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Despite being the second largest tobacco producer in the world, Brazil does not have prevalence studies about green tobacco sickness (GTS).A cross-sectional study was carried out on a sample of Brazilian tobacco workers. The sample was described according to socio-demographic, behavioral, and occupational variables. Gender-stratified multivariate analyses examined variables associated with GTS.GTS prevalence among men in the previous month was 6.6%, while among women it was 11.9%. Among men, age, being a non-smoker, hanging tobacco sticks in the barn, harvesting wet leaves, and exposure to physical exertion were risk factors for GTS. Among women, tying hands of tobacco, transporting bales, harvesting wet leaves, having had contact with pesticides, and exposure to physical exertion were positively associated with GTS.Research is required to improve methods for GTS screening, as well as the ability to distinguish GTS from pesticide poisoning. Health professionals should be trained to diagnose and treat GTS. Am. J. Ind. Med. 57:726–735, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.