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“Breath test” describes several different kinds of analysis, not one universal test. Alcohol instruments measure ethanol in exhaled air; some medical tests measure gases produced after a person takes a specific substance. An alcohol breathalyzer does not detect other drugs, and a result from any breath test only answers the question its instrument and protocol are designed to answer.
How does a breathalyzer work?
An alcohol breathalyzer measures ethanol in a person’s breath. Evidential instruments are designed to sample expired alveolar air—the air from the lung’s air sacs—rather than simply treating any breath sample as equivalent. The immediate measurement is breath alcohol concentration (BrAC), not a direct measurement of alcohol in blood.
Different devices can use different sensing methods. A fuel-cell sensor oxidizes ethanol and measures the resulting electrical signal; an infrared instrument measures absorption associated with ethanol. Not every device uses both methods, and a consumer breath tester should not be treated as equivalent to an approved evidential instrument.
What is the difference between screening and evidential alcohol tests?
Alcohol breath devices can have different roles in an investigation. In the United States, the National Highway Traffic Safety Administration (NHTSA) distinguishes preliminary breath-test (PBT) screening devices from evidential breath-test (EBT) devices. A screening result is not automatically equivalent to a result from a jurisdiction-approved evidential instrument.
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| Test type | Purpose | What the result means |
|---|---|---|
| Preliminary breath test (PBT) | Handheld screening during a roadside investigation in the United States | A screening measurement used in the investigation; it is not automatically an evidential result |
| Evidential breath test (EBT) | Alcohol measurement using a device that conforms to applicable specifications | May produce a result used as evidence in court, subject to the applicable jurisdiction and procedures |
| Clinical diagnostic breath test | Assess a specified medical question using a particular test protocol | A result interpreted for that test’s intended use, not a general measure of intoxication or health |
NHTSA maintains specifications and lists of conforming US evidential instruments, screening devices and calibration units. Separately, the UK Home Office describes technical requirements for police evidential breath-alcohol instruments approved for Great Britain; its guidance was last updated on 29 April 2026. These approval systems are jurisdiction-specific, not interchangeable international certifications.
Can a breathalyzer detect drugs?
No. Alcohol screening and evidential breath devices are designed to identify alcohol, not drugs other than alcohol. NHTSA explicitly states that PBT, EBT and PAS devices cannot detect other drugs. An alcohol reading therefore cannot establish whether someone has taken a different drug, and a breathalyzer result should not be presented as a general test for impairment.
Personal breath testers are a separate consumer product category, but the information available here does not establish the accuracy of any particular model. A consumer device is not a substitute for an approved evidential instrument, a medical test or a safe decision about driving.
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How does a urea breath test detect H. pylori?
A urea breath test (UBT) uses a different chemical strategy from an alcohol breathalyzer. It is intended to help assess infection with Helicobacter pylori (H. pylori), not to measure alcohol. The patient first provides a baseline breath sample, drinks a prepared urea mixture, and then provides another sample. The test system measures labeled carbon dioxide in the later breath sample.
H. pylori can break down urea, producing carbon dioxide. When the test’s labeled urea is metabolized, the labeled carbon can appear in exhaled carbon dioxide; an increase in the post-dose sample is a sign of infection. The exact label and device depend on the specific test: FDA’s general overview describes labeled substrates such as carbon-13 urea, while its PyloPlus information describes a system assessing radioactive carbon dioxide.
For PyloPlus, FDA’s 2024 supplement overview describes a second breath sample taken about 20 minutes after the mixture and an indication for people aged three years or older when a doctor suspects H. pylori infection. FDA identifies it as a clinician-used test prescribed by a doctor. The result is considered alongside medical history; it is not a stand-alone diagnosis of every cause of stomach symptoms.
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Do all medical breath tests look for the same thing?
No. A diagnostic breath test is built around a specific substrate, analyte, instrument and clinical indication. FDA’s overview of breath-test combination products describes labeled substrates that can lead to detectable labeled carbon dioxide or other gases. Its examples include tests related to H. pylori, gastric-emptying disorders, carbohydrate malabsorption and intestinal bacterial overgrowth. These are separate test applications, not capabilities of one all-purpose “disease breathalyzer.”
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| Test context | What is measured | Typical protocol | Question it addresses |
|---|---|---|---|
| Alcohol breath test | Ethanol in expired air | Breath sampling, with evidential instruments sampling expired alveolar air | What alcohol measurement does the instrument report? |
| Urea breath test for H. pylori | Labeled carbon dioxide in breath after labeled urea | Baseline sample, urea mixture, then a later breath sample | Is there a metabolic signal consistent with H. pylori infection? |
| Other diagnostic breath tests | A test-specific labeled or disease-associated gas | Depends on the substrate and intended test | Does the measured signal address that test’s specified clinical indication? |
Why do calibration and quality controls matter?
A forensic alcohol instrument’s reading is only useful within a sound testing program. NHTSA describes quality-assurance plans that specify inspection, maintenance, calibration and recalibration intervals, along with records of those activities. Calibration units provide known ethanol-vapor concentrations for calibration checks.
Competence and quality systems also matter beyond the instrument itself. NIST’s OSAC standards library lists ANSI/ASB Standard 153-23, a 2023 standard concerning proficiency testing in forensic toxicology laboratories and breath-alcohol programs. These safeguards support reliable operation; they do not turn an alcohol device into a test for other substances or determine what a result means outside the applicable procedure.
What can a breath-test result establish?
Interpret a result within the test’s own purpose and protocol. An alcohol instrument reports an alcohol measurement from breath; a clinical breath test looks for a defined signal after a particular procedure. Neither result should be generalized into a conclusion about every drug, every form of impairment or every disease. For court or medical decisions, the relevant jurisdiction’s rules or a clinician’s interpretation apply.
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