Cotinine is the first-stage metabolite of nicotine, a toxic alkaloid that produces stimulation of the autonomic ganglia and central nervous system when in the body. Nicotine is a drug to which virtually every member of a tobacco smoking society is exposed to whether through direct contact or second-hand smoke which can lead to an increased risk of lung cancer. In addition to tobacco, nicotine is also commercially available as the active ingredient in smoking replacement therapies such as nicotine gum, transdermal patches and nasal sprays.