Recent and projected changes in global climate may increase nicotine absorption and the risk of green tobacco sickness

Dermal transfer of nicotine during tobacco harvest can cause green tobacco sickness (GTS), characterized by nausea, vomiting, headache and dizziness. Rainfall and high temperatures are etiological factors known to increase the prevalence of GTS. We analyzed recent and projected trends in these factors for major tobacco-growing regions to assess potential exacerbation in GTS occurrence. We analyzed climate parameters, including recent trends (since the 1970s) in temperature and precipitation metrics during the tobacco harvest period for Southern Brazil; Yunnan Province, China; Andhra State, India; and North Carolina, USA. We applied Shared Socio-economic Pathways (SSPs) based scenarios for Tier 1 Scenario Model Intercomparison Project (ScenarioMIP) within the Coupled Model Intercomparison Project phase 6 (CMIP6), (SSPs of 1–2.6, 3–7.0 and 5–8.5 from 2020 to 2100). Established protocol for nicotine dermal patches and temperature were used as a proxy to estimate potential nicotine absorption. For three locations, cumulative maximum temperatures during harvest and temperature extremes rose significantly since the 1970s as did cumulative rainfall during harvest. Projected maximum temperatures at SSP 3–7.0 and 5–8.5 projections through 2100 did increase for all locations. Estimates of nicotine skin absorption with rising temperature show significant increases for both recent changes in three locations, and for all locations for SSP projections of 3–7.0 and 5–8.5 from 2020 to 2100. This study across multiple continents, highlights a potential link between recent and projected anthropogenic change and potential increases in GTS risk. Under SSP 5–8.5, nicotine absorption could increase by ~50% by the end of the century, which may have widespread impacts on the incidence of GTS, especially among younger tobacco workers. Transfer of nicotine from tobacco leaves to the skin can result in a type of poisoning called green tobacco sickness (GTS) for field workers who harvest tobacco. Transfer is linked to temperature and rainfall, which are both impacted by global climate change. We examined recent (from 1970-present) and projected future (present to 2100) changes in these measures for four global locations where tobacco is grown. North Carolina, Brazil, China and India all show an increase in average maximum temperatures or rainfall since the 1970s. We find that recent or future changes in the climate are associated with an increased likelihood of skin absorption of nicotine. This study, across multiple continents, highlights a potential link between climate change that could increase the risk of GTS for tobacco workers. Ziska and Parks explore the potential impact of anthropogenic climate change on nicotine absorption in major tobacco-growing regions. Analysis of recent and projected environmental changes suggests the likelihood of increased dermal transfer of nicotine, leading to increased green tobacco sickness incidence amongst tobacco workers.