Short Michigan Alcoholism Screening Test (SMAST)
SMAST Calculator
Do you feel you are a normal drinker? (No = 1)
Does your spouse/parents worry about your drinking?
Do you feel guilty about your drinking?
Do friends/relatives think you are a normal drinker? (No = 1)
Are you able to stop drinking when you want? (No = 1)
Have you ever attended an AA meeting?
Has drinking created problems with you and your spouse?
Have you ever gotten in trouble at work because of drinking?
Have you ever neglected obligations/family/work for 2+ days due to drinking?
Have you ever gone to anyone for help about your drinking?
Have you ever been in a hospital because of drinking?
Have you ever been arrested for drunk driving?
Have you ever been arrested for drunk behavior?
SMAST Score:
0
Non-Problem Drinker
0 points: No apparent alcohol problem.
Screens for alcohol abuse.
Why Use
Shorter than the 25-item Michigan Alcoholism Screening Test, while retaining its validity.
Formula
Addition of the selected points (ask the patient the following): 0 points 1 point Patient feels they are a normal drinker (i.e., that they drink less than or the same amount as most people) Yes No Spouse or other near relative has worried or complained about patient’s drinking No Yes Patient has ever felt guilty about drinking No Yes Friends/relatives think patient is a normal drinker Yes No Patient is able to stop drinking when they want Yes No Patient has ever attended an Alcoholics Anonymous meeting No Yes Drinking has ever created problems with spouse or other near relative No Yes Patient has gotten into trouble at work because of drinking No Yes Patient has neglected family, obligations, or work for ≥2 days in a row because of drinking No Yes Patient has ever sought help for drinking No Yes Patient has ever been in a hospital because of drinking No Yes Patient has ever been arrested for driving while intoxicated No Yes Patient has ever been arrested for other drunken behavior (even if only a few hours) No Yes
Pearls / Pitfalls
Studies have used various cutoffs to indicate a positive screening test, with a wide variety of sensitivity and specificity. Ensure you know the standard of care in your practice.
Advice
Patients with heavy alcohol use should also be screened for other illicit drug use.
More Information
Interpretation: SMAST Score Interpretation Recommendation 0–2 Low risk, no apparent problem Repeat screening as needed 3 Borderline risk, potential early alcohol problem Consider further investigation ≥4 High risk, likely alcohol abuse Full assessment recommended