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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

The downside of these medications is their adverse side effects, which can include nausea, headaches, irritability, insomnia, and in extreme cases seizures

Treating tobacco dependence: guidance for primary care on life-saving interventions

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