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Diagnosis

Nicotine Cotinine (Urine)

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Does this test have other names?

Cotinine urine test, nicotine urine test


What is this test?

This test measures the amount of cotinine in your urine. Cotinine is a chemical your body makes after you are exposed to nicotine. Measuring cotinine is better than measuring nicotine because nicotine disappears from your system within a few hours, but cotinine remains for a day or more.


Why do I need this test?

You may have this test to measure your progress in a program to help you quit smoking. This test can also help your health care provider figure out the right dose for a nicotine patch to help you stop smoking.

You may need to take a cotinine test if you're applying for a job at a company that prohibits smoking. Some insurance companies may require this test as part of a health exam before approving a policy. This test is also done to check for nicotine poisoning.


What other tests might I have along with this test?

You may also have blood and saliva tests for cotinine.


What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your provider.

Cotinine is measured in nanograms per milliliter (ng/mL):

  • Cotinine levels in a nonsmoker are generally less than 10 ng/mL.

  • Cotinine levels in a light smoker or someone exposed to secondhand smoke are 11 ng/mL to 30 ng/mL.

  • Cotinine levels in a heavy smoker may be more than 500 ng/mL.


How is this test done?

This test requires a urine sample. You will get instructions on how to collect the sample.


Does this test pose any risks?

This test has no known risks.


What might affect my test results?

If you use nicotine replacement medicine, such as gum or a patch, the cotinine test will not give an accurate result. Breathing in secondhand smoke can also affect the result. If you haven't smoked or been exposed to nicotine in 7 to 10 days, your cotinine levels start to return to a normal level.


How do I get ready for this test?

Drink enough water before the test so that you can urinate. Try to stay away from places where you could be exposed to secondhand smoke for several days before the test. Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use. 

Author: Iliades, Chris MD

© 2000-2025 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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