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This is in mismatch with [18] who found that number of smokers at home did not have significant effects on cotinine level.Regard the level of cotinine among studied patients groups there was a highly statistically increase in patients group when compared to control group mean level was: 6.20 2.59 (0.13 9.94), 1.11 0.69 (0.13 2.24) ng/ml respectively (table 5) and by using Tukey's test, there was highly statistically significant decrease in patients group with LRTI when compared to patients with URTI and control group (table 6)