Nicotine and cotinine in urine (24-hour collection)

Why This Test Is Done

Your healthcare provider may order this test if you suspect recent tobacco use, are part of a smoking cessation program, or need to monitor exposure levels in a controlled setting (e.g., workplace or research study). It provides a comprehensive picture of nicotine intake beyond what a single blood or saliva test could show.

What to Expect Before the Test

You’ll collect a 24-hour urine sample starting from the day the test begins. Follow your provider’s instructions carefully—this includes timing the collection and storing the sample properly. Avoid certain medications or substances that could interfere with results.

What the Results Mean

Higher levels of nicotine or cotinine suggest recent tobacco use. Lower levels may indicate abstinence or reduced exposure. Results are interpreted in the context of your medical history and other factors, such as diet or metabolism.

Common Causes of Abnormal Results

Elevated levels may be due to smoking, vaping, or other nicotine-containing products. False elevations can occur if you consumed certain medications (e.g., some antidepressants) or substances (e.g., nicotine replacement therapies).