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

Background 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. Methods 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 Intercomparisons Project (ScenarioMIP) within the Coupled Model Intercomparison Project phase 6 (CMIP6). (SSPs of 1–3, 7.0 and 5.8–5.5 from 2020 to 2100). Established protocol for nicotine patches and temperature were used as a proxy to estimate potential nicotine absorption. Results For these locations, cumulative maximum temperatures during harvest and temperature extremes rose significantly since the 1970s as did cumulative rainfall during harvest. Projected maximum temperatures at SSPs 3.0–7.0 and 5.8–5.5 projections through 2100 increase for all locations. Estimates of nicotine absorption with rising temperature show significant increases for both recent changes in those locations, and for projections for SSP projections of 3.0–7.0 and 5.8–5.5 from 2020 to 2100. Conclusions This study across multiple continents, highlights a potential link between climate change and potential increases in GTS risk. Under SSP 5.8–5.5, 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.