A nicotine test is a laboratory analysis used by insurers to detect the presence of nicotine or its metabolites, such as cotinine, in an applicant's blood, urine, or saliva. The test helps verify smoking status and differentiate between tobacco users and non-users, which is crucial because smoker rates are typically much higher due to increased mortality risk. Some carriers also distinguish between cigarette smoking, occasional cigar use, nicotine replacement therapy, and e-cigarette or vaping use, applying different underwriting rules. Nicotine tests are generally performed as part of paramedical exams or lab kits ordered during underwriting. Results influence risk classification, premium levels, and eligibility for preferred or standard non-tobacco classes.

In practice, nicotine test results often explain why a client received smoker rates despite claiming to be a non-smoker. Advisors may need to clarify whether recent nicotine use came from cigarettes, cigars, vaping, or cessation products, and how the carrier interprets each scenario. Some carriers require a period of nicotine-free tests-such as 12 or 24 months-before reclassifying an insured from smoker to non-smoker. Producers counsel clients who are quitting smoking to wait until they can truthfully answer non-use questions and pass nicotine tests before applying for preferred rates. When discrepancies arise between application answers and nicotine test results, underwriters may adjust class, request explanations, or decline coverage for misrepresentation. Understanding nicotine test protocols helps advisors set accurate expectations and guide clients through re-underwriting opportunities after successful cessation.