Cotinine Testing

A Diagnostic Test for Nicotine Metabolites in Birds Exposed to Second-hand Smoke

Presented August 2003 AAV conference
Presenting Author: Carolyn Cray, PhD
University of Miami, Division of Comparative Pathology, Miami, FL

Interpretive Review and comments by Dr. Nemetz:

Second-hand smoke or environmental tobacco smoke (ETS) is one of the most controversial public human health issues. However, there is a growing body of evidence implicating ETS as a possible cause of lung cancer, bronchitis, and heart disease in humans. ETS contains at least 43 compounds known as human or animal carcinogens. ETS has also been shown to have significant effects on general respiratory, dermatologic, and ocular health.

In 1998 a paper showed dogs as a good model of human cancer s as it relates to ETS exposure. No studies have yet been done on birds; however bird's unique respiratory anatomy makes them highly sensitive to any airborne toxin. Most people remember the old story of the canary that was taken into the coal mines with the miners. Being very sensitive to airborne toxins the canary would succumb before the miners would ever detect a problem, thereby saving the lives of the miners.

Exposure by ETS in pet birds can be from chemicals inhaled from the air, chemicals ingested during preening of contaminated feathers, and inhalation of chemicals from owners' clothes or skin when the birds are in close contact.

Cotinine is a major metabolite of nicotine and is used as a preferred target for assay in humans. Dr. Cray evaluated this same assay for its usefulness in birds. It was found to work well on blood and feces, but blood levels were more consistent. The overall sensitivity and specificity of this test is in excess of 94%.


Many birds housed with smokers (whether they smoke in or out of the house) have presented to The BIRD Clinic with variable and chronic low-grade infections, respiratory compromise, heart disease, skin mutilation, as well as other nondescript symptoms. Perhaps some of these ailments are directly related to ETS?

Now there is a test that can quantitatively evaluate the true effects of the household on the bird and help the bird as well as the owner better treat the situation and effectively measure the improvement by this exciting new blood test.

2005 Update: Since this presentation, Dr. Nemetz has tested patients suspect of ETS poisoning and demonstrated cotinine levels as much as 100X normal. Two cases were feather pluckers, one had cancer, one had heart disease, and one had pulmonary scarring.

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