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Cotinine Test - Smoker's Nicotine Test for Cotinine Testing

Nicotine Testing -or- Urine Cotinine Test

Buy Cotinine Test

 

Cotinine Test - Nicotine Test!  This is the perfect test to check for tobacco use.  Our cotinine tests are used by clinics, tobacco free programs, schools, parents and individuals.  To see if your own system is free of nicotine, use this simple cotinine test kit.  Cotinine will typically remain in the body 2 to 4 days after the last cigarette.

For more information on nicotine test - cotinine test,

see our Nicotine Test FAQ - Cotinine Test Q&A

See also Information on How To Interpret Cotinine Test Results

WHAT IS COTININE?

Cotinine is the first-stage metabolite of nicotine, a toxic alkaloid that produces stimulation of the autonomic ganglia and central nervous system when in humans.  Nicotine is a drug to which virtually every member of a tobacco-smoking society is exposed whether through direct contact or second-hand inhalation.  In addition to tobacco, nicotine is also commercially available as the active ingredient in smoking replacement therapies such as nicotine gum, transdermal patches and nasal sprays.  In a 24-hour urine, approximately 5% of a nicotine dose is excreted as unchanged drug with 10% as cotinine and 35% as hydroxycotinine; the concentrations of other metabolites are believed to account for less than 5%.1  While cotinine is thought to be an inactive metabolite, it’s elimination profile is more stable than that of nicotine which is largely urine pH dependent.  As a result, cotinine is considered a good biological marker for determining nicotine use.  The plasma half-life of nicotine is approximately 60 minutes following inhalation or parenteral administration.Nicotine and cotinine are rapidly eliminated by the kidney; the window of detection for cotinine in urine at a cutoff level of 200 ng/mL is expected to be up to 2-3 days after nicotine use.  The COT One Step Cotinine Test Device (Urine) is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of Cotinine in urine.  The COT One Step Cotinine Test Device (Urine) yields a positive result when the Cotinine in urine exceeds 200 ng/mL.

Nicotine Test Instructions - Directions for How To Use Cotinine Test Device

Urine Cotinine Test (Nicotine Test) for Cotinine Testing

Description

CAS-COT - Cotinine Test Device (nicotine test)
General Description:  Cotinine Urine Test For Nicotine (cotinine metabolite). This Cotinine Test Device tests for the presence of Cotinine (metabolized nicotine) in human urine - Cotinine Urine Test.

RETAIL $9.95.  OUR PRICE $4.95

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Nicotine Test FAQs - Cotinine Test Questions & Answers

Question

Answer

What is cotinine?

 Cotinine [COAT-e-neen] is a chemical that is made by the body from nicotine, which is found in cigarette smoke. Since cotinine can be made only from nicotine, and since nicotine enters the body with cigarette smoke, cotinine measurements can show how much cigarette smoke enters your body.

 Is cotinine harmful?

 As far as we know, cotinine itself is not harmful. Cotinine is used simply to measure how much tobacco smoke has entered your body. However, many studies show that some of the 4,000 other chemicals found in tobacco smoke are harmful.

 Why should I have a cotinine test?

 If you are serious about stopping or reducing your smoking, or if you are interested in the amount of smoke that has entered your body, this test can be very useful. By knowing what your starting level of cotinine is, you can see how successful your efforts to stop smoking are.

How can I pass a cotinine test?

The best thing to do is to stay away from tobacco smoke, even second hand smoke.  Even though you would not show up positive on a cotinine test when exposed to second hand smoke, it is best to stay away from the smoke for health reasons. 

 How is cotinine measured?

 Our Cotinine test is a simple nicotine test that can measure cotinine in human urine (so simple you can use it at home)!

 Why don't you just ask how much I smoke?  Or just keep track?

 Smoking behavior varies. For example, two people could each smoke a pack of cigarettes a day. One may smoke unfiltered cigarettes, inhaling deeply with each puff, while the other may smoke a low tar, filtered cigarette, puffing lightly and smoking only half of each cigarette. The cotinine test would be able to show a difference in the amount of cigarette smoke entering the bodies of these two smokers.

