Debunking the Myths: the facts about Cotinine

by Betsy Sears on November 12, 2012

According to the Foundation for a Smokefree America, smoking is the single most preventable cause of death and disease causing more fatalities than cocaine, auto accidents, AIDS, alcohol, heroin, fire, suicide and homicide combined. In honor of the Great American Smokeout being held on November 15th, we want to focus our attention for the next few weeks on smoking and how this habit affects an applicant’s overall health, as well as placement rates when applying for life insurance.

The Relationship between Nicotine and Cotinine

Cigarettes are made up of tar, carbon monoxide, acetaldehyde, nitrosamines, nicotine and 4,000 different carcinogenic chemicals. Nicotine, a highly abused, highly toxic alkaloid found in tobacco products such as cigars, cigarettes and chewing tobacco is metabolized into cotinine by the liver, which is then excreted in the urine. When an applicant applies for life insurance and provides a urine sample, that sample is tested for cotinine at the laboratory. If the cotinine result comes back positive, the applicant will be rated as a smoker during the underwriting process and receive a much higher premium than a non-smoker.

In general, cotinine can probably be detected between a few days and a week after smoking cessation. The concentration of cotinine in an applicant’s body is dependent upon several variables including:

  • Low vs. high nicotine cigarettes
  • Time of last tobacco use
  • Amount of tobacco used
  • Hydration level of applicant
  • Individual metabolic differences

At ExamOne, we utilize a very targeted immunoassay to test for the presence of cotinine. This highly customized reagent eliminates the need to complete a cotinine confirmation test.

Cotinine Myths

As a life insurance agent, you may have had an applicant with a positive cotinine result tell you things like this:

“I’ve never had a cigarette before in my life”

“I wore my sister’s jacket and she is a smoker”

“I was at a concert/bar last night and everyone around me was smoking”

“I smoked one cigar to celebrate my new grandchild and I have never smoked before”

The truth is that those types of explanations do not generally hold true. Indulging in a rare cigar or being around people who smoke is most likely not going to result in a positive cotinine result. A positive cotinine test is usually the result of someone who smokes, chews tobacco or wears a nicotine patch.

What Can You Do?

The number one thing you can do for your applicants is try to educate them on the hazards of smoking and provide resources to help them quit. Quest Diagnostics, ExamOne’s parent company, has teamed up with the American Cancer Society on the Choose You initiative, providing resources and tools to help in smoking cessation. To find out more about what you can do to help your applicants quit and stay smoke free, visit the Choose You site.

In next week’s blog, we will focus on the nationwide trends and the increased costs that come with smoking.

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