Maricela Ruelas is a manager at a vineyard in Medford, Oregon. She trims, harvests – whatever needs doing. This year, she has done much of that work in a face mask.

Wildfire smoke has plagued her and her fellow workers nearly continuously for “a couple of months”, she said through a translator, leading to pounding headaches. “It was horrible, horrible this year.”

For Ruelas, the smoke isn’t just a nuisance; it’s an economic hardship. She and her co-workers are paid by the hour, so when they have to leave work early because their heads and lungs hurt, they don’t get paid. And Ruelas sends less money home to her grown children in Guadalajara.

The west is drier, hotter than ever, frequently on fire. Thanks to reduced snowpacks in the mountains, the soil is parched by early summer and forests are tinder. What firefighters once called a “fire season” is now referred to as a “fire year”, since the fires start so early and rage deep into fall.

These extreme phenomena are causing some people to consider leaving the western US, a place long conceptualized in the American imagination as the land of balmy weather and fresh starts. Some have already left. They are sick of wildfire smoke; worried that a lack of water will destroy their communities or about climate migrants from other parts of the country; and struggling with the heat itself.

A family wear masks in the smoke-filled streets after the Thomas wildfire swept through Ventura, California, in December 2017. Photograph: Mark Ralston/AFP/Getty Images

“I felt bad leaving people behind who don’t have that ability to uproot,” said Michael Lakeman, a New Zealander who moved with his American wife and kids back to his home country from Seattle this summer. “We’d been living in Seattle for 17 years, really good life. Good jobs, good friends, nice house.” The seed of the idea to move was planted when Donald Trump won the presidential election. Lakeman and his wife didn’t want their daughters growing up in a “political climate of misogyny” – but Lakeman also worried about the effects of climate change, including wildfire smoke and the disruptions caused by internal migration away from the hottest cities.

As a consultant on renewable energy, he thought about climate change a lot. He worried about Seattle, already straining from the influx of many tech workers, ending up as an overcrowded refuge for those fleeing drought and heat in the desert south-west. “What happens when the Colorado river dries up?” he wonders. “Where are the millions of people who call Phoenix and Vegas home going to go when there is no water?”

Lakeman’s young daughters are adjusting to Auckland. Lakeman describes New Zealand as “small, not crowded, maritime, far away from the rest of the world – a good place to escape”.

Climate change has already raised temperatures across the globe. The United States is predicted to be about 2.5F (1.4C) hotter from 2021 to 2050 compared with the late 20th century.

On the porch of his home in Klamath Falls, a 64-year old marine veteran, his forearms decorated with patriotic tattoos, looks out over a sparkling blue lake and golden, grass-covered hills. The man doesn’t want to use his name because he doesn’t want his employer to know he is thinking of leaving the area.

His view is stunning, but he has barely seen it lately. For most of the last few months, smoke has blanketed the Klamath Basin, reaching levels deemed “unhealthy” and “hazardous” by the Environmental Protection Agency. The man has chronic obstructive pulmonary disorder and uses an oxygen tank 24 hours a day. For much of the summer, he hasn’t even been able to come out on the porch without a mask over his oxygen tubing. The future holds little hope: researchers project that smoke from wildfires will double by mid-century and triple by 2100 in the American west.

A hiker in Phoenix walks past a heat warning sign at sunrise in July. Arizona’s largest city is also an ‘urban heat island’ – a phenomenon that pushes up temperatures in areas covered in heat-retaining asphalt and concrete. Photograph: Matt York/AP

The man’s daughter is 11. He bought her a cruiser bike this summer but she hasn’t been on it once. She played video games inside instead. Every morning, the man wakes up and checks the air quality. “First thing I do when I get up, I hit refresh on my laptop to see if I can get on my porch,” he said. “It feels like you are a prisoner of your own environment.”

He has told his reluctant wife and child that he is near the breaking point. “If it is like this next summer,” he said, “we’re out.”