 How much cotinine is normal?

 People who do not smoke or who are not exposed to other peoples' smoke should not have measurable cotinine. People who do smoke will have a cotinine level of 10 or higher in their blood, and a typical smoker has levels of 150 to 450 units. Levels in urine are ten times higher.

 How can I reduce my cotinine?

 The only way to reduce your cotinine level is to stop or reduce your exposure to cigarette smoke.

 How long should it take for me to see a drop in my cotinine level if I stop smoking today?

 Depending on how high your level is to begin with, your level could drop to that of a nonsmoker in 7 to 10 days.

 If I stop smoking, then start again, how soon will cotinine show up in my body?

 Our Cotinine test can detect cotinine as soon as one day after you've had a cigarette.

 If I switch to a low nicotine cigarette, will my cotinine level drop?

 It might, but it depends on how you smoke low nicotine cigarettes. To satisfy a craving for nicotine, some people smoke more low nicotine cigarettes than they would regular cigarettes, and their cotinine level may actually increase.

 Do nicotine patches, gum, or aerosols have an effect on cotinine levels?

 Because they all use nicotine, these devices can increase cotinine levels. If you are having a cotinine test, make sure that you mention on the lab slip that you are using nicotine replacement products.

 What about other people's smoke? Won't my cotinine level increase if I breathe other people's smoke?

 If you breathe a lot of cigarette smoke even though you yourself don't smoke, your cotinine level may be higher than that of a non-smoker. If so, you should try to avoid places where there is a lot of smoke.

 How can I stop smoking?

 There are many different ways to stop smoking, but there is no one way that's best for everybody. The cotinine test will help you to measure the success of whatever way you try. Ask your doctor for advice, or contact organizations that are experienced in helping people give up cigarettes.

Where can I buy a Cotinine test? Right here!  We are one of the largest distributor of Cotinine Tests on the internet.
Why buy tests from Transmetron?
  1. We sell only the best test kits on the market!

  2. Excellent customer service.  Our customer service is surpassed by none!

  3. Wide selection of other urine and saliva tests.  We have one of the largest selections of Drug Tests on the internet, including Saliva Drug Test Kits.  We also offer other tests such as Urine Menopause Test, Urine Ovulation Test - Fertility Test, and Pregnancy Tests.  We offer a wide range of drug testing supplies such as gloves and cups.   

What does cotinine have to do with my pregnancy?

Studies show that babies born to women with high cotinine levels are more likely to be growth retarded. These smaller, weaker babies may need to spend more time in the hospital and may require special medical care. Women who smoke during pregnancy may also be at higher risk for miscarriage and other pregnancy problems.

If I reduce my cotinine level, will my baby be all right?

No one can guarantee any pregnant woman that her baby will be all right, but by stopping smoking, you will be removing a cause of many pregnancy problems.

 Are there any forms of tobacco that do not contain nicotine?

No, they all contain nicotine. This includes pipe tobacco, cigars, snuff, chewing tobacco, etc. If you use any of these, nicotine may be detected in your system.

Can I be required to be tested for tobacco use?

Since tobacco use is legal for adults, this would generally only apply to people who are court-ordered to be tested, such as for child-custody reasons. However, since smokers tend to have higher health costs and are at an increased risk for developing a variety of diseases, some health and life insurance companies may require their applicants to be tested for tobacco use prior to accepting them as clients.

Where can I find information about quitting smoking?

There are many national organization and government resources available.

What kinds of nicotine replacement products are available?

There are a variety of over-the-counter (OTC) products and a few that are available by prescription. OTC products include nicotine gum, patches, and lozenges. Those available by prescription include nicotine patches, inhalers, and nasal sprays. It is important to follow directions for their use and to keep them away from children. The products are intended to be used in conjunction with a smoking cessation program. Talk to your doctor about the best options for you.
What do various levels of Cotinine mean? <10 ng/mL - considered to be consistent with no active smoking

10 ng/mL to 100 ng/mL  - associated with light smoking or moderate passive exposure

300+ ng/mL - heavy smokers - more than 20 cigarettes a day

What are the signs or symptoms of nicotine overdose?

