Nicotine,Serum

Nicotine, Serum

What it is

The Nicotine, Serum test measures the concentration of nicotine in the blood. Nicotine is the addictive substance found in tobacco products, e-cigarettes, and some nicotine replacement therapies (gum, patches, lozenges). Because nicotine is metabolized quickly in the body, this test reflects very recent exposure and is often combined with cotinine testing for a longer detection window.

Uses

This test is used to:

• Confirm active tobacco or nicotine product use.
• Assess nicotine exposure in non-smokers (secondhand smoke).
• Monitor compliance in smoking cessation programs.
• Support medical, insurance, or employment screening requirements.

Symptoms That May Lead to the Test

A doctor may recommend this test if you have symptoms linked to nicotine toxicity such as nausea, increased heart rate, sweating, dizziness, or abdominal cramps. It may also be ordered when tobacco use needs verification before certain medical treatments (e.g., surgery, organ transplant) or for public health studies.

Abnormal Results

Elevated Serum Nicotine: Indicates very recent nicotine use, typically within a few hours. High levels may suggest heavy smoking, e-cigarette use, or nicotine overdose.

Low/Undetectable Nicotine: Suggests no significant recent nicotine exposure. However, due to nicotine’s short half-life (~2 hours), cotinine testing is often preferred to confirm exposure over a longer period (up to several days).

Risks

The test requires a blood sample from a vein. Risks are minimal and may include slight pain, bruising, or dizziness at the puncture site. These side effects are temporary and usually harmless.