Nicotine and Metabolites, Urine, Quantitative

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.