Acute overdoses of nicotine, such as might happen if a child ingests nicotine lozenges or gum, are relatively rare but generally require immediate medical attention. Symptoms can include a burning mouth, nausea, abdominal pain, salivating (drooling), diarrhea, sweating, confusion, dizziness, agitation, increased heart rate, rapid or difficult breathing, convulsions, coma, and even death.

Cotinine Test Information

Interpreting Cotinine Test Levels:

  • Cotinine levels <10 ng/mL are considered to be consistent with no active smoking.

  • Values of 10 ng/mL to 100 ng/mL are associated with light smoking or moderate passive exposure.

  • Levels above 300 ng/mL are seen in heavy smokers - more than 20 cigarettes a day. 

  • In urine, values between 11 ng/mL and 30 ng/mL may be associated with light smoking or passive exposure, and levels in active smokers typically reach 500 ng/mL or more.

Nicotine is rapidly metabolized and has a short half-life, but cotinine is metabolized and eliminated at a much lower rate. Because of the resulting increase with time in the cotinine to nicotine ratio in the body, including in the brain, it is of interest to examine the effect of cotinine on nicotine-induced changes.  This is typically done thru cotinine testing, either by cotinine blood test or by a cotinine drug test (sometimes referred to as a nicotine test - although nicotine is not actually being tested.

 

Cotinine assays (for cotinine testing) provide an objective quantitative measure that is more reliable than smoking histories or counting the number of cigarettes smoked per day. A cotinine test also permits the measurement of exposure to second-hand smoke (passive smoking).  

 

Both major depression and depressive symptoms are associated with a high rate of nicotine dependence, and a history of major depression has an adverse impact on smoking cessation. The main objective of this study was to investigate whether continuous ingestion of nicotine affects indices of depressive behavior in the rat. The test compared cholinergic- and serotonergic-hypersensitive Flinders Sensitive Line rats (FSL), a genetic animal model of depression, with their control counterparts, Flinders Resistant Line rats (FRL). Female rats of both lines were allowed access to a solution of nicotine bitartrate (100 microg/mL) in tap water for 14 days. Subsequent behavioral testing revealed striking effects of continuous ingestion of nicotine on depressive-like behavior of both lines. FSL and FRL rats that ingested nicotine for 14 days displayed less immobility in the 10-min forced-swim test (an index of depressive-like behavior) relative to the animals of both lines that were not exposed to nicotine or exposed to nicotine for shorter periods of time. This finding indicates that ingested nicotine has antidepressant properties that are independent of the genetic difference between FSL and FRL female rats. Animal studies on nicotine ingestion and withdrawal may become an important source of insights into the comorbidity of depression and nicotine self-administration.

 

Buy Urine Cotinine Test

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One Step Cotinine Test Device

A rapid, one step test for the qualitative detection of Cotinine (nicotine metabolite) in human urine.

 

Intended Use

The COT One Step Cotinine Test Device (Urine) is a lateral flow chromatographic immunoassay for the detection of Cotinine in human urine at a cut-off concentration of 200 ng/mL. This test will detect other related compounds, please refer to the Analytical Specificity table in this package insert.

This assay provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas chromatography and mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.

