How Do Insurance Companies Test for Nicotine?

How Do Insurance Companies Test for Nicotine?
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When applying for life insurance, and in some cases health insurance, certain lifestyle habits may end up costing you more each months in premiums. One of these habits is smoking or other nicotine use. Employers who provide health insurance as part of their benefits package may also charge more in premiums for smokers. Even if you mark non-smoker on your application form, many insurance companies require a medical exam before offering coverage. Lying about smoking habits on your insurance application can cause an immediate denial of coverage.


All nicotine tests are done using a bodily sample. Although nicotine can be tested through saliva and hair, most commonly nicotine is tested in urine or blood samples. This is because, in most cases, a blood or urine sample is a regular part of a physical examination for insurance.


Most nicotine tests are done using competitive immunoassay. In this testing process, testing strips are coated with a substance that acts as a cotinine antigen. The urine is mixed with a gold antibody, which will color the antigen line once the two come in contact with each other. Once the testing strip is placed in contact with the urine and antibody mixture, the mixture will absorb into the strip. If cotinine is present in the urine, the cotinine will prevent the antibody from coloring the antigen line, resulting in a positive test result. If no cotinine is present in the urine, the antibody will freely color the antigen line, resulting in a negative result.

Length of Time

Although nicotine can only be tested in the blood for a few hours after using, due to its fast metabolism by the liver, the resulting metabolite cotinine can remain much longer in your urine and blood. In fact, according to the Foundation for Blood Research, cotinine can be tested in your system for up to 10 days before dropping back to the level of a non-smoker. For those who have smoked for many years, it may take even longer to drop to normal.


Insurance companies base their premiums off of health risks. The higher chance you will need to access your coverage (such as through healthcare costs or death), the more money they will eventually have to pay out to cover those costs. According to the American Heart Association, more than 444,000 deaths in the United States alone can be attributed to nicotine use through cigarette smoking. Nicotine use also increases rates for heart disease, and even some forms of cancer, both of which are expensive to treat. To make up for the increased financial risk of using nicotine, insurance companies charge more to these individuals for insurance.