Fagerstrom Test for Nicotine Dependence

Original/alternative title:  FTND


The Fagerstrom Test for Nicotine Dependence was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains six items that evaluate the quantity of cigarette consumption, the compulsion to use, and dependence. It is useful as a screen for nicotine dependence and as a severity rating that can be used for treatment planning and prognostic judgments.

The Modified Fagerstrom Tolerance Questionnaire (mFTQ; Prokhorov et al., 1998) is an adapted version of a scale originally designed to assess behavioral indicators of physical dependence on nicotine among adult smokers (FTQ). It includes a modified set of adult symptoms for adolescents to address graded levels of smoking behavior, avoidance of the physiological effects of nicotine deprivation, and perceived difficulty refraining when prevented from smoking. It has been shown to predict continued smoking, quantity and frequencey of tobacco use, and shorter periods of abstinence from smoking over time.

The FTND is sometimes also called the FTCD -- Fagerstrom Test for Cigarette Dependence.

Additional information

Heatherton TF; Kozlowski LT; Frecker RC; Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence : a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991;86(9):1119-1127.

Prokhorov AV, et al. Testing the nicotine dependence measure mFTQ for adolescent smokers: A multinational investigation. Am J Addict 2017;26(7):689-696. doi: 10.1111/ajad.12583

Carpenter MJ; Baker NL; Gray KM; Upadhyaya HP. Assessment of nicotine dependence among adolescent and young adult smokers: a comparison of measures. Addictive Behaviors 2010;35(11):977-982.

Courvoisier DS; Etter J. Comparing the predictive validity of five cigarette dependence questionnaires. Drug and Alcohol Dependence 2010; 107(2-3):128-133.

Courvoisier D; Etter J. Using item response theory to study the convergent and discriminant validity of three questionnaires measuring cigarette dependence. Psychology of Addictive Behaviors 2008;22(3):391-401.

Rios-Bedoya CF, Snedecor SM, Pomerleau CS, Pomerleau OF. Association of withdrawal features with nicotine dependence as measured by the Fagerstrom Test for Nicotine Dependence (FTND). Addict Behav 2008;33(8):1086-9.

Kleinjan M; van den Eijnden RJJM; van Leeuwe J; Otten R; Brug J; Engels RCME. Factorial and convergent validity of nicotine dependence measures in adolescents: Toward a multidimensional approach. Nicotine and Tobacco Research 2007;9(11):1109-1118.