Green tobacco sickness (GTS) is a form of nicotine poisoning that affects those who come into contact with moist tobacco leaves. If tobacco is harvested while it is still wet, it poses a serious danger to agricultural laborers. The effects of tobacco’s nicotine, which can range from moderate to severe, are subsequently absorbed via the skin.

While GTS is a condition that can be avoided, it nonetheless poses a serious health risk to agricultural workers around the world, especially in nations where tobacco farming is a large business. Although the long-term implications of recurrent nicotine exposure by GTS are unknown, they may include an increased risk of nicotine addiction and other negative health effects related to tobacco use.


The symptoms of Green Tobacco Sickness (GTS) can vary, but they generally appear within a few hours after exposure to wet tobacco leaves. Some common symptoms of GTS include:

  • Nausea and vomiting
  • Dizziness and headache
  • Abdominal cramps and diarrhea
  • Sweating and fever
  • Rapid heartbeat and low blood pressure
  • Weakness and fatigue
  • Difficulty breathing


The diagnosis of Green Tobacco Sickness (GTS) is typically made based on the individual’s symptoms and history of exposure to wet tobacco leaves. Here are some of the ways that healthcare providers may diagnose GTS:

  • Physical examination. A healthcare provider may perform a physical exam to check for symptoms such as nausea, vomiting, abdominal pain, and difficulty breathing.
  • Exposure history. Healthcare providers may ask questions about the individual’s work history.
  • Laboratory tests. Laboratory tests may be performed to check for levels of nicotine and cotinine in the blood, urine, or saliva. Nicotine and cotinine are metabolites of nicotine and are used to confirm exposure to tobacco. 
  • Differential diagnosis. Healthcare providers may consider other possible causes of the individual’s symptoms, such as food poisoning, heat exhaustion, or viral gastroenteritis. 


The treatment for Green Tobacco Sickness (GTS) typically involves supportive care and management of symptoms. Here are some of the ways healthcare providers may treat GTS:

  • Rest
  • Rehydration
  • Medications
  • Oxygen therapy
  • Prevention

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