Test library
Blood Cotinine Test
The nicotine metabolite blood screen measures cotinine and related compounds that the body produces from nicotine. It is used to assess tobacco or nicotine exposure and to support cessation and monitoring programs.
Order Nicotine Metabolite Screen, Blood
Order online and visit a local collection site, or choose an at-home kit where available. No referral and no insurance required.
Order Nicotine Metabolite Screen, Blood- Typical turnaround
- 1-3 business days
- Starting price
- From $159
- Results
- Confidential, online
Quick answer
The nicotine metabolite blood screen measures compounds the body forms when it processes nicotine, mainly cotinine. Cotinine stays in the blood longer than nicotine itself, which makes it a useful marker of recent tobacco or nicotine exposure. The test is used in cessation programs, research, and some monitoring settings. A healthcare provider interprets the result with the person's history.
What this test measures
Nicotine is the addictive substance in tobacco, and the body converts it into several metabolites. The most studied is cotinine, which has a longer half-life than nicotine and is therefore easier to detect. Measuring cotinine in blood gives an indication of recent nicotine exposure from cigarettes, cigars, smokeless tobacco, or nicotine replacement products. It does not distinguish the source of nicotine by itself.
The test uses a blood sample and reports cotinine along with related metabolites such as nicotine and trans-3-hydroxycotinine when the laboratory measures them. Cotinine can also be measured in urine or saliva, but blood testing offers a direct measurement at the time of collection. Detection windows depend on how much nicotine was used and how frequently.
Results reflect exposure, not addiction or intent. A detectable level shows that nicotine entered the body recently, whether from tobacco, an e-cigarette, or a cessation product. Very heavy passive exposure can raise cotinine in some settings, though usually to lower levels. A qualified healthcare provider interprets the result in the appropriate context.
- Cotinine (primary nicotine metabolite)
- Nicotine
- Trans-3-hydroxycotinine
- Nicotine N-oxide when reported
- Cotinine-to-creatinine ratio when included
- Qualitative or quantitative nicotine metabolite screen
Why people order this test
- Assess recent tobacco or nicotine exposure
- Support smoking cessation and monitoring programs
- Verify abstinence in a structured program
- Evaluate exposure in research or clinical settings
- Objectively document nicotine exposure with a provider
How to prepare
No fasting is required for this blood test. A sample is drawn from a vein, usually at the arm. Follow any timing instructions from the laboratory, and share current nicotine or tobacco product use with the ordering provider.
Understanding your results
Results are usually reported within one to three business days. The report shows whether nicotine metabolites were detected and may include a quantitative cotinine level. A healthcare provider interprets the result with the person's history of tobacco or nicotine use.
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Frequently Asked Questions
What does this test measure?
It measures cotinine and related compounds that the body produces from nicotine. Cotinine is the main marker used to assess recent nicotine exposure.
How long can cotinine be detected?
Cotinine remains detectable longer than nicotine itself, but the window depends on how much nicotine was used and how often. A provider can explain what to expect.
Can the test tell what source of nicotine I used?
Not by itself. Cotinine reflects nicotine exposure from any source, including tobacco and nicotine replacement products.
Do I need to fast?
No fasting is required unless the test is combined with another panel that calls for it.
What does a positive result mean?
It indicates recent nicotine exposure. A healthcare provider interprets the result with the person's history and the reason for testing.
Ready to get tested?
Order online and visit a collection site near you, or choose a mail-in kit. No referral and no insurance required.
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