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Wellness Center

 


Take the Tobacco Dependency quiz below to determine your level of addiction to nicotine. You may want to print out the quiz and bring it with you to your first Tobacco Cessation counseling session.

 

How many cigarettes per day do you smoke?

Points

10 or less

0

11 - 20

1

21 - 30

2

31 or more

3

 

 

Smokeless: How many tins or pouches per week?

Points

Low: less than one per week

1

Moderate: 2-3 per week

1

Severe: More than 3 per week

2

31 or more

3

 

 

How soon after you wake up do you smoke your
first cigarette or take your first dip or chew?

Points

Within 5 minutes

3

6 - 30 minutes

2

31 - 60 minutes

1

After 60 minutes

0

Do you smoke/chew more frequently during the first hours after awakening than during the rest of the day?

Points

Yes

1

No

0

Which cigarette/chew would you hate most to give up?

Points

The first one in the morning.

1

Any other

0

Do you find it difficult to refrain from tobacco in places where it is forbidden, e.g., in church, at the library, in a movie theater?

Points

Yes

1

No

0

 

 

Do you use tobacco if you are so ill that you are in bed most of the day?

Points

Yes

1

No

0

 

 

FAGERSTROM KEY

SCORE

Level of Dependence

6 - 10

Severe

4 - 5

Moderate

3 or less

Mild

 

 

 

 


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North Dakota State University
Phone: +1 (701) 231-5200 / Fax: (701) 231-5205
Campus address: Wallman Wellness Center 100
Physical/delivery address: 18th Street and Centennial Blvd., Fargo, ND 58102
Mailing address: NDSU Dept. 5140 / PO Box 6050 / Fargo, ND 58108-6050
Page manager: NDSU Wellness Center

http://www.ndsu.edu/wellness/contact/

Last Updated: Wednesday, August 03, 2011 8:19:38 AM