What Does a Cotinine Urine Test Detect?
Cotinine is a chemical compound that is a byproduct of nicotine metabolism. It is utilized as a biomarker to detect tobacco use and exposure to tobacco smoke. When nicotine enters the body, it is metabolized in the liver where it is converted to cotinine. Cotinine has a longer half-life than nicotine, making it a reliable indicator of tobacco use.
Table of Contents
- Introduction
- Principle of Cotinine Urine Test
- Clinical Significance
- Test Procedures and Parameters
- Interpretation of Results
- Company Solutions
- References
Introduction
The presence of cotinine in urine is a key indicator used by healthcare providers to assess tobacco exposure. Given its longer half-life, cotinine can be detected in urine for up to 7 days following exposure to nicotine. This makes it a valuable tool for smoking cessation programs, insurance assessments, and clinical studies.
Principle of Cotinine Urine Test
The cotinine urine test is based on immunoassay techniques, such as Enzyme-Linked Immunosorbent Assay (ELISA) or more specific chromatographic methods like Gas Chromatography-Mass Spectrometry (GC-MS). These tests measure the concentration of cotinine in urine to a degree of precision necessary for clinical diagnostics.
Clinical Significance
Cotinine levels in urine correlate with the degree of nicotine exposure:
- Non-smokers: < 10 ng/mL
- Light smokers or passive exposure: 10 - 100 ng/mL
- Active smokers: > 100 ng/mL
These results can aid in distinguishing between active smokers, passive exposure, and non-smokers.
Test Procedures and Parameters
Standard urine cotinine tests involve the collection of a urine sample, which is then analyzed using either immunoassay or chromatographic methods. Key parameters include:
- Sensitivity: As low as 5 ng/mL for advanced immunoassays.
- Specificity: GC-MS provides near 100% specificity.
- Time to Result: Typically, 24 to 48 hours depending on the method.
Interpretation of Results
A positive test result signifies exposure to nicotine, whether through direct smoking or secondhand smoke. Clinicians must consider potential variables such as diet, metabolism, and potential cross-reactivity with other substances.
Company Solutions
Leading companies offering cotinine urine test solutions include:
- LabCorp: Provides comprehensive testing services, including both standard and expanded panels for cotinine detection.
- Quest Diagnostics: Offers reliable immunoassay testing with detailed result interpretation.
- Alere Toxicology: Specializes in workplace testing solutions with rapid turnaround times.
References
- Benowitz, N. L., et al. (2009). Biomarkers of tobacco exposure: comparison of urine and serum cotinine levels. Cancer Epidemiology Biomarkers & Prevention, 18(12), 3265-3271.
- Hukkanen, J., et al. (2005). Metabolism and disposition kinetics of nicotine. Pharmacological Reviews, 57(1), 79-115.
- Pérez-Stable, E. J., et al. (1995). Urinary cotinine levels in non-smoking adults: effects of exposure to environmental tobacco smoke. American Journal of Public Health, 85(5), 735-738.