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Nicotine Cotinine (Urine)

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 quit smoking. This test can also help your healthcare 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?

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

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 healthcare 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. 

Medical Reviewers:

  • Chad Haldeman-Englert MD
  • Raymond Kent Turley BSN MSN RN
  • Raymond Turley Jr PA-C