Background: In China, betel nut users were initially concentrated in specific regions and ethnic groups. However, in recent years, public health concerns have been raised because betel nuts, addictive substances, have become largely used by Chinese migrant workers. Methods: This study adopts an anthropological fieldwork research methodology to investigate the rise in betel nut consumption among Chinese migrant workers. We observe the everyday lives of migrant workers in the rural-urban area of Wuhan. We use in-depth interviews to understand their psychology and behaviors toward betel nut consumption. Discussion: The study’s results indicate that the observed increase in betel nut consumption among migrant workers is not only the result of the spread of betel nuts across regions and groups, but more importantly, it is related to the working and living conditions, social interaction, consumption culture, and masculinity image of migrant workers. The consumption of betel nuts reflects the political-economic structure and socio-cultural background to which Chinese migrant workers belong. Conclusion: The increasing consumption of betel nuts is a social issue that requires thorough research and government engagement. We contend that anthropology research may help identify the social mechanisms incentivizing betel nut consumption and solve the related public health issues among Chinese migrant workers from public policy and social governance perspectives.