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Smoking and Tobacco

Tobacco in System



Will a nicotine patch show positive on a test?


Yes - Cotinine is the metabolic byproduct of nicotine that is tested, and it can be detected in the urine, blood, or saliva. Nicotine replacement medications produce cotinine just as tobacco does.

Cotinine will be 10 times more concentrated in a urine test than either blood or saliva, but is subject to contamination.*

Typically, the patch comes in 3 steps: 21mg, 14 mg, and 7 mg; these doses would be comparable to about a pack of cigarettes/day; 2/3 pack day, and 1/3 pack/day, respectively.

According to the Foundation for Blood Research:

"Cotinine levels <10 ng/mL are considered to be consistent with no active smoking. Values of 10 ng/mL to 100 ng/mL are associated with light smoking or moderate passive exposure, and levels above 300 ng/mL are seen in heavy smokers - more than 20 cigarettes a day. In urine, values between 11 ng/mL and 30 ng/mL may be associated with light smoking or passive exposure, and levels in active smokers typically reach 500 ng/mL or more."

Sources for information on Cotinine are:

*Foundation for Blood Research: www.fbr.org

*Centers for Disease Control: www.cdc.gov/tobacco

For more information:

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Response by:

Kathy Vesha, RN, BSN, MA
Kick It!
The James
The Ohio State University