Amy, a 59-year-old female, has multiple medical conditions including type 2 diabetes, morbid obesity, chronic obstructive pulmonary disease, depression as well as complex social situation, such that she has reported occasional incidences of domestic violence. She admitted to being a regular marijuana smoker, and has been smoking for about 40 years now, even though she attempted to quit before a number of times.

As a healthcare professional, how confident are you in assessing the nicotine dependence of patients like Amy?
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Using the Fagerström Test for Nicotine Dependence measure, Amy was found to be usually smoking within 30 minutes after waking up, and would be smoking around 15 cigarettes per day. Her reading on the Smokerlyzer® was 58 ppm.

When asked about her previous quit attempts, she said that she found it too hard, often finding herself coughing, nauseous and dizzy and would go back to smoking 1-2 weeks later.