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Tests That Check for Nicotine in the Body

By Juliet Wilkinson ; Updated July 18, 2017

Health insurance carriers, doctors and clinics commonly test to identify nicotine in the body. Testing does not show actual nicotine levels; rather, the three tests available identify the component of cotinine in the body, a byproduct of tobacco use. The October 2008 American College of Chest Physicians annual conference noted that 75 percent of nicotine-addicted Americans were currently seeking treatment for tobacco dependence. Nicotine addiction can impair the ability to obtain inexpensive health insurance, life insurance and even use certain medications.


The American Heart Association states that nicotine levels will be elevated in the blood for up to eight hours after the last tobacco use. Levels of measurable cotinine will be at least 10 times greater in the blood of smokers than nonsmokers. Additionally, heavy smokers can have blood levels of cotinine as high as 450 units, as opposed to a non-smoker who can have zero units.


Commonly used for job screening, the urine nicotine test is accurate, simple and effective. Nicotine is concentrated in the urine, as that is how it exits the body. Levels of cotinine in the urine can be 10 times greater than that in the blood. According to the Centers for Disease Control and Prevention, cotinine levels can only be established in the urine; the urine cotinine test does not show how much nicotine the person being tested is using.


Traces of cotinine representing levels of nicotine use can be found in saliva. Even those who do not smoke, but are in close proximity to smokers, may test higher for cotinine in saliva than a non-smoker. Saliva test kits are available for over-the-counter purchase and take minutes to weeks for results, dependent upon the kind of kit purchased. Most doctor’s offices and clinics use the instantaneous kit, where a cotton swab gathers a miniscule amount of saliva. Some home kits require moving a cotton ball around the mouth for 30 seconds, then mailing the cotton ball to a processing center for cotinine identification.

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