Question 1

What FTND score indicates severe nicotine dependence?

Accepted Answer

A score of 8-10 indicates very high (severe) dependence requiring intensive pharmacotherapy and counseling. Scores of 5-7 indicate moderate dependence where pharmacotherapy should be strongly considered, 3-4 indicate low to moderate dependence, and 0-2 indicate very low dependence (Heatherton et al., 1991).

Question 2

How does the FTND inform smoking cessation treatment?

Accepted Answer

Patients scoring 5+ are candidates for NRT, varenicline, or bupropion, with dosing often adjusted by score severity. The first item (time to first cigarette after waking) is the single strongest predictor and can guide initial NRT dosing even alone.

Question 3

Which FTND item is the strongest predictor of dependence?

Accepted Answer

Item 1 ('How soon after waking do you smoke your first cigarette?') is consistently the strongest predictor. This item and item 4 (cigarettes per day) form the Heaviness of Smoking Index (HSI), a 2-item short form that correlates well with the full FTND. Smoking within 5 minutes of waking (score = 3) is the strongest indicator.

Question 4

Is the FTND applicable to non-cigarette nicotine products?

Accepted Answer

The standard FTND is validated only for cigarette smokers. A modified version (FTND-ST) exists for smokeless tobacco. It is not validated for e-cigarettes, cigars, or pipes. For non-cigarette products, use product-specific tools when available.

Question 5

What does my FTND score mean?

Accepted Answer

We have a detailed scoring guide that explains how to interpret your FTND results, including severity ranges and recommended clinical actions. Read our full scoring guide.

FTND: Fagerström Test for Nicotine Dependence

Take the FTND assessment. 6-item test measuring physical nicotine addiction to guide smoking cessation treatment. Free validated nicotine dependence screening.

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