Nicotine and Metabolites, Serum or Plasma, Quantitative
Ordering Recommendation

Use to detect and monitor nicotine, cotinine, and trans-3'-hydroxycotinine in serum or plasma. Serum or plasma testing may be useful when a valid urine specimen cannot be obtained (anuretic or dialysis).

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
Plain red, green (sodium heparin), lavender (EDTA), pink (K2EDTA), or SST. 
Specimen Preparation
Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 4 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 1 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Plasma or whole blood collected in lt. blue (sodium citrate). Specimens exposed to repeated freeze/thaw cycles. Hemolyzed specimens. 
After separation from cells: Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 3 years 
Reference Interval
Effective August 17, 2015
Drugs CoveredCutoff Concentrations
Nicotine2 ng/mL
Cotinine (metabolite)2 ng/mL
3-OH-Cotinine (metabolite)2 ng/mL

Interpretive Data
Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Positive cutoff: 2 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 10 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, or limitations of testing. This test cannot distinguish between use of tobacco and purified nicotine products. The concentration value must be greater than or equal to the cutoff to be reported as positive.

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
0092362Nicotine, S/P, Quant3853-9
0092363Cotinine, S/P, Quant10365-5
00923643-OH-Cotinine, S/P, Quant35140-3
* 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
  • Cotinine
  • Nicotine
  • Nicotine and Cotinine, LC/MS/MS, Serum/Plasma
  • Pain Management