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What causes false positive for Nicotine in a drug screening test?

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Posted on Fri, 18 Jul 2014
Question: Hi, please advise me what I need to do in response to the Nicotine false positive test result. I quit smoking 14 years ago and have not smoked since then. I researched and learned that vegetarian diet and working with metal can cause false positive for Nicotine test, and I am a Machinist and a vegetarian. Should I visit a doctor to proof that I am not a smoker to obtain the insurance premium that I should get. Thanks.
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Answered by Dr. Preeti Parakh (3 hours later)
Brief Answer:
Go for confirmatory tests.

Detailed Answer:
Hi,

Welcome to Healthcare Magic!

It is not unusual for people to falsely test positive for nicotine in screening tests. It is also well-known that environmental exposure including passive smoking can cause false positive results in screening tests. To confirm whether the result was false or not, you have the option of going for confirmatory tests. The gold standard for detecting nicotine or cotinine is Gas chromatography/ mass spectrophotometry (GC/MS). It is a more expensive test than the one used in screening, and therefore is not performed routinely.

In my opinion, you should call up the insurance company and ask them for a confirmatory test. They can arrange for the test themselves or otherwise, let you know how you can get it done yourself. I expect this will take care of your problem.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Preeti Parakh

Addiction Medicine Specialist

Practicing since :2002

Answered : 1486 Questions

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What causes false positive for Nicotine in a drug screening test?

Brief Answer: Go for confirmatory tests. Detailed Answer: Hi, Welcome to Healthcare Magic! It is not unusual for people to falsely test positive for nicotine in screening tests. It is also well-known that environmental exposure including passive smoking can cause false positive results in screening tests. To confirm whether the result was false or not, you have the option of going for confirmatory tests. The gold standard for detecting nicotine or cotinine is Gas chromatography/ mass spectrophotometry (GC/MS). It is a more expensive test than the one used in screening, and therefore is not performed routinely. In my opinion, you should call up the insurance company and ask them for a confirmatory test. They can arrange for the test themselves or otherwise, let you know how you can get it done yourself. I expect this will take care of your problem. Best wishes. Dr Preeti Parakh MD Psychiatry