Nicotine testing in residency
I am an incoming PGY-1 at a large academic center and have a urine drug screen scheduled in a few days.
I am currently prescribed nicotine replacement therapy for smoking cessation and have been using it as directed. I began wondering whether my program might also be testing for nicotine in addition to the standard urine drug screen. There was never any mention of nicotine testing.
I reviewed all onboarding documents and do not see any mention of nicotine or cotinine testing and only a general urine drug screen requirement. I am also aware that this institution previously had a tobacco-free hiring policy in the late 2000s and early 2010s, but I have not seen any reference to nicotine testing or tobacco use screening in the current residency contract or recent materials. They also don’t mention this policy in any contract or policy now.
Given this, I wanted to ask:
- How likely is it that nicotine/cotinine testing could still be included but not explicitly stated?
- If nicotine testing is performed, would providing a valid prescription for NRT typically be sufficient to explain a positive result?
I know this is stupid to be thinking of right before the test but it just popped into my head now. I have never been tested for nicotine so not sure how this process works either.
Posted Jun 8, 2026, 4:50 AM UTC