Heaviness of Smoking Index Assessment

Answer the following two questions about your smoking habits to assess your smoking intensity and dependence.

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

0 - After 60 minutes

1 - 31-60 minutes

2 - 6-30 minutes

3 - Within 5 minutes

2. How many cigarettes per day do you smoke?

0 - 10 or less

1 - 11-20

2 - 21-30

3 - 31 or more

Gender Select gender Male Female Other

Age Group Select age group 18-25 years 26-35 years 36-50 years 51-65 years 65+ years

Years of Smoking

How many years have you been smoking?

Calculate HSI Score Reset

About HSI Calculator

The Heaviness of Smoking Index (HSI) is a brief, validated tool used to assess smoking intensity and nicotine dependence using only two questions.

Clinical Guidelines:

• • Score ≥4: Consider pharmacotherapy
• • Score ≥5: Strongly recommend medication
• • Score = 6: Intensive treatment needed
• • Sensitivity: 75-85% for nicotine dependence
• • Specificity: 80-90% depending on population

HSI Advantages:

• • Quick assessment (2 questions)
• • Easy to administer
• • Validated across populations
• • Predicts quitting success
• • Guides treatment decisions

Dependence Indicators:

• • Morning smoking within 30 minutes
• • High daily consumption (20+ cigarettes)
• • Rapid smoking after waking
• • Difficulty delaying first cigarette
• • Smoking as priority activity

Quitting Difficulty by Score:

• 0-1: Easier to quit, mild withdrawal
• 2-3: Moderate difficulty, some withdrawal
• 4-5: Difficult, significant withdrawal
• 6: Very difficult, severe withdrawal

Treatment Recommendations:

• Low Dependence (0-3):
• • Behavioral counseling
• • Self-help materials
• • Support groups
• High Dependence (4-6):
• • Pharmacotherapy (NRT, varenicline, bupropion)
• • Intensive behavioral therapy
• • Medical supervision

Success Factors:

• • Strong motivation to quit
• • Social support
• • Stress management skills
• • Previous quit attempts
• • Treatment adherence
• • Avoiding triggers

Professional Resources:

• • Primary care physician
• • Smoking cessation specialist
• • Behavioral therapist
• • Quitline services
• • Support groups
• • Online programs