A two-question screening can reliably estimate a smoker’s likelihood of quitting, a finding highlighted in a recent peer-reviewed study. The goal was to identify a quick, accurate substitute for longer assessments that are cumbersome in busy clinical settings and everyday life.
The Fagerström Test for Nicotine Dependence is long regarded as the gold standard for measuring tobacco addiction. Yet its length makes it impractical for routine use, especially when patients face time constraints or when healthcare systems in Canada and the United States seek rapid decision support. In the new research, scientists demonstrated that two simple questions could often match the predictive power of the full questionnaire: whether a person lights up their first cigarette within minutes of waking, and the total number of cigarettes smoked per day. These items serve as proxies for dependency intensity and daily tobacco exposure, capturing core drivers of withdrawal risk and relapse potential.
In a large, multicenter trial, researchers applied this pared-down screening to about six thousand cancer patients. Across most subgroups, the two-question test performed on par with the Fagerström instrument in predicting quit success at 3, 6 and 9 months. The results held steady across diverse cancer types, ages, and treatment plans, suggesting that a rapid screener can provide meaningful guidance for both patients and clinicians in Canada and the United States.
Estimates of quitting success among people diagnosed with cancer vary widely, with a substantial portion continuing to smoke after diagnosis. Even so, stopping smoking after a cancer diagnosis is linked to improved treatment outcomes, a lower risk of secondary cancers, and a better overall quality of life. For individuals facing cancer therapy, a reliable, fast assessment of nicotine dependence can help tailor interventions—ranging from intensive counseling to pharmacologic aids—and can direct patients toward appropriate support from addiction specialists and behavioral health experts when needed.
Several experts emphasized that an efficient and accurate quit-potential screen is a valuable addition to oncology care. By promptly identifying patients at higher risk of continued smoking, clinicians can implement proactive strategies, such as motivational interviewing, nicotine replacement therapy, or alternative medications, and monitor progress over time to maximize the chances of cessation and better treatment response.
Earlier discussions in the field have explored how addressing tobacco use can improve cardiovascular and overall health outcomes even for those who do not fully quit. The overarching message remains clear: integrating simple, validated screening tools into routine cancer care can make a meaningful difference in survivorship, treatment success, and long-term well-being. Even in busy clinical environments, a concise two-item approach offers a practical path to identifying patients who may benefit most from targeted cessation support. This aligns with ongoing efforts to enhance patient outcomes through streamlined assessment, patient-centered counseling, and coordinated care across medical specialties.