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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)

Statistical analyses The random-effects inverse-variance weighted method was used as the main analysis due to the most precise estimation it can provide 24