Nicotine Test for Benefits at Work

[JohnMosesBrowning]

I have started in a new position and my benefits have changed. My place of work has Blue Care Network (BCN) and there are two "tiers" of coverage; enhanced and standard. The enhanced offers both lower premiums and co-pays. In order to qualify for "enhanced" I have to submit to a number of tests at a physical with my GP. Number one on the list is tobacco use. There will be a "cotinine" test administered either via blood or urine to determine tobacco use. (apparently it's possible to do a cotinine test via hair as well, but the literature from the insurance company only mentions blood and urine.)

Does anyone have any experience with such a test?
1) I only smoke about 1 pipe a day average (some days 3 bowls, other times a day or more could pass with none).
2) I only use 9mm charcoal filters in my pipes.
3) I do not typically smoke "high nicotine" blends as I am a bit sensitive to it not being a current nor former cigarette smoker.

My physical is in two weeks and I'm planning to abstain from any pipes between now and then. My hope is that I can pass this blasted test and then move on with my life. According to BCN once a negative test is achieved, no further tests are required at annual physicals.

The situation is what it is, I'm not trying to debate the "rights" of insurance companies or employers, I am just curious if anyone else has encountered this and has any insight or experience. Thanks!

 

[STP]

No experience… but I’ve read that nicotine can be traced in saliva for up to four days, in blood for about 10 days, in urine for up to three weeks, and in hair for up to three months… give or take.

 

[OSOBUCO]

look up to see what the half life T1/2 of nicotine is and then calculate from there how long you need to abstain. I will do a quick check as well - Actually if they are measuring cotinine we need to look at that

 

[didimauw]

I haven't gone without nicotine since I first started smoking cigarettes 16 years ago. I don't even know how long it stays in your system! It scares me to hear this news though.

 

[OSOBUCO]

look up to see what the half life T1/2 of nicotine is and then calculate from there how long you need to abstain. I will do a quick check as well

The half-life averages two hours. Approximately 80 to 90 percent of nicotine is metabolized by liver, lung, and kidney; the principal metabolite is cotinine, which has a plasma concentration that is 10-fold higher than nicotine.

Cotinine, the primary metabolite of nicotine, is currently regarded as the best biomarker of tobacco smoke exposure. Measuring cotinine is preferable to measuring nicotine because cotinine persists longer in the body with a plasma half-life of about 16 hours

So what this means is it will take your body 16 hours to clear half of the cotinine and another 16 hours to clear half of what remains and so on.

 

[OSOBUCO]

Nicotine and cotinine can be detoxed out of saliva within four days, however, if testing through the hair follicle method, nicotine/cotinine can be detected for up to three months to one year after the last exposure, depending on what hair test is used.

I would take a couple weeks off and then test. Hope this helps

 

[JohnMosesBrowning]

Yes, and if nicotine is detected in the test, I can still get "enhanced" coverage if I agree to participate in their "tobacco abatement program" - but will have to eventually get retested and produce a negative test, so I really want to get a clean result the first go.

 

[OSOBUCO]

I haven't gone without nicotine since I first started smoking cigarettes 16 years ago. I don't even know how long it stays in your system! It scares me to hear this news though.

Seriously - what if you quite smoking but still use nicotine gum. I have a friend that quit 10 years ago and still chews the gum.

 

[olkofri]

Heh, really, best thing to do is to abstain 100% from now till the test, and then see what happens.

 

[WVOldFart]

I have always heard that nicotine is out of the system in 2 weeks, so you should be OK. I wouldn't smoke until after your test.

 

[OSOBUCO]

Yes, and if nicotine is detected in the test, I can still get "enhanced" coverage if I agree to participate in their "tobacco abatement program" - but will have to eventually get retested and produce a negative test, so I really want to get a clean result the first go.

You should be OK after 2 weeks. Believe me I do this stuff for a living. If you turn up positive after two weeks then you are a slow metabolizer (it's called polymorphism) and it does exist but 2 weeks should still be OK. Good luck man.

 

[didimauw]

Seriously - what if you quite smoking but still use nicotine gum. I have a friend that quit 10 years ago and still chews the gum.

Wow.....interesting.....didn't think of that.

Nicotine is in everything!!!!!

 

[JohnMosesBrowning]

The half-life averages two hours. Approximately 80 to 90 percent of nicotine is metabolized by liver, lung, and kidney; the principal metabolite is cotinine, which has a plasma concentration that is 10-fold higher than nicotine.

Cotinine, the primary metabolite of nicotine, is currently regarded as the best biomarker of tobacco smoke exposure. Measuring cotinine is preferable to measuring nicotine because cotinine persists longer in the body with a plasma half-life of about 16 hours

So what this means is it will take your body 16 hours to clear half of the cotinine and another 16 hours to clear half of what remains and so on.