Moving might be challenging. He has calculated that a move to the Oregon coast, which sees fewer smoky days, would cost at least $5,000 in moving costs, plus a first and last month’s rent and security deposit. It is money he doesn’t have. For his last birthday, his daughter made decorations for the home he spends so much time trapped inside: glass jars filled with sand and seashells. “We can’t go to the ocean, so I brought the ocean to him,” she said.

There’s another problem with the coast – experts predict up to 1.6 meters (5ft) of sea-level rise on the west coast over the next 100 years. More than 130,000 coastal homes will be at risk by 2100, and acres of wetlands that buffer storms will be lost.

“I think that’s the hard part: coming to grips with the fact that there really is no safe refuge,” said Shelby Edwards, a retired major who worked on disaster preparedness in the Army and now advises companies on how to prep for the worst. “None of us humans get to escape this at this point.”

Edwards moved to central Oregon just a few years ago for the sunshine, but is now looking for someplace else she, her horses and dogs can call home. For several years, smoke and falling ash has made it impossible to ride or hike for long periods – and she fears for her health after years of inhaling “colored smoke, diesel and tons of it, dust, riot control gas, and all kinds of other burning crap that gets in your lungs” during her deployments in Afghanistan.

Shelby Edwards is looking for just the right place to go where she, her horses and dogs can call home. Photograph: Charlie Litchfield/The Guardian

Edwards doesn’t want to leave the west, but even if she did, she says nowhere is without climate impacts. “If you go into the midwest, you’ve got drought. If you go into the east coast you have hurricanes and rising sea levels, severe storms. Their flavor of disruption is different.”

She’s been searching for two years for just the right place to go within the region. One key thing she is looking for are tightly knit communities with a lot of economic diversity. She thinks they will be more resilient to any number of climate change-related problems, from fire to flooding to crop failure. “There are some communities that are brittle, that don’t have a lot of capacity for change.”

The effects of climate change across the west will vary, and the shuffling of populations could be complex, according to Solomon Hsiang, an economist who studies climate change at the University of California, Berkeley. The south-west, especially Arizona and New Mexico, is already extremely hot and only getting hotter. Hsiang expects many residents there will hunker down in the air conditioning and stay. “People who have chosen to live there are often not there because they have chosen to spend lots of time outside,” he says.

In places where going outside is part of the culture, like San Diego, extreme heatwaves might send more people packing.

But the Pacific west – California, Oregon and Washington – is predicted to be one of the areas of the country that will warm the least under climate change, despite persistent wildfire smoke, and might end up attracting migrants from other areas of the country. So the patterns of movement will be complex, Hsiang says.

It was faith in her community that helped freelance writer Cally Carswell decide to stay in Santa Fe, New Mexico.

Early this year she had been spooked by an eerily warm and dry winter in an already arid city. “We barely got any snow at all,” she said. “I could see the snow on the mountains melt within a day or two each time we got snowfall.” She worried that drought might destroy the community and with it the value of her home, and wrote an essay about her indecision over whether to leave for High Country News.

In the end, her research into the water-saving moves the city was making made her cautiously optimistic. But she’s not sure how long she’ll stay. “It is something we are going to have to feel out as we go,” she said

Carswell, as a freelancer, is relatively free to move. It is harder for those whose livelihoods are tied to the land, like Ruelas. She knows the fires are getting worse, and worries about long-term health effects, but she does not want to leave her job.

She feels powerless to do anything about the situation, though she dreams of a big machine that would absorb all the smoke that is hurting her and her co-workers. She feels that politicians and those in power don’t care about her suffering and are happy to profit off her by selling her medicine when she gets sick. She wishes that people with the luxury of working inside in climate-controlled offices would treat her with more humanity.

On the smokiest days, she said, the sun looks strange and she can feel the smoke start to hurt by midday. “Sooner or later,” she says, “there will be consequences.”