Nicotine and Metabolites, Urine, Quantitative
Ordering Recommendation

Recommended for determination of active or passive nicotine use or for differentiation between nicotine replacement and tobacco use. For a screening test to determine active exposure to nicotine and compliance with smoking-cessation programs, Cotinine Screen, Urine (2007081) is preferred.

Quantitative Liquid Chromatography-Tandem Mass Spectrometry
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Random urine. 
Specimen Preparation
Transfer 4 mL with no additives or preservatives urine to an ARUP Standard Transport Tube. (Min: 1 mL) 
Storage/Transport Temperature
Room temperature. 
Unacceptable Conditions
Specimens exposed to repeated freeze/thaw cycles. 
Ambient: 10 days; Refrigerated: 10 days; Frozen: 8 months 
Reference Interval
Effective August 17, 2015
Drugs CoveredCutoff Concentrations
Nicotine2 ng/mL
Cotinine (metabolite)5 ng/mL
3-OH-Cotinine (metabolite)50 ng/mL
Nornicotine (metabolite)2 ng/mL
Anabasine (tobacco biomarker)3 ng/mL

Interpretive Data
Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Positive cutoff
Nicotine 2 ng/mL
Cotinine 5 ng/mL
3-OH-Cotinine 50 ng/mL
Nornicotine 2 ng/mL
Anabasine 3 ng/mL

For medical purposes only; not valid for forensic use.

This test is designed to evaluate recent use of nicotine-containing products. Passive and active exposure cannot be discriminated definitively, although a cutoff of 100 ng/mL cotinine is frequently used for surgery qualification purposes. For smoking cessation programs or compliance testing, the absence of expected drug(s) and/or drug metabolite(s) may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing. The concentration value must be greater than or equal to the cutoff to be reported as positive. Anabasine is included as a biomarker of tobacco use, versus nicotine replacement. Interpretive questions should be directed to the laboratory.

Statement B: Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Hotline History
CPT Code(s)
Component Test Code*Component Chart NameLOINC
0092357Nicotine, Urn, Quant3854-7
0092358Cotinine, Urn, Quant10366-3
00923593-OH-Cotinine, Urn, Quant33916-8
0092360Nornicotine, Urn, Quant33917-6
0092365Anabasine, Urn, Quant33915-0
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at
  • 3-Hydroxycotinine
  • Anabasine
  • Cotinine
  • Nicotine and Cotinine, LC/MS/MS, Urine
  • Nornicotine
  • Pain Management