One practical consideration: nicotine replacement therapy (patches, gum, lozenges) can produce positive cotinine results even after cigarette cessation meaning a former smoker using NRT to quit may still test positive for cotinine and be classified as a tobacco user at carriers that treat any positive cotinine as smoker-equivalent
Nematollahi, A

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It should come as no surprise, then, to find our own U.S
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This is due to how nicotine interacts with nicotinic receptors