Overview
Mental health screening questionnaires and nicotine dependence scales serve a similar purpose to the alcohol and drug screens covered elsewhere on this site: they turn a handful of plain-language questions into a number that's fast to compute and easy to track over time. PHQ-2 and GAD-7 are the two most widely used brief screens in primary care for depression and anxiety symptoms, respectively, while the Fagerström Test measures physical nicotine dependence — a different but related axis of substance use that intersects with recovery tracking once someone decides to quit.
This guide is educational content, not a diagnosis or medical advice. None of the tools below — PHQ-2, GAD-7, the Fagerström Test, or the recovery trackers that follow — can diagnose depression, an anxiety disorder, or nicotine dependence on their own. Scores from validated screening instruments are meant to be interpreted by, or in conversation with, a qualified mental health or medical professional; a high score is a reason to seek that conversation, not a self-contained conclusion, and a low score doesn't rule out symptoms that may still be worth discussing if they're affecting your daily life.
The five tools below cover brief depression and anxiety screening first, then nicotine dependence, and close with two practical recovery trackers — one quantifying the concrete benefits of quitting smoking, and one converting a sobriety day count into meaningful milestones.
Step 1: Screen for Depression in Two Questions with PHQ-2
PHQ-2 is a two-question depression screen drawn from the longer Patient Health Questionnaire family, asking specifically about the frequency of two core symptoms over the past two weeks: little interest or pleasure in doing things (anhedonia), and feeling down, depressed, or hopeless. Each question is scored 0 ("not at all") to 3 ("nearly every day"), giving a maximum score of 6.
A total score of 3 or higher is the standard threshold indicating a positive screen, at which point clinical guidelines generally recommend following up with the full 9-question PHQ-9, which adds questions on sleep, appetite, energy, concentration, self-worth, psychomotor changes, and thoughts of self-harm that PHQ-2 doesn't ask about. PHQ-2's brevity is deliberate — it's designed to be embedded into routine visits without adding meaningful time, at the cost of missing the symptom detail a longer instrument would capture. A negative PHQ-2 score doesn't guarantee the absence of depression, particularly for atypical presentations where anhedonia and low mood aren't the most prominent symptoms.
Use the PHQ-2 Calculator as a quick check-in, and treat a positive score as a cue to pursue a fuller conversation or the PHQ-9 rather than as a standalone result.
PHQ-2's two questions were chosen from a larger item bank specifically because they had the strongest individual correlation with a full depression diagnosis across validation studies, which is why a two-item scale can still carry meaningful predictive value despite its brevity. That said, sensitivity comes with a tradeoff in specificity — PHQ-2 is designed to catch as many true positives as possible even if that means some people without depression also screen positive, which is exactly why a positive result triggers a longer follow-up questionnaire rather than a direct treatment decision.
Step 2: Screen for Anxiety with GAD-7
GAD-7 asks seven questions about anxiety symptoms over the past two weeks: feeling nervous or on edge, not being able to stop or control worrying, worrying too much about different things, trouble relaxing, being so restless it's hard to sit still, becoming easily annoyed or irritable, and feeling afraid as if something awful might happen. Each item is scored 0–3, for a total range of 0–21.
Score bands are generally interpreted as minimal (0–4), mild (5–9), moderate (10–14), and severe (15–21) anxiety symptoms, with a score of 10 or higher typically flagged as the threshold warranting further clinical assessment. While GAD-7 was developed and validated specifically for generalized anxiety disorder, subsequent research has found it performs reasonably well as a broader anxiety-symptom screen across other anxiety-related conditions, which is part of why it's used so widely in primary care beyond just suspected GAD cases. It doesn't, however, distinguish which specific anxiety-related diagnosis (if any) a patient has — that requires a fuller clinical interview.
The GAD-7 Calculator totals all seven responses and shows which severity band the result falls into, which is useful both for an initial check-in and for tracking symptom trends over successive screenings during treatment.
Because GAD-7 asks about the past two weeks specifically, a single score is a snapshot rather than a lifetime measure — someone going through an unusually stressful period can score in the moderate or severe range temporarily without having a chronic anxiety disorder, and someone with a well-managed chronic condition can score low during a calm stretch. This is precisely why clinicians often value repeated GAD-7 scores over time more than any single reading; a consistent downward trend across several administrations is a much stronger signal that a treatment approach is working than one favorable score in isolation.
Step 3: Measure Nicotine Dependence with the Fagerström Test
The Fagerström Test for Nicotine Dependence (FTND) is a six-question scale measuring how physically dependent a smoker is on nicotine, distinct from the psychological habit of smoking itself. Its questions cover time to first cigarette after waking, difficulty refraining from smoking in places where it's forbidden, which cigarette of the day would be hardest to give up, cigarettes smoked per day, whether smoking is more frequent in the first hours after waking, and whether someone smokes even while sick in bed. Scoring is weighted rather than uniform — time to first cigarette and cigarettes per day carry the heaviest point values, since these two variables correlate most strongly with withdrawal severity in the validation research behind the scale.
