Overview:

When nicotine enters the body, it is broken down into various metabolites, with cotinine being the primary metabolite. Other metabolites include trans-3'-hydroxycotinine, nicotine-N-oxide, and others. These metabolites can be detected in urine, blood, or saliva samples.

• Cotinine is the most commonly tested metabolite and has a longer half-life than nicotine, which allows for better detection of tobacco use over a period of time.
• The test helps to estimate both recent nicotine consumption and chronic exposure, as cotinine levels remain detectable for up to a week after nicotine use.

Risk Assessment and Interpretation:

• Recent Nicotine Use: Elevated levels of cotinine or other metabolites indicate recent tobacco or nicotine product use.
• Chronic Exposure: Higher cotinine levels may suggest long-term tobacco use or frequent exposure to second-hand smoke.
• Nicotine Poisoning: Extremely high levels of nicotine metabolites may suggest poisoning, often accompanied by symptoms like nausea, vomiting, dizziness, and confusion.

Normal Range

• (for Cotinine in Urine):
  • Non-smokers: Below 10 ng/mL
  • Light smokers: 10–100 ng/mL
  • Moderate smokers: 100–500 ng/mL
  • Heavy smokers: 500 ng/mL and above
• Blood (Cotinine):
  • Non-smokers: 0–10 ng/mL
  • Smokers: 10–200 ng/mL
• Saliva (Cotinine):
  • Non-smokers: 0–10 ng/mL
  • Smokers: 10–200 ng/mL

Interpretation:

• Cotinine levels:

  • Non-smokers: Cotinine level of < 10 ng/mL
  • Light smokers: Cotinine level of 10-300 ng/mL
  • Heavy smokers: Cotinine level > 300 ng/mL

• Nicotine: It will typically be detectable in urine or saliva for about 1-3 days after smoking, with levels dropping quickly after use.

A positive result indicates recent nicotine exposure, but the specific levels can help determine if it's from light, moderate, or heavy use. If you're being tested for nicotine use for legal, medical, or other reasons, these results can provide insight into how much nicotine has been consumed and when.

Sample Types:

• Urine: Most commonly used for testing, as nicotine metabolites are excreted in the urine.
• Blood: Can provide a more accurate reflection of recent use.
• Saliva: Less commonly used but still a valid option.
• Hair: Occasionally used for long-term exposure testing.