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.
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 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. 

Compliance Category

Laboratory Developed Test (LDT)

Hotline History
CPT Codes

80323 (Alt code: G0480)

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