Although they belong to the same genus, tree tobacco and cultivated tobacco differ significantly in appearance, chemistry, and use. When mistaken for an edible wild plant and consumed, tree tobacco can cause severe, potentially life-threatening poisoning, as demonstrated by two recent cases treated at Rambam Health Care Campus (Rambam).
Recently, two Thai foreign workers in their 40s were admitted to Rambam with acute poisoning after ingesting tree tobacco (Nicotiana glauca), a common wild plant found throughout Israel.
The two men apparently picked the plant and prepared it as a soup. Within hours of eating it, they developed symptoms of acute poisoning. Fortunately, they brought the plant with them to the hospital where it was quickly identified.
The tree tobacco plant brought to Rambam by the patients.
Photography: Rambam HCC
“We have never encountered a poisoning case like this,” says Osnat Aspis, Head Nurse of Rambam's Division of Critical Care Medicine. “Because the patients brought the plant with them, we were able to identify it quickly and begin appropriate treatment without delay.”
Although tree tobacco poisoning is rare, other people in Israel have previously required medical treatment after consuming the plant.
One of the patients remains in serious condition. After developing respiratory failure, he was sedated, intubated, and placed on mechanical ventilation. The second patient improved and was transferred to an internal medicine department for observation.
Tree tobacco (Nicotiana glauca) is the only tobacco species that grows wild in Israel. It grows throughout almost every region of the country, commonly appearing in open fields, vacant urban lots, construction sites, and near garbage dumps. Unlike cultivated tobacco (Nicotiana tabacum), a non-woody crop grown commercially for its nicotine-rich leaves, tree tobacco is a woody shrub or small tree whose principal toxic alkaloid is anabasine.
“Anabasine acts similarly to nicotine,” explains Dr. Yael Lurie, Director of the National Poison Information Center at Rambam. "Ingesting any part of the plant may cause nausea and vomiting, excessive salivation and sweating, dizziness, headache, tremors, fluctuations in blood pressure and heart rate, muscular weakness, breathing difficulties, and, in severe cases, seizures or loss of consciousness.”
“The severity of poisoning depends on the quantity consumed. Severe poisonings have been documented, and although uncommon, fatalities have been reported,” says Dr. Lurie. “There is no specific antidote. Treatment focuses on supporting vital organ function until the body metabolizes and eliminates the toxin.”
“Casual contact with the plant should not pose a risk of poisoning. However, we strongly urge the public not to pick or prepare teas or meals from wild plants unless they have been positively identified by qualified experts,” emphasizes Dr. Lurie. “In any suspected poisoning, it is important to bring the suspected source to the emergency department whenever possible. Because these patients brought the plant with them, our advisers—a volunteer team of expert botanists—quickly identified the tree tobacco.”
