Appendix 5: The Hooked On Nicotine Checklist (HONC)

AuthorJames G. Wigmore
appendix 5
The Hooked On Nicotine Checklist
. Have you ever tried to quit, but couldn’t?
. Do you smoke NOW because it is really hard to quit?
. Have you ever felt like you were addicted to tobacco?
. Do you ever have strong cravings to smoke?
. Have you ever felt like you really needed a cigarette?
. Is it hard to keep from smoking in places where you are not
supposed to?
When you haven’t used tobacco for a while OR when you tried to stop smoking:
. Did you f‌ind it hard to concentrate because you couldn’t quit?
. Did you feel more irritable because you couldn’t smoke?
. Did you feel a strong need or urge to smoke?
. Did you feel nervous, restless, or anxious because you couldn’t
The HONC is a measure of severity of diminished autonomy. Individuals
who score a zero on the HONC by answering NO to all ten questions enjoy
full autonomy over their use of tobacco. In schools and clinics, smokers
who have scores above zero can be told that they are already hooked.
Source: adapted from DiFranza et al, “Measuring the Loss of Autonomy Over Nicotine Use
in Adolescents: The DANDY (Development and Assessment of Nicotine Dependence in
Youths) Study.” Archives of Pediatrics and Adolescent Medicine, : –, .

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