What do my cotinine test results mean?
October 1, 2011 8:01 PM   Subscribe

I just got back my lab results from a life insurance physical, and it's showing results for tobacco use. I had told the doctor that I'm a nonsmoker - how screwed am I?

I am a light-moderate smoker (a pack or so a week), and I didn't even realize that a urine test could be used for tobacco (I'm a moron). The number on the lab results is 2.31 (no units) and there is a mysterious "H" next to the number (none of my other results have this and I'm not sure what it means. Based on some googling, it looks like below 10ng or so is unlikely for someone who is a smoker and is more likely to be secondhand smoke exposure. Is my 2.31 measured in ng or something else? What does the mysterious "H" mean? Am I going to get into legal trouble for having lied to the doctor? Can I offer to retake the test (I am perfectly capable of not smoking for a few days, even a week or so, if that would help)? Please advise!
posted by anonymous to Health & Fitness (13 answers total)
The H almost certainly means 'high'. There's often the normal range listed somewhere on lab results, but not always, I don't think.
posted by hoyland at 8:07 PM on October 1, 2011

They aren't going to arrest you. they may decline to cover you, or they may rate you as a smoker.

If they decline to cover you, apply to another company, be honest about the smoking.

What you don't want to happen is to get the policy after making a false statement about being a non-smoker, kicking the bucket, and having the company discover you lied and not paying out... not much sense in paying the premium....
posted by HuronBob at 8:12 PM on October 1, 2011 [2 favorites]

You will not be in legal trouble, but may have trouble securing coverage from another company if the first declines to cover you. There is a clearinghouse of information, formerly the Medical Information Bureau that companies use to exchange information about insurance applicants. As the folks above said, it's still a possibility to get coverage at the rate for a smoker. IIRC, it may also be possible to request a new test in some situations, but you would have to check with the paperwork you signed to consent to the testing.
posted by goggie at 8:22 PM on October 1, 2011 [1 favorite]

If they decline to cover you, apply to another company, be honest about the smoking.

What you don't want to happen is to get the policy after making a false statement about being a non-smoker, kicking the bucket, and having the company discover you lied and not paying out... not much sense in paying the premium....

This. Yes, rates are (much!) higher for smokers, but the last thing you want is, should the worst happen, for the insurance company to decline to pay because they found out you're a tobacco user on a non-smoker policy.
posted by xedrik at 8:51 PM on October 1, 2011

For an individual I know who had more or less the same thing happen (a saliva test uncovered his occasional cigar smoking), it basically just meant a jack in the rates. P.S. You are a smoker.
posted by nanojath at 8:53 PM on October 1, 2011 [13 favorites]

What Goggie said. VERY bad idea to lie to the insurance company. You're not in legal trouble but you are at risk of not getting life insurance coverage...from any company. Here's what I recommend:

Talk to the agent you are working with. Be HONEST this time. I'm sure this is not the first time they've been lied to about smoking.

This lab test is now part of your medical record and will be available to any insurance company you apply to for coverage. The Medical Information Bureau already has info on any prescriptions, hospitalizations, and other medical events, so no use lying about those things either.

If the agent is cool, he'll re-quote you a policy at the smoking rate. If you have an independent agent who has been shopping around for a policy, it's often the case that the company offering the best price on a non-smoker policy is not the same as the company offering the best price on a smoker policy. Ask about this.

If you are declined coverage, that goes on your permanent record and is disclosed to any future company you apply for a policy with... makes it much harder to get coverage. Again, ask your agent about this.

Good luck. And do try to quit smoking. It's gonna kill you.
posted by dudeman at 9:07 PM on October 1, 2011 [1 favorite]

You can also quit smoking. Some policies will let you be re-tested at some future time and you may be able to get a better rate if you can actually stop. Ask your agent.
posted by jeffamaphone at 10:44 PM on October 1, 2011 [1 favorite]

PLEASE don't lie to any insurance company about anything on the application. I used to do life insurance claims, and if someone died within the contestable period (2 years at our company) we did a complete medical underwriting on them.

I hated getting medical records of someone who had gotten a policy as a non-smoker and the records clearly reflected that he/she smoked (or finding out that someone had lied about ANYTHING material). We had to rescind the policy (deny the claim) and the spouse who had counted on getting the life insurance money got nothing. Please don't do that to your family.
posted by la petite marie at 11:06 PM on October 1, 2011 [17 favorites]

The reason insurance rates for smokers are higher is because they die sooner. So maybe this freaking out isn't a lesson about telling the truth, it's a lesson about quitting smoking.
posted by thorny at 11:11 PM on October 1, 2011 [6 favorites]

OP here (forgot I had a sock puppet lying around)...

Yes, I know I'm a smoker. And I know I should quit. Thank you to everyone who contributed concrete advice about where to go from here.

This doesn't excuse my behavior at all, but: I'm young (not a minor, but still pretty young), and the life insurance policy is actually being purchased by my dad. I have a strained relationship with my dad, and also a pretty complicated and serious medical history (I'm honestly not sure any insurance company is going to want to sell me a policy regardless of the smoking). I've had some negative experiences in the past where he's been more involved in my medical information than he should have been, and I've been a bit on edge about that throughout this whole process. Obviously, insurance fraud is a much worse thing than my parents finding out that I smoke, and I was being irrational. I guess my other question is, when my dad gets the policy, is it just "here's the policy, it costs x much, the end" or does it clearly indicate "this is the policy for smoky mcsmokersons who smoke too much and are going to die of smoking any second now"? How much medical information can legally be revealed if I'm not the one who purchased the policy? (Once again, I'm an adult and I realize it's not the end of the world if my dad finds out I smoke, but I might as well brace myself...)
posted by lenorebeadsman at 1:31 AM on October 2, 2011

Those are all questions you should be asking the agent who is issuing the policy. You should be able to call them directly. But I'm pretty sure on the policy, if they issue it, it will say your age and the word "smoker".
posted by jeffamaphone at 9:08 AM on October 2, 2011

Thanks, all.

Once I pulled my head out of my panicking ass, it became glaringly obvious that, duh, the easiest thing to do was to be honest. I talked to the insurance agent and gave her accurate info on how much I smoke, and I discussed with her how I can go about applying for a nonsmoker policy someday down the road when I successfully quit for good. I also had a very upfront conversation with my dad, who it turned out, was already completely aware that I smoke (I guess I hadn't been hiding it as well as I'd thought). In conclusion, epic freak-out over nothing, other than my cancer-and-heart-disease-ridden future (which is really enough to worry about, isn't it?)

For people who may come across this thread in the future who are actually interested in cotinine tests, this is more or less what the information I've tracked down on the internet says (so apologies if there are errors, but I think this is more or less on track)
In a blood test, cotinine results should look something like the following:
<1> 10-100 ng Light smoker
100-500 ng Moderate smoker
500+ ng Heavy smoker (pack a day+)
In a urine test, multiply all numbers by 10. (My 2.31 was in micrograms in a urine test, which works out to 2310 ng or the equivalent of 231 in a blood test --> moderate smoker.) For light-moderate smokers, you can expect cotinine to stay detectable for a good 7-10 days after your last cigarette, but for all the reasons listed in the comments above mine, trying to game the system is a bad plan.
posted by lenorebeadsman at 9:28 PM on October 6, 2011

Oops some formatting stuff there. Should say:
Less than 10 ng Nonsmoker
10-100 ng Light
posted by lenorebeadsman at 9:29 PM on October 6, 2011

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