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HelpTest Code NICOU Nicotine and Metabolites, Random, Urine
Additional Codes
Cotinine
Reporting Name
Nicotine and Metabolites, UUseful For
Monitoring tobacco use
Monitoring patients on nicotine-replacement therapy for concurrent use of tobacco products
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube: Plastic, 5 mL, aliquot tube
Specimen Volume: 3 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Specimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 365 days | ||
| Ambient | 28 days |
Reference Values
Non-tobacco user with no passive exposure:
NICOTINE
<5.0 ng/mL
COTININE
<5.0 ng/mL
ANABASINE
<2.0 ng/mL
NORNICOTINE
<2.0 ng/mL
Day(s) Performed
Monday through Thursday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80323
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| NICOU | Nicotine and Metabolites, U | 43125-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 82510 | Nicotine | 3854-7 |
| 21321 | Cotinine | 10366-3 |
| 21324 | Nornicotine | 33917-6 |
| 21323 | Anabasine | 33915-0 |
Interpretation
Urine nicotine in the range of 1000 to 5000 ng/mL with cotinine in the range of 1000 to 8000 ng/mL indicates the subject is either actively using a tobacco product or on high-dose nicotine patch therapy.
The presence of anabasine and nornicotine indicates a subject on patch therapy who is actively using a tobacco product.
Typical findings are as follows:
While using a tobacco product:
-Peak nicotine concentration: 1000 to 5000 ng/mL
-Peak cotinine concentration: 1000 to 8000 ng/mL
-Anabasine concentration: 10 to 500 ng/mL
-Nornicotine concentration: 30 to 900 ng/mL
Tobacco user after 2 weeks complete abstinence:
-Nicotine concentration: <30 ng/mL
-Cotinine concentration: <50 ng/mL
-Anabasine concentration: <2.0 ng/mL
-Nornicotine concentration: <2.0 ng/mL
Nontobacco user with passive exposure:
-Nicotine concentration: <20 ng/mL
-Cotinine concentration: <20 ng/mL
-Anabasine concentration: <2.0 ng/mL
-Nornicotine concentration: <2.0 ng/mL
Nontobacco user with no passive exposure:
-Nicotine concentration: <5.0 ng/mL
-Cotinine concentration: <5.0 ng/mL
-Anabasine concentration: <2.0 ng/mL
-Nornicotine concentration: <2.0 ng/mL
Clinical Reference
1. Dale LC, Hurt RD, Hays JT. Drug therapy to aid in smoking cessation. Tips on maximizing patients' chances for success. Postgrad Med. 1998;104(6):75-78, 83-84
2. Rudasingwa G, Kim Y, Lee C, Lee J, Kim S, Kim S. Comparison of nicotine dependence and biomarker levels among traditional cigarette, heat-not-burn cigarette, and liquid e-cigarette users: Results from the Think Study. Int J Environ Res Public Health. 2021;18(9):4777. doi:10.3390/ijerph18094777
3. Sharma P, Sane N, Anand SD, Marimutthu P, Benegal V. Assessment of cotinine in urine and saliva of smokers, passive smokers, and nonsmokers: Method validation using liquid chromatography and mass spectrometry. Indian J Psychiatry. 2019;61(3):270-276. doi:10.4103/psychiatry.IndianJPsychiatry_61_18
Report Available
2 to 5 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.