Reference Interval Determination for Anabasine: A Biomarker of Active Tobacco Use

Laboratory detection of nicotine exposure is important for esta-blishing eligibility for organ transplant and elective surgery. Nicotine testing is also used to verify compliance with nicotine re-placement therapies (NRT), smoking cessation programs and for life insurance purposes. Nicotine metabolites, such as cotinine and trans-30-hydroxycotinine, are used as biomarkers of nicotine expo-sure. For some clinical applications, it is important to distinguish between active use of tobacco products versus NRT. Anabasine is a tobacco alkaloid that has been used as a biomarker of active tobac-co use. However, the use of anabasine as an insecticide, and its pres-ence in consumables other than nicotine products, suggests that anabasine may not be specific to tobacco use/exposure. Here, we determine the reference interval for anabasine in the urine of non-smokers and compare it to the range of anabasine concentrations observed in the presence or absence of nicotine metabolites