Nicotine Addiction Test

1. How soon after waking do you smoke your first cigarette?

Within 5 minutes 6-30 minutes 31-60 minutes 60 +

2. Do you find it difficult to stop from smoking in places where it is forbidden?

Yes No

3. Which cigarette would you hate to give up?

The first one in the morning Other

4. How many cigarettes per day do you usally smoke?

10 or less 11 to 20 21 to 30 31 or more

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

Yes No

6. Do you smoke even though you are sick in bed most of the day?

Yes No