Cotinine Test

Authored By: Dr. Leonard Leng.
Last updated: Mar 25, 2025.

A cotinine test measures the levels of cotinine in the body to assess nicotine use or exposure to tobacco products. Cotinine is a chemical produced when the liver metabolises nicotine, making it a suitable indicator for identifying recent tobacco use. Unlike nicotine, which is quickly eliminated from the bloodstream, cotinine remains detectable for a longer period, making it a more reliable marker.

Cotinine tests are commonly performed for the following reasons:

• Confirming Tobacco Use: Detecting nicotine consumption through tobacco or products containing nicotine.
• Assessing Secondhand Smoke Exposure: Determining exposure to environmental tobacco smoke, especially in children or non-smokers.
• Health or Insurance Screenings: Verifying adherence to non-smoking requirements for insurance policies or health programmes.
• Smoking Cessation Programmes: Tracking progress in reducing or quitting nicotine use.

Cotinine tests are conducted using various methods, each offering different levels of accuracy and detection windows based on the test's purpose.

Urine tests are the most commonly used due to their non-invasive nature and suitability for general health screening. Saliva tests are also non-invasive and convenient, making them popular for workplace testing. Blood tests are typically more accurate than urine or saliva tests and are often conducted in clinical settings, such as hospitals. For long-term detection, hair tests are valuable in forensic or specialised occupational assessments, as they can identify cotinine exposure over extended periods.

Depending on the type of test, a urine, blood, saliva, or hair sample is provided and sent to a laboratory for analysis. The procedure involves minimal to no discomfort.

To ensure accurate results, inform your doctor about any nicotine replacement therapies or exposure to secondhand smoke. Additionally, refrain from using nicotine-containing products as instructed by your doctor to avoid contamination.

Several factors influence cotinine levels in the body:

• Frequency of Nicotine Use: Regular smokers have higher cotinine levels compared to occasional users.
• Type of Nicotine Product: Different nicotine products, such as patches, and gum, vary in how they deliver nicotine, influencing cotinine absorption and levels.
• Metabolic Rate: Individual metabolic differences can impact how quickly nicotine is processed.
• Secondhand Smoke Exposure: Passive exposure can result in detectable cotinine levels, albeit lower than active smokers.

Cotinine test results are generally reported as either positive (presence of cotinine) or negative (absence of cotinine). The interpretation of results depends on the detection threshold, which varies by test type. For instance:

• Urine tests generally have a detection threshold typically ranging from 50 to 200 ng/mL.
• Saliva tests tend to have lower detection thresholds, often ranging from 10 to 25 ng/mL.
• Blood tests usually detect levels between 10 and 20 ng/mL.

In clinical or research settings, a cotinine level chart may sometimes be provided to display exact levels detected in the sample and how they compare to reference ranges. However, for most standard screenings, results are generally presented as positive or negative.

At ATA Medical, we offer the urine cotinine test and other related urine tests at the following prices:

At our clinic, the urine test typically takes 30 to 60 minutes during non-peak hours. Test results are usually available within 1 to 3 days, and your doctor will communicate them to you via phone or email.