Help! Pre-employment nicotine test!

[noviceRN22]

So,I have a question regarding pre-employment URINE nicotene test/cotinine test. I have been free and clear of cigarettes for 3 days and have to test in 5 days. I have been drinking approx a gallon of water daily and totally stayed free and clear of any type of second hand smoke. I bought an online urine cotinine test where I tested negative. However, the level I test could only tell me that my urine concentration was below 200 ng/ml.

After doing some research online, I feel like the standard for a negative test result is less than that off 200 ng/ml. Does anyone know the standard they test in urine. Also, do you think if my levels are already below 200, that I'd be able to pass the test in 5 days? Please no cruel posts or judgements...I just want facts!

[brandy1017, ASN, RN]

That's ridiculous, what is this a police state we're working in! I think they don't want smokers because they might actually take their breaks!

[JustBeachyNurse, LPN]

The cut off varies by the facility parameters and the method used. If they are using a screening dip stick, then 200 sounds about right (the same as your otc test), but if they are using GC/MS or another analytical test the parameters are likely more sensitive. When I worked in pharmaceutical research we used a 200 cut off for most studies to rule out smokers but not totally exclude those who may have been exposed to second hand smoke.

Like others said be careful drinking too much water before your test so that you do not dilute your urine and fail on a low specific gravity as trying to cheat the test. I would think that would be a bigger flag, especially if they are including drugs of abuse in the screen.

There is no way of knowing what the actual cut off for the facility is without asking their lab or HR.

Oh and a 6 month smoking history detected by a saliva test is pure bunk. Perhaps checking a hair sample for nicotine metabolites may be able to determine a long term habit (just like other drug metabolites or toxin metabolites).

Good luck. Only you can determine your best course of action for your personal needs.

[NotFlo]

hoopschick said:

My previous 675 dollars a year in premiums has now essentially doubled to 1300. For a single, no family employee in a basic 80/20 PPO.

How about 3600 for a single in a "CDHP" (consumer driven health plan because they've done away with the PPO) with a 1500 deductible before they start paying for anything, no coverage for preexisting for one year, and that is just for medical, doesn't include dental or vision, which would add another 100 a month.

Told the benefits lady I might as well just die. Makes it impossible for CNAs to afford, impossible to provide insurance for your own children, and even when you have it you could go broke paying deductibles and "co-insurance" costs.

[StrwbryblndRN]

Sad what it is coming to. I am happy an employer has the resources to give to their employees help with HTN, smoking, weightloss. But to be required to stay employed or get a job is just wrong.

I read somewhere on AN that someone did not get hired because they could not lift 50lbs without looking like they were straining.

Next thing you know they won't hire anyone who drives a motorcycle or participates in contact sports or who does not participate in some kind of exercise. You need an MRI of your head/spine just to get an interview, in addition you would need a psych consult with in office therapy for 2 weeks before interview begins.

I know it seems far fetched. But anyone who remembers when smoking was allowed in the hospital would have never thought that it would come down to a drug screen to get hired.

It is not looking good.

[mazy]

Esme12 said:

Slippery slope to a police state......

So fine don't give the obese smoker a job. Let them sit at home smoking their cigarettes and collecting SSI, SSDI, or welfare and let medicare/medicade foot the bill.....

while the rest of the working slim non smokers pay for it....

Now that's the way to decrease the debt and "entititlement" programs and improve the economy!:nuke:

Very well said. It bothers me that people come up with these overly simple, knee-jerk, draconian plans for those in society who do not engage in desirable behaviours -- deny jobs and health care to the obese, the smokers, the this, the that. What do they think is going to happen to those people? Do we just ship 'em off to a desert island like Australia? Anybody done a cost analysis of that option?

At any rate, to the OP, congratulations on quitting smoking, and I hope that no matter what happens with this job, that you can stick to it. I quit a couple years ago, it was the hardest thing I've ever done, but I'm very happy.

Also, best to stop drinking so much water. You can fail for a test that comes up with dilute urine.

[hiddencatRN, BSN, RN]

I'm sorry, but I don't think a week is long enough to test negative on a nicotine test. One of the hospitals I was looking at also doesn't hire smokers and I think you needed a month smoke-free to pass their urine test and if you didn't you couldn't reapply for another 6 months.

