Table of contents:
- Definition
- What is cotinine?
- When should I take cotinine?
- Precautions & warnings
- What should I know before taking cotinine?
- Process
- What should I do before taking cotinine?
- How is cotinine processed?
- What should I do after taking cotinine?
- Explanation of the Test Results
- What do my test results mean?
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Definition
What is cotinine?
The cotinine test functions to check the concentration of cotinine in the blood. Cotinine is another form of nicotine. Cotinine is formed when nicotine is metabolized by oxidation. Cotonine has a cycle half-life in the body, about 20 hours, and is usually found after smoking for a few days to a week. Cotinine is an important indicator of exposure to cigarette smoke, even in passive smokers, because the amount of cotinine in the blood is proportional to the amount of exposure to cigarette smoke. Continine can be checked through serum, urine, or other biological fluids (saliva for example). Cotinine can be found in the urine after smoking for 2-4 days.
The concentration of cotinine in the blood will increase if you consume any tobacco product (cigarette, chewing, dipping, inhaling). You will also increase your cotinine from consuming nicotine gum, patches, or replacement pills. The concentration of nicotine can also be estimated in the blood, but only for "Half-life" nicotine (about 2 hours), a very short time. Nicotine metabolism can also be measured in urine.
The concentration of cotinine in saliva and urine is usually low but is very easy to extract and is not expensive. The concentration of cotinine will vary depending on the amount of tobacco, filter, respiration, height, sex, and weight of the person being tested. Cotinine concentrations may increase if they are second-hand smoke. Dehydration and kidney function can affect the concentration of cotinine in urine, so when the cotinine test is done it also produces creatinine.
When should I take cotinine?
The cotinine test is done in the form of a screening test to help a person quit smoking, monitor the effectiveness of treatment, and to determine the dose of therapy. Insurance companies and HR managers also perform this test to check whether a potential employee is a smoker or not. This test is also done to determine custody of the child. When a person participates in a smoking cessation program, a cotinine test will be performed to assess their adherence.
Because smoking can increase other health risks, this test can be done before orthopedic surgery, spinal braces, wound excisions, plastic surgery, and liver transplant surgery.
You may also be advised to do this test if you have nicotine poisoning. The following are the symptoms of nicotine poisoning:
- gag
- dizzy
- drooling (salivating)
- weak
The following symptoms are more severe:
- high blood pressure or slowed heart rate
- shortness of breath or breathing problems
- tightness in the abdominal wall
- agitation, hyperactivity, or irritability
- mouth burning
- confusion
- passed out
- headache
- seizures
- coma
Precautions & warnings
What should I know before taking cotinine?
Here's what you should know before taking the test:
- The results of tests taken from blood, urine, and saliva samples vary and are not interchangeable
- some pesticides may have a higher nicotine content. This substance can be a source of nicotine poisoning
- Nicotine is not only found in tobacco, but is also found in several similar plants, such as potatoes, tomatoes, and peppers. However, the nicotine concentration in these plants is very small compared to tobacco. A positive test result can determine the high nicotine content and other causes of increased nicotine content
- Cigarette mint can increase serum cotinine concentration because mint causes blood cotinine to last long
It is very important to understand the warnings and precautions before carrying out this test. If you have any questions, please ask your doctor for more information.
Process
What should I do before taking cotinine?
Your doctor will explain a process that will help you reduce anxiety. You must tell the types of tobacco you used last.
How is cotinine processed?
Blood test
The doctor takes a blood sample, then puts it in a tube with a red or purple mark (with EDTA anticoagulant) or a pink cap (antifreeze by K2EDTA).
Urine test
Your doctor takes a sample of your urine, at least 10 mL.
The doctor will send this sample to the laboratory.
Saliva test
You must spit at least 1 mL of your saliva into the tube.
Sometimes doctors also put a special cloth in your mouth for 15 minutes, then send the cloth to the laboratory.
What should I do after taking cotinine?
The sample will be stored in a cool room if it is not possible to transfer it to the laboratory. If you have any questions regarding this process, please ask your doctor for more information.
Explanation of the Test Results
What do my test results mean?
| Not a smoker | Passive smoker | Smokers abstinence> 2 weeks | Active smoker | |
| Blood | <2ng / mL | <8ng / mL | <2ng / mL | 200-800 ng / mL |
| Urine | <5ng / mL | <20ng / mL | <50ng / mL | 1000-8000 ng / mL |
| Saliva | <2ng / mL | <8ng / mL | <2ng / mL | 200-800 ng / mL |
Depending on the laboratory of your choice, the normal range of this test may vary. Discuss any questions you have about your medical test results with your doctor.