Summary

 

Cotinine is the first-stage metabolite of nicotine, a toxic alkaloid that produces stimulation of the autonomic ganglia and central nervous system when in humans. Nicotine is a drug to which virtually every member of a tobacco-smoking society is exposed whether through direct contact or second-hand inhalation.  In addition to tobacco, nicotine is also commercially available as the active ingredient in smoking replacement therapies such as nicotine gum, transdermal patches and nasal sprays. In a 24-hour urine, approximately 5% of a nicotine dose is excreted as unchanged drug with 10% as cotinine and 35% as hydroxycotinine; the concentrations of other metabolites are believed to account for less than 5%.1 While cotinine is thought to be an inactive metabolite, it’s elimination profile is more stable than that of nicotine which is largely urine pH dependent. As a result, cotinine is considered a good biological marker for determining nicotine use.  The plasma half-life of nicotine is approximately 60 minutes following inhalation or parenteral administration.2 Nicotine and cotinine are rapidly eliminated by the kidney; the window of detection for cotinine in urine at a cutoff level of 200 ng/mL is expected to be up to 2-3 days after nicotine use. The COT One Step Cotinine Test Device (Urine) is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of Cotinine in urine. The COT One Step Cotinine Test Device (Urine) yields a positive result when the Cotinine in urine exceeds 200 ng/mL.

Principle

The COT One Step Cotinine Test Device (Urine) is an immunoassay based on the principle of competitive binding. Drugs which may be present in the urine specimen compete against the drug conjugate for binding sites on the antibody.  During testing, a urine specimen migrates upward by capillary action. Cotinine, if present in the urine specimen below 200 ng/mL, will not saturate the binding sites of antibody coated particles in the test device. The antibody coated particles will then be captured by immobilized Cotinine conjugate and a visible colored line will show up in the test line region. The colored line will not form in the test line region if the

Cotinine level exceeds 200 ng/mL because it will saturate all the binding sites of anti-Cotinine antibodies. A drug-positive urine specimen will not generate a colored line in the test line region because of drug competition, while a drug-negative urine specimen or a specimen containing a drug concentration less than the cut-off will generate a line in the test line region. To serve as a procedural control, a colored line will always appear at the control line region indicating that that proper volume of specimen has been added and membrane wicking has occurred.

Reagents

The test device contains mouse monoclonal anti-Cotinine antibody-coupled particles and Cotinine-protein conjugate. A goat antibody is employed in the control line system.

Precautions

• Do not use after the expiration date.

• The test device should remain in the sealed pouch until use.

• All specimens should be considered potentially hazardous and handled in the same manner as an infectious agent.

• The used test device should be discarded according to local regulations.

Storage And Stability

Store as packaged in the sealed pouch either at room temperature or refrigerated (2-30°C). The test device is stable through the expiration date printed on the sealed pouch. The test device must remain in the sealed pouch until use. DO NOT FREEZE.  Do not use beyond the expiration date.  The urine specimen must be collected in a clean and dry container. Urine collected at any time of the day may be used. Urine specimens exhibiting visible precipitates should be centrifuged, filtered, or allowed settle to obtain a clear supernatant for testing.

Storage

Urine specimens may be stored at 2-8°C for up to 48 hours prior to assay. For prolonged storage, specimens may be frozen and stored below -20°C. Frozen specimens should be thawed and mixed before testing

Each Test Kit Includes

Test device • Dropper • Package insert

 

Materials Required But Not Included

Specimen collection container  • Timer

 

Directions For Use

How To Use Cotinine Test Devices

 

Allow test device, urine specimen to reach room temperature (15-30°C) prior to testing.

 

1.Bring the pouch to room temperature before opening it. Remove the test device from the sealed pouch and use it as soon as possible.

 

2.Place the test device on a clean and level surface. Hold the dropper vertically and transfer 3 full drops of urine (approx. 100 µL) to the specimen well (S) of the test device, and then start the timer. Avoid trapping air bubbles in the specimen well (S). See the illustration below.

 

3.Wait for the colored line(s) to appear. The result should be read at 5 minutes. It is important that the background is clear before the result is read. Do not interpret the result after 10 minutes.

 

 

Interpretation of Results

(Please refer to the illustration above)

NEGATIVE:* Two lines appear. One colored line should be in the control line region (C), and another apparent colored line should be in the test line region (T). This negative result indicates that the Cotinine concentration is below the detectable level (200 ng/mL).
*NOTE: The shade of color in the test line region (T) may vary, but it should be considered negative whenever there is even a faint line.
 

