How Dependent on Nicotine are You?

1. Do you often find yourself smoking a cigarette when you are not aware of lighting one up?

2. Do you associate your smoking with other actions such as having an alcoholic beverage or talking on the phone?

3.  Do you sometimes forget to smoke all day?

4.  Do you smoke more after having an argument with someone?

5.  Is smoking one of the greatest pleasures in your life?

6.  Does the thought of never again smoking make you feel sad?

□  Yes         □  No

□  Yes         □  No

□  Yes         □  No

□  Yes         □  No

□  Yes         □  No

□  Yes         □  No

A=0

Points

B = 1

Point

C = 2

Points

SCORE

1. How soon after you wake do you smoke your first cigarette

After 30 minutes

Within 30 minutes

N/A

2. Do you find it difficult to refrain from smoking in places where it is forbidden, such as the library, theater, doctor's office?

No

Yes

N/A

3. Which of all the cigarettes you smoke in a day is the most satisfying?

Any other than the first one in the morning

The first one in the morning

N/A

4. How many cigarettes a day do you smoke?

1-15

16-25

25+

5. Do you smoke more during the morning than during the rest of the day?

No

Yes

N/A

6. Do you smoke when you are ill (i.e. in bed most of the day)?

No

Yes

N/A

7. Does the brand you smoke have a low, medium or high nicotine content?

Low

0.4 mg

Medium

.5-.9 mg

High

1.0 mg

A score of 4 points or more suggests you are dependent on nicotine. Want to quit? Talk with your health care provider or call the Counseling and Health Promotion office at 320-363-2587.

TOTAL