Background: Nicotine-induced changes in nAChRs are linked to nicotine addiction. Results: Cotinine, the primary metabolite of nicotine, alters the assembly and expression of some subtypes of nAChRs. Conclusion: Cotinine affects trafficking and assembly of a subset of nAChRs. Significance: Cotinine has a much longer half-life in the body than nicotine, and therefore may contribute to physiological effects attributed to nicotine.