Nicotine, Cotinine, Anabasine, Tobacco alkaloids
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.
For determiniation of active vs. passive nicotine use, or to differentitate between nicotine replacement and tobacco use.
Collect a random urine. Avoid repeated freeze/thaw cycles.
Tuesday and Friday, 0800
However, samples are batched and may be run on alternate days as needed
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.
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
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.