Modified Fagerstrom Test for
Nicotine Dependence
01
How soon after you wake up, you smoke your first cigarette?
a) Within 5 minutes (3 points)b) 5 to 30 minutes (2 points)
c) 31 to 60 minutes (1 point)
d) After 60 minutes (0 point)
02
Do you find it difficult not to smoke in places where you shouldn’t or forbidden?
a) Yes (1 point)b) No (0 point)
03
Which cigarette would you most hate to give up?
a) The first one in the morning (1 point)b) Any other (0 point)
04
How many cigarettes do you smoke each day?
a) 10 or fewer (0 point)b) 11 to 20 (1 point)
c) 21 to 30 (2 points)
d) 31 or more (3 points)
05
Do you smoke more during the first few hours after waking up than during the rest of the day?
a) Yes (1 point)b) No (0 point)
06
Do you still smoke if you are so sick that you are in bed most of the day, or if you have a cold or the flu and have trouble breathing?
a) Yes (1 point)b) No (0 point)
SCORE FAGERSTROME | NO OF CIGARETTE | NICOTINE DEPENDANCE |
|---|---|---|
0 - 3 | < 10 | LOW |
4 - 6 | 10 - 25 | MODERATE |
7 - 10 | > 25 | HIGH |