Skip Ribbon Commands
Skip to main content
Sign In

26296 Nicotine and Metabolites, Urine Confirm only by LCMSMS

Nicotine and Metabolites, Urine Confirm only by LCMSMS
Test Code: CO-NICT
Synonyms/Keywords

​Nicotine, Cotinine, Anabasine, Tobacco alkaloids

Test Components

​This is a quantitative urine test utilizing Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring to determine presence and concentration of nicotine, cotinine, anabasine and trans-3-hydroxycotinine. 

Useful For

​For determiniation of active vs. passive nicotine use, or to differentitate between nicotine replacement and tobacco use. 

Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Urine​Sage urine collection container​Plastic container with no preservatives​4 mL​2 mL​1 mL
Collection Processing Instructions

​Collect a random urine.  Avoid repeated freeze/thaw cycles. 

Specimen Stability Information
Specimen TypeTemperatureTime
​Urine ​ ​​Ambient​30 days
​Refrigerated​30 days
​Frozen​1 year
Rejection Criteria
Specimens exposed to repeated freeze/thaw cycles
​Preservatives in the urine
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Marshfield

​Tuesday and Friday, 0800

However, samples are batched and may be run on alternate days as needed

​2 days​Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring
Test Information

This test utilizes LC/MS/MS to definitively identify and quantitate nicotine, two nicotine metabolites (cotinine and 3-hydroxycotinine) and anabasine. 

Nicotine acts as a central and peripheral nervous system stimulant.  In addition, nicotine is highly addictive and is associated with short-term adverse health effects, including elevated blood pressure, heart rate, and blood glucose levels.  Besides increased cancer rates, long term tobacco use is associated with increased incidence of atherosclerotic arterial disease, chronic obstructive pulmonary disease, hypertension, and low birth weight of infants born to mothers who smoke.  For patients undergoing surgery, tobacco and nicotine use have important implications.  Several studies have shown delayed healing times and increased infection and thrombosis rates in nicotine users after surgical procedures.  Tobacco use in patients receiving organ transplants is associated with elevated rates of graft loss, mortality, and new cancer. 

Seventy percent of circulating nicotine is metabolized to cotinine.  

Reference Range Information
Performing LocationReference Range
​Marshfield

Clinical Chemistry 48:9 1460-1471, 2002

Unexposed non-tobacco user: Nicotine < 2 ng/mL; Cotinine < 5 ng/mL, 3-OH Cotinine < 50 ng/mL, Anabasine < 2 ng/mL

 

Passive exposure: Nicotine < 20 ng/mL; Cotinine < 50 ng/mL, 3-OH Cotinine < 50 ng/mL, Anabasine < 2 ng/mL

 

Abstinent user for more than 2 weeks: Nicotine < 30 ng/mL, Cotinine < 50 ng/mL, 3-OH Cotinine < 120 ng/mL, Anabasine < 2 ng/mL

Interpretation

​Nicotine metabolizes to cotinine, and 3-hydroxycotinine, therefore all can be present in urine.

Anabasine presence is an indicator of tobacco inhalation and is not present with use of a nicotine patch.

Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments
​80323​1​Nicotine and Metabolites, Urine Confirmation
​G0480​1​Nicotine and Metabolites, Urine Confirmation​For Medicare/Medicaid (if needed)
Synonyms/Keywords

​Nicotine, Cotinine, Anabasine, Tobacco alkaloids

Test Components

​This is a quantitative urine test utilizing Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring to determine presence and concentration of nicotine, cotinine, anabasine and trans-3-hydroxycotinine. 

Ordering Applications
Ordering ApplicationDescription
​COM​Nicotine, Urine, Confirm
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No​Urine​Sage urine collection container​Plastic container with no preservatives​4 mL​2 mL​1 mL
Collection Processing

​Collect a random urine.  Avoid repeated freeze/thaw cycles. 

Specimen Stability Information
Specimen TypeTemperatureTime
​Urine ​ ​​Ambient​30 days
​Refrigerated​30 days
​Frozen​1 year
Rejection Criteria
Specimens exposed to repeated freeze/thaw cycles
​Preservatives in the urine
Useful For

​For determiniation of active vs. passive nicotine use, or to differentitate between nicotine replacement and tobacco use. 

Test Components

​This is a quantitative urine test utilizing Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring to determine presence and concentration of nicotine, cotinine, anabasine and trans-3-hydroxycotinine. 

Reference Range Information
Performing LocationReference Range
​Marshfield

Clinical Chemistry 48:9 1460-1471, 2002

Unexposed non-tobacco user: Nicotine < 2 ng/mL; Cotinine < 5 ng/mL, 3-OH Cotinine < 50 ng/mL, Anabasine < 2 ng/mL

 

Passive exposure: Nicotine < 20 ng/mL; Cotinine < 50 ng/mL, 3-OH Cotinine < 50 ng/mL, Anabasine < 2 ng/mL

 

Abstinent user for more than 2 weeks: Nicotine < 30 ng/mL, Cotinine < 50 ng/mL, 3-OH Cotinine < 120 ng/mL, Anabasine < 2 ng/mL

Interpretation

​Nicotine metabolizes to cotinine, and 3-hydroxycotinine, therefore all can be present in urine.

Anabasine presence is an indicator of tobacco inhalation and is not present with use of a nicotine patch.

For more information visit:
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Marshfield

​Tuesday and Friday, 0800

However, samples are batched and may be run on alternate days as needed

​2 days​Liquid Chromatography/Tandem Mass Spectrometry (LCMS/MS) using Multiple Reaction Monitoring
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments
​80323​1​Nicotine and Metabolites, Urine Confirmation
​G0480​1​Nicotine and Metabolites, Urine Confirmation​For Medicare/Medicaid (if needed)
For most current information refer to the Marshfield Laboratory online reference manual.