Brief Description
The Hooked on Nicotine Checklist (HONC) is a tool used to assess the loss of autonomy over tobacco use, particularly in young smokers. It was developed to help identify early signs of nicotine dependence in adolescents and to evaluate how quickly users become hooked on nicotine. The HONC emphasizes the concept of losing control over nicotine use. It assesses when smokers start feeling compelled to smoke despite knowing the health risks and/or wanting to quit. The checklist consists of 10 yes or no questions designed to evaluate when a respondent begins experiencing difficulty quitting or resisting smoking in situations where they would normally avoid it. While it can be used with any smoker, the HONC is particularly useful for adolescents and young smokers. It detects early stages of nicotine dependence, sometimes even after just a few cigarettes.
Assessment Administration Type
Self-report
Number of questions
10
Age Range for Administration
12+
Recommended Frequency of Administration
No recommended standard frequency. Blueprint recommends using this as a screening tool to assess level of nicotine dependence. See clinical considerations for further information about administration frequency.
Summary of Scoring and Interpretations
The HONC consists of 10 items, each with binary “Yes” (1) or “No” (0) response options. The HONC total score is calculated by summing the number of positive responses, with higher scores indicating more loss of autonomy, or loss of control over nicotine use. Even one positive response (i.e., total score of 1) indicates the onset of nicotine dependence.
Blueprint Adjustments
N/A
Clinical Considerations
Estimated completion time: 2-3 minutes
Clinicians can use the HONC for follow-up assessments to track changes in dependence levels over time.
While effective for identifying early dependence, the HONC may not provide a comprehensive view of addiction in long-term, heavy smokers, for whom tools like the Fagerstrom Test for Nicotine Dependence (FTND) may be more appropriate. The FTND is available for use within Blueprint’s library.
In adolescents, even a low score could suggest a need for education or prevention strategies to avoid further use.
There is no research evidence providing clear recommendations for frequency of administration. However, based on monitoring of smoking cessation progress, it could be helpful to administer the HONC at regular intervals (e.g., every 1-2 months) to reassess dependence, track behavioral changes, and adjust treatment plans.
A positive HONC score can signal the early onset of dependence, suggesting a need for close monitoring. This is important because early dependence often predicts future heavier smoking and difficulty quitting.
Citation
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