POSITIVE: One colored line appears in the control line region (C). No line appears in the test line region (T). This positive result indicates that the Cotinine concentration exceeds the detectable level (200 ng/mL).
 

INVALID: Control line fails to appear. Insufficient specimen volume or incorrect procedural techniques are the most likely reasons for control line failure. Review the procedure and repeat the test using a new test device. If the problem persists, discontinue using the lot immediately and contact your local distributor.

Quality Control

A procedural control is included in the test. A colored line appearing in the control line region (C) is considered an internal procedural control. It confirms sufficient specimen volume, adequate membrane wicking and correct procedural technique. 

Limitation

 

1.The COT One Step Cotinine Test Device (Urine) provides only a qualitative, preliminary analytical result. A secondary analytical method must be used to obtain a confirmed result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method..1,2

2.It is possible that technical or procedural errors, as well as other interfering substances in the urine specimen may cause erroneous results.

3.Adulterants, such as bleach and/or alum, in urine specimens may produce erroneous results regardless of the analytical method used. If adulteration is suspected, the test should be repeated with another urine specimen.

4.A positive result indicates only that the presence of Cotinine is above the cut-off concentration.  It does not indicate or measure level of consumption.

 

 

Other Information about nicotine test, nicotine testing, cotinine test, cotinine testing:

How is the nicotine test – cotinine test used?

Nicotine or its primary metabolite, cotinine are most often tested to evaluate tobacco use. Long term use of tobacco products can increase the risk of developing many diseases including lung cancer, COPD, stroke, heart disease, and respiratory infections, or exacerbate asthma, and blood clot formation. In pregnant women, smoking can retard fetal growth and lead to low birth weight babies.

Because use of tobacco products can greatly affect the health of individuals, companies may use nicotine/cotinine testing to evaluate prospective employees for tobacco use. Many health and life insurance companies test applicants for nicotine or cotinine as well.

Nicotine and cotinine can both be measured qualitatively or quantitatively. Quantitative testing can help distinguish between active smokers, tobacco users who have recently quit, non-tobacco-users who have been exposed to significant environmental tobacco smoke, and non-users who have not been exposed.

Cotinine may also be measured in saliva and in hair, although hair testing is primarily used in a research setting, such as a study of non-smokers exposure to tobacco smoke.

Blood or urine nicotine may be ordered by itself or along with cotinine if a doctor suspects that someone is experiencing a nicotine overdose.

When a patient has reported that they are using nicotine replacement products but are no longer smoking, nicotine, cotinine, and urine anabasine measurements may sometimes be ordered. Anabasine is present in tobacco but not in commercial nicotine replacement products. If a sample tests positive for anabasine, then the person is still using tobacco products.

When is the nicotine test – cotinine test ordered?

Cotinine and/or nicotine may be ordered whenever an evaluation of tobacco use status or tobacco smoke exposure is required. When a person enters a smoking cessation program, blood or urine cotinine tests may be ordered to evaluate compliance. Urine, blood, or saliva testing may be performed as a screen for tobacco use when someone is applying for life or health insurance, or applying for work with an employer that prohibits smoking. Testing may also be ordered by a court for child custody purposes. Since smoking can increase the risks of medical complications, testing may be performed prior to the start of some drug therapies or surgical procedures.

Nicotine and cotinine are sometimes measured when a patient has symptoms that the doctor suspects may be due to a nicotine overdose. Symptoms of mild nicotine poisoning may include:

  • Nausea, vomiting

  • Dizziness

  • Drooling

  • Weakness

More serious nicotine poisoning may result in:

  • Increased blood pressure and/or heart rate, which then suddenly drops

  • Slowed or difficulty breathing

  • Seizures

  • Coma

Hair testing is rarely performed in a clinical setting but may be ordered when an evaluation of longer term tobacco use is desired.

What does the test result mean?

