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Home > Tobacco Use Cessation Program > Didactic Components > Fagerstrom Nicotine Dependence Questionnaire

The Fagerstrom Nicotine Dependence Questionnaire

QUESTION: ANSWERS: SCORE:

1. How soon after you wake up do you smoke your first cigarette? (circle appropriate number)

 

a. Within 5 minutes

b. 6-30 minutes

c. 31-60 minutes

d. After 60 minutes

3

2

1

0

2. Do you find it difficult to refrain from smoking in places where it is forbidden (such as churches, theaters, libraries, etc.)?

a. Yes

b. No

1

0

3. Which of all the cigarettes you smoke in a day is the most satisfying?

a. The first one in the morning

b. Any other

1

0

4. How many cigarettes do you smoke a day?

 

 

a. 10 or less

b. 11-20

c. 21-30

d. 31 or more

0

1

2

3

5. Do you smoke more in the morning than during the rest of the day?

a. Yes

b. No

1

0

6. Do you smoke if you are so ill that you are in bed most of the day?

a. Yes

b. No

1

0

Your Score =

 _______

Score Results:

0-5 = low to moderate nicotine dependence

6-10 = high nicotine dependence

 
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