Total scores range from 0–10, with 0–2 indicating very low dependence, 3–4 low to moderate, 5–7 moderate, and 8–10 high dependence. Higher FTND scores are associated with more intense withdrawal symptoms upon quitting and a higher likelihood of needing pharmacological support (like nicotine replacement therapy or prescription medication) rather than behavioral strategies alone to quit successfully. Because it measures physical dependence specifically, someone who smokes lightly but immediately upon waking can score higher than someone who smokes more cigarettes spread evenly across a day without an early-morning urge.
The Fagerstrom Test Calculator totals the weighted responses and shows the dependence category, which is a useful input when deciding how much support — over-the-counter patches versus a prescription cessation aid versus counseling — a quit attempt might need. For a longer-range view of smoking's cumulative health impact rather than current dependence, the Pack-Year glossary entry explains the separate metric doctors use to estimate lung disease risk from smoking history.
Step 4: See the Payoff of Quitting with the Smoking Recovery Calculator
Once someone has quit, the Smoking Recovery Calculator turns the abstract decision to stop smoking into concrete, motivating numbers: cigarettes avoided and money saved, calculated from days since quitting, cigarettes smoked per day before quitting, and cost per pack. The math is straightforward — days quit multiplied by the prior daily cigarette count gives cigarettes avoided, and that figure divided by cigarettes per pack, multiplied by cost per pack, gives money saved — but seeing the running total can reinforce a quit attempt during the weeks when cravings are hardest to manage.
This calculator deliberately doesn't factor in nicotine dependence severity from a tool like the Fagerström Test — it reports the same savings and cigarette-avoidance numbers regardless of how difficult the quit was physically, because the financial and consumption math doesn't change based on withdrawal intensity. Someone with a high Fagerström score and a harder quit will see identical numbers here to someone with a low score and an easier one, if their prior smoking habits were the same; the value of this tool is motivation and tracking, not a measure of how hard the process has been.
The Smoking Recovery Calculator recalculates automatically as more days pass, making it a simple tool to revisit periodically — many people find watching the savings number grow over months to be a stronger deterrent to relapse than the original decision to quit.
Step 5: Track Your Sobriety Milestones
The Sobriety Calculator takes a single input — total days sober — and converts it into a clean breakdown of weeks, months, and years, removing the mental math involved in figuring out that 187 days is roughly six months and one week. This matters more than it might seem: many recovery frameworks and support communities attach specific meaning to milestone intervals like 30 days, 90 days, six months, and one year, and knowing exactly where a day count falls relative to those markers is useful for both personal motivation and for conversations with a sponsor, counselor, or support group.
The calculator doesn't make judgments about what counts as a "reset" after a relapse — different recovery programs and personal philosophies handle that differently, and the tool simply converts whatever day count is entered. Some people track a single running streak that restarts at zero after any lapse, while others track cumulative sober time across multiple periods separately from a current streak; the Sobriety Calculator supports either approach since it only needs a day count as input, without imposing a specific recovery philosophy.
Used alongside the Smoking Recovery Calculator for nicotine or the alcohol and drug screening tools covered elsewhere on this site, the Sobriety Calculator rounds out a recovery-tracking toolkit that spans screening, quantifying progress, and marking milestones.
Recovery from any substance is rarely linear, and the calculator's simplicity is intentional — it doesn't ask about relapses, triggers, or intensity of cravings because those are conversations best had with a sponsor, counselor, or support group rather than modeled in a single number. What it does well is turn an easy-to-lose-track-of day count into a shareable, easy-to-communicate figure, whether that's for a personal journal entry or a check-in at a meeting.
Key Terms
- PHQ-2 — a two-question depression symptom screen; a positive score prompts follow-up with the longer PHQ-9
- GAD-7 — a seven-question anxiety symptom screen scored 0–21, with 10+ generally flagged for further evaluation
- Fagerström Test — a six-question scale measuring physical nicotine dependence, distinct from the psychological habit of smoking
- Pack-Year — a standardized measure of lifetime cigarette exposure (packs per day × years smoked) used to estimate long-term disease risk
- Anhedonia — loss of interest or pleasure in activities, one of the two core symptoms PHQ-2 screens for
- Nicotine Replacement Therapy (NRT) — patches, gum, or lozenges used to ease withdrawal during a quit attempt, often recommended for higher Fagerström scores
- Recovery Milestone — a specific sobriety interval (30 days, 90 days, one year) that many recovery programs treat as a meaningful marker of progress