In the blood, nicotine levels can rise within a few seconds of a puff on a cigarette. The quantity depends on the amount of nicotine in the cigarette and the manner in which a person smokes, such as how deeply they inhale. Test results are not interchangeable. Concentrations will be higher in urine than in blood or saliva. There is also some variability from person to person and some genetic differences in the rate that nicotine is metabolized and in the rate that cotinine is cleared from the body. When someone stops using tobacco and nicotine products, it can take more than two weeks for blood levels of cotinine to drop to the level that a non-tobacco user would have and several weeks more for urine levels to decrease to very low concentrations.

In general, high levels of nicotine or cotinine indicate active tobacco or nicotine replacement use. Moderate concentrations indicate a tobacco user who has not had tobacco or nicotine for two to three weeks. Lower levels may be found in a non-tobacco user who has been exposed to environmental smoke. Very low to non-detectible concentrations are found in non-tobacco users who have not been exposed to environmental smoke or a tobacco user who has refrained from tobacco and nicotine for several weeks.

Patients whose nicotine overdose is self-evident may not be tested for nicotine or cotinine. Concentrations would typically be increased, but levels do not necessarily correlate with the severity of a person’s symptoms.

Is there anything else I should know?

Some pesticides contain high concentrations of nicotine. This can be another source of nicotine poisoning.

A person’s genetic makeup may influence how they metabolize nicotine. Variations in the genes that code for the CYP2A6 liver enzyme affect the rate of nicotine metabolism.

Why get tested?

To detect the presence of and/or measure the quantity of nicotine or cotinine in blood, urine, saliva, or sometimes hair; to determine whether someone uses tobacco or has been exposed to secondhand smoke; sometimes performed to evaluate for acute nicotine poisoning

 

When to get tested?

Whenever someone requires confirmation of tobacco usage or exposure to secondhand smoke; occasionally when nicotine overdose is suspected

 

What sample is required?

A blood sample collected from a vein in your arm or a random urine sample; sometimes a saliva sample or, rarely, a hair sample

 

What is being tested?

Nicotine is a addictive alkaline chemical found in the tobacco plant and concentrated in its leaves. It is inhaled with each puff on a cigarette and ingested with chewing tobacco. Nicotine is metabolized by the liver into more than 20 compounds, which are excreted by the kidneys into the urine. Both tobacco use and exposure to tobacco smoke can increase nicotine and its primary metabolite, cotinine, concentrations in the body. Levels also rise with nicotine replacement products such as nicotine patches and gums. In large amounts, nicotine can be poisonous.

 

Cotinine is the major metabolite of nicotine and is usually the test of choice to evaluate tobacco use or exposure to tobacco smoke because it is stable and is only produced when nicotine is metabolized. Cotinine has a half-life in the body of between 7 and 40 hours, while nicotine has a half-life of 1 to 4 hours. Blood and/or urine cotinine tests may be ordered along with nicotine tests. In some cases, other nicotine metabolites, such as nicotine-1´-N-oxide, trans-3´-hydroxycotinine, or nornicotine, or other tobacco chemicals, such as anabasine in urine, may also be tested.

 

The presence of nicotine and/or cotinine in an individual’s sample may indicate the use of tobacco products or exposure to environmental tobacco smoke. Testing may be used in a number of situations to evaluate the possible use of tobacco products such as in smoking cessation programs, prospective employment assessments, and evaluations of applicants for health or life insurance.

Nicotine and cotinine testing may also be ordered in cases of suspected nicotine poisoning. Acute overdoses of nicotine, such as might happen if a child ingests nicotine lozenges or gum, are relatively rare but generally require immediate medical attention. Symptoms can include a burning mouth, nausea, abdominal pain, salivating (drooling), diarrhea, sweating, confusion, dizziness, agitation, increased heart rate, rapid or difficult breathing, convulsions, coma, and even death.

 

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm and/or a random urine sample is collected. Occasionally, a saliva sample may be obtained - directly or by soaking a collecting cloth or swab with saliva. Rarely, a hair sample may be collected.

 

How is it used?

