• Prevention
  • Addiction medicine
  • Pulmonology
  • General medicine

Fagerström score

Assess tobacco dependence

The six-item Fagerström Test for Nicotine Dependence (FTND) assesses tobacco dependence, particularly through the smoking pattern. It contributes to the initial evaluation of a smoking patient, without encapsulating all the factors involved in smoking cessation.

Number of questions
6 questions
Approximate duration
1 to 2 minutes
Population
Adult cigarette smokers
Modality
Self-administered questionnaire or interview

QuestionnaireFagerström

SELF-QUESTIONNAIRE

Not all items carry the same weight. The number of cigarettes and the time between waking up and having the first cigarette contribute heavily to the result; the other items explore related behaviours.

Are you patient?

You can fill it in yourself based on your usual consumption. A low score does not mean that smoking is risk-free or that support would be unnecessary.

Question 1 / 6

1

How soon after you wake up do you smoke your first cigarette?

Terms of contract

The interview allows the total score to be supplemented with previous attempts, experienced difficulties, and the patient's expectations. The questionnaire does not replace this contextualization.

Score interpretationFagerström

The total score is between 0 and 10. The time to the first cigarette and the number of cigarettes per day are worth up to 3 points; the other questions are worth 1 point.

Total score

First reading

  • 0 to 2

    No dependence detected according to the scale (0 to 2).

  • 3 to 4

    Low dependence according to the scale (3 to 4).

  • 5 to 6

    Moderate dependence according to the scale (5 to 6).

  • 7 to 10

    High or very high dependence according to the scale (7 to 10).

The six-question Fagerström test assesses cigarette dependence on a score of 0 to 10: - 0 to 2 points: no dependence according to the test. - 3 to 4 points: low dependence. - 5 to 6 points: moderate dependence. - 7 to 10 points: high or very high dependence. These categories correspond to the full version of the test. They are not directly comparable to those of the simplified two-question Fagerström test, which is scored out of 6 points. The result must be supplemented by a clinical evaluation and does not, on its own, determine smoking cessation treatment.

The result indicates one dimension of dependence. It is not sufficient to determine a treatment or dosage, which require an individualised assessment. The test was developed for cigarettes and should not be transposed without validation to other nicotine products.

Frequently asked questions

Sources and references

Todd F. Heatherton, Lynn T. Kozlowski, Richard C. Frecker, Karl O. Fagerström

Initial validation: British Journal of Addiction, 1991. Interpretation guide: HAS, 2014.

Questionnaires and associated scores

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