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Bolded Tests are performed 

at a CNE Laboratory.

 

GENERAL INFORMATION

 

SPECIMEN COLLECTION INFO

PATIENT INSTRUCTIONS

 

 

 

 

 

 

 

 

Chief of Pathology & Laboratory Medicine Review

Mayo Clinic Laboratories

Test Code NICOS Nicotine and Metabolites, Serum

Additional Codes

CNE Order Code: Nicotine

Reporting Name

Nicotine and Metabolites, S

Useful For

Monitoring tobacco use in a clinical setting

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Red top (serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.8 mL

Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

NICOTINE

<3.0 ng/mL

 

COTININE

<3.0 ng/mL

Day(s) Performed

Monday through Sunday

CPT Code Information

80323

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
NICOS Nicotine and Metabolites, S 90226-2

 

Result ID Test Result Name Result LOINC Value
21313 Nicotine 3853-9
21314 Cotinine 10365-5

Interpretation

Serum nicotine concentration in the range of 30 to 50 ng/mL with cotinine in the range of 200 to 800 ng/mL indicates the subject is either actively using a tobacco product or on nicotine replacement therapy.

 

To discriminate if a patient on nicotine replacement therapy is also actively using a tobacco product, see NICOU / Nicotine and Metabolites, Random, Urine analysis; the presence of anabasine in urine, a tobacco alkaloid not present in nicotine replacement products, indicates recent tobacco use.

 

Typical findings are as follows:

 

While using a tobacco product:

-Peak nicotine concentration: 30 to 50 ng/mL

-Peak cotinine concentration: 200 to 800 ng/mL*

*Higher values may be seen in subjects with high cytochrome P450 2D6 activity

 

Tobacco user after 2 weeks complete abstinence:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <3.0 ng/mL

 

Nontobacco user with passive exposure:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <8.0 ng/mL

 

Nontobacco user with no passive exposure:

-Nicotine concentration: <3.0 ng/mL

-Cotinine concentration: <3.0 ng/mL

Report Available

2 to 4 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method 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.