Cotinine test is a laboratory test that measures the presence of cotinine, a primary metabolite of nicotine, in blood, urine, or saliva to determine whether an individual uses tobacco or nicotine products. Because cotinine persists longer than nicotine, it is a reliable marker of recent smoking or vaping. Life insurers use cotinine testing during underwriting to verify smoker or non-smoker status, which significantly affects risk class and premium. Some carriers also consider nicotine-replacement products or occasional cigar use in their cotinine and underwriting guidelines.

Underwriters rely on cotinine test results from paramed exams or labs to confirm an applicantTMs tobacco status. Positive cotinine findings typically lead to smoker or tobacco rates even if the applicant reported as non-smoker, raising misrepresentation concerns. Advisors prepare clients by explaining that tobacco use must be disclosed accurately and that carriers may offer improved premiums after sustained cessation and negative cotinine tests. Understanding cotinine testing helps advisors discuss tobacco questionnaires honestly and avoid surprises when lab results differ from stated habits.