Fagerström Test for Nicotine Dependence (FTND) Calculator
The Fagerström Test for Nicotine Dependence (FTND) is the most widely used clinical tool for measuring how physically dependent a smoker is on nicotine. Answer all 6 questions to get your score (0–10) and see the corresponding dependence level and recommended treatment approach.
Q1 — How soon after waking do you smoke your first cigarette?
Q2 — Do you find it difficult to refrain from smoking in places where it is forbidden?
Q3 — Which cigarette would you hate most to give up?
Q4 — How many cigarettes per day do you smoke?
Q5 — Do you smoke more in the first hours after waking than during the rest of the day?
Q6 — Do you smoke even when you are so ill that you are in bed most of the day?
Low dependence
- 1
Morning urgency score (Q1)
Q1 = 2 = 2Time to first cigarette — weighted 0–3, the strongest predictor of physical dependence. - 2
Daily cigarettes score (Q4)
Q4 = 1 = 1Cigarettes per day — also weighted 0–3. - 3
Remaining questions (Q2 + Q3 + Q5 + Q6)
0 + 0 + 0 + 0 = 0 - 4
FTND total score
2 + 1 + 0 = 3
How does this calculator work?
The FTND scores 6 questions about smoking behaviour to produce a 0–10 nicotine dependence score. Q1 (time to first cigarette) and Q4 (cigarettes per day) carry the most weight (0–3 each). Score 0–2: very low; 3–4: low; 5: medium; 6–7: high; 8–10: very high. Higher scores indicate a need for pharmacotherapy to successfully quit.
Formula
How this is calculated
The FTND was developed by Heatherton, Kozlowski, Frecker, and Fagerström (1991) as a refinement of the earlier Fagerström Tolerance Questionnaire. It uses six questions selected for their strong correlation with salivary cotinine levels — the objective biomarker of nicotine exposure. Two questions (Q1 and Q4) are scored on a four-point scale (0–3) because they have the strongest predictive value: how soon after waking the first cigarette is smoked, and daily cigarette consumption. The remaining four questions contribute one point each.
Scores are interpreted in five bands: 0–2 very low, 3–4 low, 5 medium, 6–7 high, and 8–10 very high dependence. Higher scores predict greater withdrawal severity and a lower likelihood of unassisted quitting. Treatment guidelines (e.g. NICE, WHO) use FTND scores to guide pharmacotherapy: lower scores may be managed with a single nicotine replacement product, while scores of 6 or above typically warrant combination pharmacotherapy (e.g. patch plus fast-acting form) or prescription medication such as varenicline or bupropion.
The FTND is a screening and monitoring tool. It does not measure psychological or social dependence, and scores should always be interpreted alongside a full clinical assessment.
Frequently asked questions
Q1 (time to first cigarette) and Q4 (cigarettes per day) have the strongest correlation with nicotine blood levels and withdrawal severity, so they are weighted more heavily. Time to first cigarette is particularly predictive: smokers who light up within 5 minutes of waking score 3, reflecting a very strong physiological drive to restore overnight-depleted nicotine levels.
Most clinical guidelines suggest that scores of 6 or above (high dependence) warrant prescription-strength treatment — typically varenicline or bupropion, or a combination of nicotine replacement forms. Scores of 5 or below can often be managed with a single over-the-counter nicotine replacement product plus brief counselling. Your doctor or pharmacist can advise on the best option for your situation.
The FTND was validated specifically for cigarette smokers. Its questions about cigarettes per day and first-morning cigarette do not translate directly to e-cigarettes or smokeless tobacco. Adapted versions such as the E-cigarette Dependence Scale (E-CDS) exist for vaping. This calculator should only be used by cigarette smokers.
Also known as
TG we-Calculate Editorial Team. (2026). Fagerström Test for Nicotine Dependence (FTND) Calculator [Online calculator]. TG we-Calculate. https://we-calculate.com/calculator/fagerstrom-test-for-nicotine-dependence-calculator
TG we-Calculate Editorial Team. "Fagerström Test for Nicotine Dependence (FTND) Calculator." TG we-Calculate. 2026. https://we-calculate.com/calculator/fagerstrom-test-for-nicotine-dependence-calculator.
TG we-Calculate Editorial Team, "Fagerström Test for Nicotine Dependence (FTND) Calculator," TG we-Calculate, 2026. [Online]. Available: https://we-calculate.com/calculator/fagerstrom-test-for-nicotine-dependence-calculator
@misc{wecalculate_fagerstrom_test_for_nicotine_dependence_calculator, title = {Fagerström Test for Nicotine Dependence (FTND) Calculator}, author = {{TG we-Calculate Editorial Team}}, howpublished = {\url{https://we-calculate.com/calculator/fagerstrom-test-for-nicotine-dependence-calculator}}, year = {2026}, note = {TG we-Calculate} }
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