Kamal Sonavane knew she’d pass out if she chewed smokeless tobacco one more time. It was a scorching April afternoon in the middle of another of India’s brutal heat waves, and with no job to go to, the farmworker had already chewed tobacco five times that day. “Even an addicted person avoids doing this in extreme heat because there’s a risk of fainting,” she says.

Yet Sonavane repeated the familiar ritual: adding the slaked lime to the tobacco leaves, then putting the mixture in her mouth. “I would have anyway collapsed, either because of the heat waves or the mounting stress,” she says, sitting in her two-room brick house in Bhadole in the Indian state of Maharashtra. Anxious about money, her lack of work, and the extreme heat, she turned to the tobacco once again.

Climate change is making farming in Maharashtra harder. This in turn impacts day laborers, who are hired when agricultural help is needed. “Every few months, farmers report losses caused by heat waves or floods,” says community health worker Shubhangi Patil, who serves the Kolhapur district where Sonavane lives. When crops fail, earnings become more precarious, and farm laborers “resort to substance use to forget their problems,” says Patil. It’s a prevailing issue across the region, Patil says.

It’s also a phenomenon that isn’t limited to India—or to countries with predominantly low- and middle-income wages. Research from other regions has found groups responding to the pressures of climate change by increasing their consumption of alcohol and other substances, with potentially deleterious effects on their health.

A landless farmworker in her mid-60s, Sonavane has been toiling in the fields of Kolhapur for over 25 years. A decade earlier, she says, she didn’t chew smokeless tobacco. “I despised it,” she says. “Today I can’t stay even a few hours without it.”

The weather, she says, started to get bad in western Maharashtra in 2019. “This region has seen two floods, unbearable heat, incessant rainfall, hail storms, and a drought,” all in the past three years, Sonavane says. Farmers have faced tremendous losses: 36 million hectares of sugarcane, onions, rice, and other crops lost over the past five years, according to Maharashtra’s department of agriculture. Farm workers are currently finding it difficult to get even eight days of work a month because crop damage is so common, Sonavane says.

With no resources for dealing with the stress of being out of work, Sonavane stumbled across the solution of soothing her anxiety with smokeless tobacco, which costs just 10 rupees ($0.12) a packet. Like cigarettes and vapes, chewing tobacco contains nicotine, a central nervous system stimulant. Users say it elevates their mood; improves concentration; and relieves anger, tension, and stress. “They desensitize grief, sadness, and negativity for a while,” says Kolhapur-based clinical psychologist Shalmali Ranmale Kakade, referring to tobacco and other commonly abused substances, such as alcohol.

But nicotine is also highly addictive, and in heavy tobacco users, those positive effects may simply be the consequences of staving off withdrawal. Repeatedly chewing tobacco also causes many types of cancer—including those of the mouth, oesophagus, stomach, and bladder.