As penalties for smoking increase there will be incentives for a smoker to try to avoid detection.
If cotinine is being used to screen for smoking, then abstinence for 3-4 days will be sufficient to test in the negative range.
Ways to detect a smoker trying to avoid detection:
(1) measure nicotine metabolites in hair
(2) measure urinary NNAL (see previous section) which can be positive for a month or more
(3) perform random urine screening for cotinine
Testing on a Monday after a holiday weekend or following a party can often detect usage.
To read more or access our algorithms and calculators, please log in or register.
Specialty: Toxicology, Emergency Medicine, Critical Care
ICD-10: ,
