Nicotine detection tests can detect nicotine or its metabolite, cotinine, in urine, blood, saliva, and hair samples. Cotinine in urine is the most sensitive detection technique, while hair tests can evaluate long-term tobacco use. Urine tests are commonly used by insurance companies to differentiate between active and passive smokers.
Life or health insurance applications often include a nicotine detection test. Gas chromatography can detect nicotine, or its primary metabolite, cotinine, in urine, blood, saliva, and hair samples. Measurement of cotinine in urine is considered the most sensitive nicotine detection technique. None of these tests will perfectly distinguish between active smokers, passive or secondhand smokers, and non-smokers, because individual differences in nicotine metabolism vary widely. However, nicotine detection tests will provide a good estimate of overall nicotine exposure.
Nicotine is the addictive chemical found in cigarettes and chewing tobacco. Chewing or inhaling tobacco introduces nicotine into the body, where it is metabolized by the liver and excreted in the urine. The major metabolite of nicotine is cotinine, and cotinine is the primary method of detection for nicotine, because it has a half-life up to 10 times longer than nicotine. In other words, it is stable in the body for much longer. In cases of suspected nicotine overdose, such as when a child eats nicotine gum, the nicotine is measured instead of the cotinine.
Detection of nicotine using hair samples is rare outside of experimental testing because it is expensive. However, hair tests can evaluate long-term tobacco use, because they can detect nicotine exposure up to 10 days before sample collection. Saliva nicotine tests are simple and non-invasive; saliva is absorbed from the mouth using a cloth or swab for sampling, but it can be difficult to obtain a large enough sample. Children or adults with dry mouth may not produce enough saliva for a test sample. Saliva tests are also based on very recent nicotine exposure and may fail to differentiate active light smokers from passive smokers.
Blood samples allow for the detection of cotinine in blood plasma, although a blood sample requires much more processing than urine or saliva samples. The blood sample is first centrifuged to separate the blood cells from the plasma, then the heavy proteins are precipitated. The test tube is centrifuged a second time and then placed in an evaporator to eliminate any residual liquid; dry proteins, including cotinine, are dissolved using methyl alcohol. Again, the tube is centrifuged to separate any remaining heavy proteins and the fluid is poured off and used for analysis. This process takes more time and money than urine or saliva tests.
Urine nicotine detection is very sensitive and will detect even small levels of secondhand smoke. It is the most common method used by insurance companies to differentiate active smokers from passive smokers. Whether nicotine detection is through urine, saliva or blood serum, the difference can be seen between people who actively smoke three or more cigarettes a day and those with high levels of secondhand smoke. Heavy smokers can also be differentiated from light smokers by the amount of cotinine in the sample.
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