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.

Mnemonic

NICOTINEUR

Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-4 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

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.

Remarks
Stability

Ambient: 10 days; Refrigerated: 10 days; Frozen: 8 months

Reference Interval

Effective August 17, 2015

Drugs Covered Cutoff Concentrations
Nicotine 2 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.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

80323 (Alt code: G0480)

Components

Component Test Code* Component Chart Name LOINC
0092357 Nicotine, Urn, Quant 3854-7
0092358 Cotinine, Urn, Quant 10366-3
0092359 3-OH-Cotinine, Urn, Quant 33916-8
0092360 Nornicotine, Urn, Quant 33917-6
0092365 Anabasine, Urn, Quant 33915-0
* 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 click the sidebar link to access the Interface Map.

Aliases

  • 3-Hydroxycotinine
  • Anabasine
  • Cotinine
  • Nicotine and Cotinine, LC/MS/MS, Urine
  • Nornicotine
  • Pain Management
Nicotine and Metabolites, Urine, Quantitative