Most tobacco users are aware of its harmful health effects. Pressures to quit tobacco use come from the movement towards smoke-free requirements in various medical care programs and insurance policies designed to reduce, or assess health hazards. However, the nicotine found in tobacco products is powerfully addictive and makes quitting extraordinarily difficult. Monitoring the amount of nicotine, and its major metabolite, cotinine, in urine can be particularly useful in assessing compliance with nicotine replacement therapy or tobacco abstinence.
Nicotine is metabolized into cotinine by the liver, though approximately 10% passes through the body unchanged. Nicotine and cotinine are excreted in the urine where they accumulate in accordance with dose. Nicotine is eliminated relatively quickly with a half-life of two hours, compared to the 16-20 hour half-life of cotinine.
PremierTox identifies nicotine and cotinine in urine by UPLC-MS/MS. The detection range begins at the low cutoffs of 2 ng/mL for the parent drug, nicotine, and 5 ng/mL, for its metabolite, cotinine. PremierTox will report quantified drug levels up to 20,000 ng/mL for nicotine, and 25,000 ng/mL for cotinine.
Though many factors can affect the rate of nicotine metabolism and elimination, the following may serve as initial interpretation guidelines for nicotine test results:
Active users of tobacco, or products containing nicotine, typically have nicotine and cotinine levels >100 ng/mL, and frequently have test results in the following ranges:
Non-users of tobacco, or nicotine replacement products, even when passively exposed, are likely to have test results in the following ranges: