Nicotine and Metabolites, Serum (Sendout)

Interpretation

Method

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reference Range

See individual components

Ref. Range Notes

Reference Values:

Nicotine:	<3.0 ng/mL
Cotinine:	<3.0 ng/mL

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 Nicotine and Metabolites, Urine (Sendout) [RUNIC]; 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

Interferences and Limitations

Cautions: Knowledge of time elapsed between last dose and specimen collection is important for interpretation of test results.

References

• Mayo Clinical & Interpretive Information: Nicotine and Metabolites, Serum

Ordering & Collection

Specimen Type

Blood

Collection

6 mL blood in RED TOP tube

Unacceptable: Serum gel tubes/SST are not acceptable.

Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 28 days.

Quantity

Requested: 0.8 mL serum
Minimum: 0.5 mL serum

Processing

Receiving Instructions

Centrifuge sample and transfer serum into a separate plastic vial. Refrigerate serum.

Sendouts:

• Order Mayo Test: NICOS.
• Interfaced: Yes [Interface: 601; Department: MARF]

Stability: Refrigerated (preferred): 28 days; Frozen: 28 days; Ambient: 28 days.

Misc Sendout

Performance

Lab Department

Sendouts Mayo Lab (RF)(MARF)

Frequency

Performed: Monday through Sunday. Report Available: 2-4 days from sample receipt at Mayo.

Available STAT?

No

Performing Location(s)

Sendout	Mayo Clinic Laboratories (Superior Drive) 800-533-1710 3050 Superior Drive NW Rochester, MN 55901

Billing & Coding

CPT Codes

G0480

LOINC

43125-4

Interfaced Order Code

UOW3891