Nicotine poisoning is a toxic condition that occurs when someone is exposed to excessive levels of nicotine, typically through ingestion of tobacco products, e-cigarettes, or nicotine replacement therapies. It is caused by acute nicotine toxicity that overstimulates nicotinic acetylcholine receptors in the nervous system, leading to dangerous symptoms. The Nicotine and Cotinine, LC/MS/MS, Urine test is the most important test for confirming acute nicotine exposure and assessing the severity of poisoning.
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Nicotine poisoning is caused by acute exposure to toxic levels of nicotine that overwhelm the body's ability to process it safely. Common sources include accidental ingestion of tobacco products by children, drinking liquid nicotine from e-cigarettes, using multiple nicotine replacement products simultaneously, or exposure to nicotine-containing pesticides. Even small amounts of concentrated nicotine can be dangerous, particularly in children and pets, as nicotine is rapidly absorbed through the skin, mucous membranes, and digestive tract.
The Nicotine and Cotinine, LC/MS/MS, Urine test is the most important test for nicotine poisoning because it accurately measures both nicotine and its primary metabolite cotinine using highly sensitive mass spectrometry technology. Extremely elevated nicotine levels confirm acute toxic exposure, while cotinine levels help assess the timeline and severity of poisoning since cotinine remains in the body longer than nicotine itself. This test is particularly valuable when the exposure history is unclear or when healthcare providers need objective data to guide treatment decisions in emergency situations.
You should get tested immediately if you or someone you know experiences symptoms like severe nausea, vomiting, excessive salivation, rapid or irregular heartbeat, high blood pressure, tremors, confusion, or difficulty breathing after potential nicotine exposure. Testing is especially important for children who may have ingested tobacco products or e-cigarette liquids, as they are more vulnerable to nicotine's toxic effects. Anyone who has been exposed to concentrated nicotine sources or is experiencing unexplained severe symptoms after using multiple nicotine products should seek emergency medical attention and testing right away.
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What this means
Your cotinine test came back negative, meaning no cotinine was detected in your urine. This confirms that you have not been exposed to tobacco smoke recently and indicates successful tobacco-free status, whether from quitting smoking or avoiding secondhand smoke exposure.
Recommended actions
Continue avoiding tobacco products and secondhand smoke environments
Maintain healthy habits that support your tobacco-free lifestyle like regular exercise and stress management
Consider retesting in 6-12 months to document ongoing tobacco-free status for insurance or employment
Share your success with others who may be trying to quit smoking for motivation
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