I opted not to apply there- I don't smoke but I find that sort of policy really intrusive.

[C287]

Unexposed non-tobacco user :

Nicotine Less than 2 ng/mL

Cotinine Less than 5 ng/mL

3-OH-Cotinine Less than 50 ng/mL

Nornicotine Less than 2 ng/mL

Anabasine Less than 3 ng/mL

Passive exposure:

Same as above Less than 20 ng/mL

Less than 20 ng/mL

Less than 50 ng/mL

Less than 2 ng/mL

Less than 3 ng/mL

Abstinent user for greater than 2 weeks:

Nicotine Less than 30 ng/mL

Cotinine Less than 50 ng/mL

3-OH-Cotinine Less than 120 ng/mL

Nornicotine Less than 2 ng/mL

Anabasine Less than 3 ng/mL

Active tobacco product use :

Same as above 1000 - 5000 ng/mL

1000 - 8000 ng/mL

3000 - 25000 ng/mL

30 - 900 ng/mL

3 - 500 ng/mL*

Hope this helps; ranges are from the send out reference laboratory our hospital uses. How they determine nicotine exposure is a little more complicated than just a neg/pos cotinine level; they can assess both nicotine and cotinine metabolites. There is a significant difference in serum/saliva/urine specimens. Urine is ten times higher than serum or saliva; which is why they choose to use urine. Keep in mind that even nicotine patches and gum also constitute nicotine intake as well. It is true that the amount you once smoked (tar, mg of nicotine per cig etc play a role) is the biggest factor in how quickly you will clear. Chin up, keep up with the H20, and best wishes you'll be all clear by time for the test.

[redge03]

I wish they did a psych eval were I work....lol! Every DON we get is plain nuts!

I will probably get smacked for this but we learned about this site in a drug course we take yearly! May be a little too late. I would not condone this for illegal drug use. Also....What about the drinkers???!

[Amanda.RN]

A friend of mine had to take the saliva test for her employer's insurance. I think she quit 5 days prior to the test and passed (it was negative). I'm not sure about the urine or serum tests though.

Good luck!

...and PS - since you've been successfully smoke-free for the last 3 days and you have every intention of being for the next 5 days, I encourage you to stay smoke-free, even after the test! :)

[twinmommy+2, ADN, BSN, MSN]

noviceRN22 said:

THANK YOU onedayitllbeme and nursekellyh. As I said before I don't know how far below 200 I am but I do know that my levels are under that value. So i presume if I keep up the good work, I'll be okay!

The only thing I can say is just go take the test when they say to do it. You have done all you can besides reversing time to stop smoking earlier. And you can't call in sick on test day. So...good luck to you and stick it out, quit completly. I've been quit for 1.5 years now and feel great. Keep up the good work.

[iwanna]

I don't know about the urine tests. I know that I applied for a job that asked if you smoked or use any tobacco products in the last 90 days. I was using a patch under 90 days, so I know where my application went.

SN: My son is a freqent pot smoker and wanted to learn how to beat a drug test. He learned thrugh his research that saliva tests are easier to beat. His test was saliva, and he smoke only two days prior to the test. I think saliva is the easiest test to pass. Hair testing is the hardest. And, the urine tests are easily beat by using otc products from GNC. I saw this on a local newscast. But, I don't know if nicotine is included in these products to pass drug screens.

Actually, I think drug tests are a big joke. My daughter knew of a girl that was an opiate addict, and she always passed her drug tests because she drank pure cranberry juice. So, it just shows that these tests are not fool proof.

I know this was just a question about nicotine and not drugs. But, I just wanted to comment on what a joke these tests are. And, a new mom, lost her newborn baby because she tested positive for some drug. I don't remember what exactly it was. It was a false positive, she had ingesed a poppyseed dressing earlier in the day, she went into labor. She had a lawsuit against the hospital. The same hospital has another similar case. The new mother had a poppyseed bagel. She lost her baby for five days. The other mother lost hers for 75 days.

[njs5068]

I am in the same boat. Stopped cold Turkey on Friday, tested the following Thursday. Still awaiting results. Geisinger offered me the ICU RN position, contingent on the passing of the nicotine/drug screen.