Nicotine or its primary metabolite, cotinine are most often tested to evaluate tobacco use. Long term use of tobacco products can increase the risk of developing many diseases including lung cancer, COPD, stroke, heart disease, and respiratory infections, or exacerbate asthma, and blood clot formation. In pregnant women, smoking can retard fetal growth and lead to low birth weight babies.

Because use of tobacco products can greatly affect the health of individuals, companies may use nicotine/cotinine testing to evaluate prospective employees for tobacco use. Many health and life insurance companies test applicants for nicotine or cotinine as well.

 

Nicotine and cotinine can both be measured qualitatively or quantitatively. Quantitative testing can help distinguish between active smokers, tobacco users who have recently quit, non-tobacco-users who have been exposed to significant environmental tobacco smoke, and non-users who have not been exposed.

 

Cotinine may also be measured in saliva and in hair, although hair testing is primarily used in a research setting, such as a study of non-smokers exposure to tobacco smoke.

Blood or urine nicotine may be ordered by itself or along with cotinine if a doctor suspects that someone is experiencing a nicotine overdose.

 

When a patient has reported that they are using nicotine replacement products but are no longer smoking, nicotine, cotinine, and urine anabasine measurements may sometimes be ordered. Anabasine is present in tobacco but not in commercial nicotine replacement products. If a sample tests positive for anabasine, then the person is still using tobacco products.

 

When is it ordered?

Cotinine and/or nicotine may be ordered whenever an evaluation of tobacco use status or tobacco smoke exposure is required. When a person enters a smoking cessation program, blood or urine cotinine tests may be ordered to evaluate compliance. Urine, blood, or saliva testing may be performed as a screen for tobacco use when someone is applying for life or health insurance, or applying for work with an employer that prohibits smoking. Testing may also be ordered by a court for child custody purposes. Since smoking can increase the risks of medical complications, testing may be performed prior to the start of some drug therapies or surgical procedures.

 

Nicotine and cotinine are sometimes measured when a patient has symptoms that the doctor suspects may be due to a nicotine overdose. Symptoms of mild nicotine poisoning may include:

  • Nausea, vomiting

  • Dizziness

  • Drooling

  • Weakness

 

More serious nicotine poisoning may result in:

  • Increased blood pressure and/or heart rate, which then suddenly drops

  • Slowed or difficulty breathing

  • Seizures

  • Coma

 

Hair testing is rarely performed in a clinical setting but may be ordered when an evaluation of longer term tobacco use is desired.

 

What does the test result mean?

In the blood, nicotine levels can rise within a few seconds of a puff on a cigarette. The quantity depends on the amount of nicotine in the cigarette and the manner in which a person smokes, such as how deeply they inhale. Test results are not interchangeable. Concentrations will be higher in urine than in blood or saliva. There is also some variability from person to person and some genetic differences in the rate that nicotine is metabolized and in the rate that cotinine is cleared from the body. When someone stops using tobacco and nicotine products, it can take more than two weeks for blood levels of cotinine to drop to the level that a non-tobacco user would have and several weeks more for urine levels to decrease to very low concentrations.

 

In general, high levels of nicotine or cotinine indicate active tobacco or nicotine replacement use. Moderate concentrations indicate a tobacco user who has not had tobacco or nicotine for two to three weeks. Lower levels may be found in a non-tobacco user who has been exposed to environmental smoke. Very low to non-detectible concentrations are found in non-tobacco users who have not been exposed to environmental smoke or a tobacco user who has refrained from tobacco and nicotine for several weeks.

 

Patients whose nicotine overdose is self-evident may not be tested for nicotine or cotinine. Concentrations would typically be increased, but levels do not necessarily correlate with the severity of a person’s symptoms.

 

Is there anything else I should know?

Some pesticides contain high concentrations of nicotine. This can be another source of nicotine poisoning.

 

A person’s genetic makeup may influence how they metabolize nicotine. Variations in the genes that code for the CYP2A6 liver enzyme affect the rate of nicotine metabolism.

 

 

 

 

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