Interesting...I wonder how many "halves" before it is beneath their detectible levels though. I don't have the paperwork with me, but if anyone is interested I can post what the levels are that they're looking for.

 

[OSOBUCO]

Now you got me nerding out here a little bit. The predominant enzyme involved in nicotine and cotinine metabolism is CYP2A6 where nicotine is metabolized primarily to cotinine, and cotinine primarily to trans-3'-hydroxycotinine. CYP2A6 has been suggested as a highly polymorphic gene because it is located in a small chromosomal region that contains several genes and some unequal crossover events, point mutations and genetic conversions between CYP2A6 and CYP2A7. Note these type of enzymes are located primarily in the liver as are many other enzymes that clear toxins form the body.

In seems Asians have a higher incidence of polymorphism leading to impaired CYP2A6 function. The frequencies of these alleles vary considerably among different ethnic populations, the deletion alleles being most common in Orientals (up to 20%). Studies in Japanese suggest that CYP2A6 poor metabolizer genotypes result in altered nicotine kinetics whereas similar studies in Caucasian populations have not revealed any clear associations between variant CYP2A6 genotypes and smoking behaviour.

 

[OSOBUCO]

As I said - I do this stuff for a living...It's amazing the crap I can find out in a jiffy after being immersed in hardcore science for >30 years

 

[OSOBUCO]

Interesting...I wonder how many "halves" before it is beneath their detectible levels though. I don't have the paperwork with me, but if anyone is interested I can post what the levels are that they're looking for.

Now you are thinking like a scientist!!!! You need it BQL (below quantifiable limits). Two weeks should be fine. Now if you were smoking weed you would be in trouble as THC depots in fatty tissue and sticks around a long damn time, esp if you are heavy

 

[hoosierpipeguy]

Ask them if the obese people are excluded from the enhanced program. Then turn in your them and tell them you're not going to work for a bunch of douche bags that discriminate against smokers.

 

[JohnMosesBrowning]

Now you got me nerding out here a little bit. The predominant enzyme involved in nicotine and cotinine metabolism is CYP2A6 where nicotine is metabolized primarily to cotinine, and cotinine primarily to trans-3'-hydroxycotinine. CYP2A6 has been suggested as a highly polymorphic gene because it is located in a small chromosomal region that contains several genes and some unequal crossover events, point mutations and genetic conversions between CYP2A6 and CYP2A7. Note these type of enzymes are located primarily in the liver as are many other enzymes that clear toxins form the body.

In seems Asians have a higher incidence of polymorphism leading to impaired CYP2A6 function. The frequencies of these alleles vary considerably among different ethnic populations, the deletion alleles being most common in Orientals (up to 20%). Studies in Japanese suggest that CYP2A6 poor metabolizer genotypes result in altered nicotine kinetics whereas similar studies in Caucasian populations have not revealed any clear associations between variant CYP2A6 genotypes and smoking behaviour.

Well I'm just a regular old white dude, so I'm not thinking that helps me much. Or does it? No one's ever said I come off as highly polymorphic and I don't identify as such, so...I'll be good then?

All kidding aside, it is interesting to read about. I honestly understand about 2% of what you've written there, but from the things I've looked up about it it is interesting. I will be very curious to see if this thread hangs around for a few days if any chimes in with first hand experience with such a test. Thanks for all the help and replies!

 

[JohnMosesBrowning]

Ask them if the obese people are excluded from the enhanced program. Then turn in your them and tell them you're not going to work for a bunch of douche bags that discriminate against smokers.

Yup, that's number 2 on the list after tobacco use. "Enhanced level" requires a BMI under 30. Some folks at work with a BMI above that are on their respective "program" and have been given Fitbits to track their movement and have step requirements. Cholesterol and blood sugar are on there as well.

 

[OSOBUCO]

Well I'm just a regular old white dude, so I'm not thinking that helps me much. Or does it? No one's ever said I come off as highly polymorphic and I don't identify as such, so...I'll be good then?

All kidding aside, it is interesting to read about. I honestly understand about 2% of what you've written there, but from the things I've looked up about it it is interesting. I will be very curious to see if this thread hangs around for a few days if any chimes in with first hand experience with such a test. Thanks for all the help and replies!

LOL - Basically being white means you are less likely to be polymorphic and your enzymes will clear the compound normally. ie they will not be slower and you should be good at two weeks. Also, since we do not inhale a pipe much the nicotine we take in is via saliva and mucous membranes and the concentration in plasma is much lower than with cigarette smokers even though pipe tobacco contains more nicotine on a gram for gram basis. You should be good brother