a doctor or another qualified provider. A useful conversation can also cover:

  • What you currently smoke and how often
  • Previous quit attempts
  • Current health conditions and medicines
  • What support you prefer
  • Concerns about side effects or cost

Those details matter when choosing support. Six answers are not enough. The FTND total cannot replace them.

Context still decides.

Limitations

The FTND does not measure:

  • Dependence on e-cigarettes, cigars, pipes, or smokeless tobacco
  • Every psychological or social reason for smoking
  • Motivation or readiness to quit
  • What happened during previous quit attempts
  • Which treatment is safe or suitable for you
  • Whether a future quit attempt will succeed

A lower score does not mean quitting will be easy or that support is unnecessary. A higher score does not mean quitting is impossible.

Source boundary

The NIH record and the 1991 revision establish the six-question structure, current-cigarette scope, and 0-to-10 sum. The NIH score record supplies the five descriptive bands. None of those facts makes the total a universal medication threshold.

Some forms use small wording changes or first confirm current cigarette smoking. Use the same version, eligibility rule, and scoring labels when comparing results over time.

Version details matter.

CAGE: Alcohol Screening Questionnaire: A separate four-question lifetime alcohol screen.

PHQ-9: Patient Health Questionnaire-9: A depression symptom screen for the past two weeks.

GAD-7: Generalized Anxiety Disorder-7: An anxiety symptom screen for the past two weeks.

Related assessment information

These pages cover related assessments. They may measure different constructs or use different populations and recall periods.

AUDIT · 10 questions What the 10-item AUDIT measures, how its 0-to-40 score works, and why WHO risk zones guide follow-up rather than diagnose an alcohol use disorder.AUDIT-C · 3 questions What AUDIT-C measures, how its 0-to-12 total works, and why a positive cutoff depends on the exact form and screening policy.CAGE · 4 questions The CAGE asks four yes-or-no questions about lifetime alcohol-related concerns. Scores run from 0 to 4; a result of 2 or higher supports fuller assessment.CAGE-AID · 4 questions What the four-item CAGE-AID screens for, how its 0-to-4 score works, and why one-point and two-point decision rules serve different purposes.DAST-10 · 10 questions What the 10-item DAST measures, how its 0-to-10 score works, and why the result needs follow-up rather than a diagnosis.DUDIT · 11 questions What the 11-item DUDIT measures, how its 0-to-44 total is calculated, and why its published cutoffs need population context.

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