Indoor cooking smoke is a leading source of household air pollution, affecting billions of people worldwide. In many parts of the world, women are most often responsible for preparing meals, placing them at the center of this exposure and at the greatest risk from prolonged contact with smoke produced by solid fuels and inefficient stoves.
Every day, more than 2.1 billion people—primarily in low- and middle-income countries—rely on open fires or rudimentary stoves to cook their food (1). The smoke generated during cooking does not simply dissipate when the meal is finished; it often lingers in enclosed spaces, extending exposure beyond the cooking period itself.
As a result, women and children experience the heaviest health burden from household air pollution. Many spend hours each day in poorly ventilated kitchens, breathing in high concentrations of smoke that contribute to respiratory disease, pregnancy complications, and long-term health risks.
While the burden is greatest in regions that rely heavily on solid fuels, research increasingly shows that cooking-related air pollution can also affect women in higher-income countries—particularly in homes and workplaces where combustion or high-temperature cooking is common.
The health risks of cooking smoke exposure
Cooking smoke is not a single pollutant, but a concentrated mix of fine particles and harmful gases produced when solid fuels are burned indoors. When exposure occurs daily and over long periods—as it does for many women—the health consequences can be severe and cumulative.
Exposure to PM2.5 and carbon monoxide greatly increases the risk of chronic obstructive pulmonary disease (COPD), lung cancer, and asthma (1).
According to a study published in BMJ Open Respiratory Research, women in households using biomass fuels are 1.38 times more likely to develop COPD than those using cleaner energy sources (2). Indoor air pollution is also a major contributor to heart disease and stroke, as inhaling toxic fumes accelerates atherosclerosis and raises blood pressure.
Research indicates that cooking smoke exposure may also affect mental health. A survey of women who were the main household cooks in Kenya, Cameroon, and Ghana found higher rates of depression among those using charcoal or wood, as well as poorer mental well-being among women who spent more time cooking each week. (3).
Pregnant women are especially vulnerable, as air pollution has been linked to maternal hypertensive disorders, placental abruption, preterm birth, low birth weight, infant mortality, adverse lung and respiratory effects, and postpartum depression (5). And because women are typically responsible for cooking even when other household members are present, this exposure often continues daily and across life stages—reinforcing a pattern of risk that can span generations (4).
This persistent exposure raises an important question: why are women more likely to experience cooking smoke in the first place?
Why women face higher exposure to cooking smoke
Women face the greatest health impacts from indoor cooking smoke due to deeply rooted gender roles and, in some cases, differences in biological susceptibility. Some studies suggest women may experience different biological responses to air pollution, increasing vulnerability to chronic respiratory disease (5).
In many cultures, women are responsible for cooking, spending hours each day in cramped, poorly ventilated spaces. This prolonged exposure elevates their intake of fine particulate matter, or PM2.5 — particulate matter measuring 2.5 microns in diameter or smaller.
Exposure is especially high in households that rely on biomass or kerosene, where cooking often takes longer and produces heavier smoke, increasing both the duration and intensity of daily exposure.
Is cooking smoke bad for pregnancy?
Exposure to cooking smoke has been linked to low birth weight, as pollutants cross the placental barrier and impair fetal development (6). Emerging research also suggests a connection between indoor air pollution and cervical cancer (7).
Cooking smoke may contribute to serious pregnancy-related complications. A multi-country study led by researchers at King’s College London found a significant association between household exposure to smoke from solid-fuel cooking and increased rates of eclampsia—a life-threatening condition characterized by severe hypertension and seizures during pregnancy. The risk was highest in households using wood or charcoal and where kitchen ventilation was poor, underscoring how both fuel type and airflow influence maternal health outcomes (8).
Evidence also points to impacts beyond physical health. A large population-based study in China found that maternal exposure to cooking smoke during pregnancy was associated with a markedly higher risk of hyperactivity behaviors in children by age three. The risk increased with more frequent cooking and was higher in households using coal or gas compared to electricity, particularly where kitchen ventilation was poor. These findings suggest that indoor cooking smoke may affect early neurodevelopment, extending the health burden across generations (9).
Where indoor cooking smoke remains most common
The health impacts of indoor cooking smoke are most severe in regions where solid fuels remain the primary source of household energy.
Cooking smoke has a disproportionate impact on women in rural and low-income communities across sub-Saharan Africa, South Asia, and parts of Latin America, where reliance on solid fuels like wood, charcoal, and dung remains widespread.
Sub-Saharan Africa
In sub-Saharan Africa, women in rural areas often cook over open fires in enclosed spaces, leading to chronic exposure that contributes to an estimated half a million premature deaths each year (10). In Ethiopia, biomass fuel makes up 95% of total primary energy consumption; household air pollution in Ethiopia has also been tied to 67,830 annual deaths (11).
Over 175 million Nigerians burn biomass for cooking; over 128,000 preventable deaths in 2019 have been ascribed to indoor air pollution and biomass burning (12).
South Asia
South Asia faces similar challenges, particularly in India, Bangladesh, and Nepal (13) (14). According to a study conducted in Southern Nepal, the median daily average PM2.5 concentration for people cooking with traditional cookstoves was 66.7 times higher than the 2021 WHO guideline for daily exposure of 15 μg/m3 (15).
India’s Ujjwala Yojana program has provided millions of rural households with LPG connections while reducing dependence on firewood, cow-dung, coal, crop residue, and kerosene as cooking solutions (16).
Latin America
In Latin America, where clean energy adoption has improved, rural communities in Brazil, Mexico, and Central America continue to struggle with indoor air pollution.
Open fires and traditional fuels are relied upon daily by 12% of the population of Latin America (17). However, residential firewood use has declined in the past two decades. Firewood accounted for 43% of household energy fuel in 2004 and dropped to 31% by 2024.
North America and Europe
In the United States, a large cohort study found that frequent indoor wood burning from fireplaces and stoves was associated with a higher risk of lung cancer among women, even among never-smokers (18). Importantly, this increased risk was observed in both urban and rural settings, highlighting that indoor combustion sources can pose health risks regardless of geography.
Broader evidence from Western countries reinforces these findings. A systematic review of studies conducted across Europe, Canada, the United States, Australia, and New Zealand identified a strong association between indoor solid fuel exposure and chronic obstructive pulmonary disease (COPD) (19). The review also noted elevated risks of respiratory issues linked to residential coal and wood burning.
Cooking smoke exposure beyond its most common settings
Although indoor cooking smoke is most often discussed in the context of solid-fuel use, similar exposure pathways exist in many modern environments—where enclosed kitchens, combustion sources, and high-temperature cooking can still generate harmful air pollutants.
Occupational exposure in professional kitchens
Women working in professional kitchens face additional risks due to prolonged exposure to cooking fumes. High-temperature frying and grilling release carcinogenic and mutagenic compounds, including polycyclic aromatic hydrocarbons. Studies from Norway have shown that cooks and kitchen workers experience higher rates of respiratory distress, reduced lung function, and increased mortality from airway diseases (20).
Similar concerns have been documented elsewhere. Research in South Korea found that female school cooks and kitchen clerks were at elevated risk for lung cancer associated with cooking fume exposure. (21). A meta-analysis of case-control studies spanning Europe, Canada, New Zealand, and China further concluded that women working as cooks may face a higher lung cancer risk independent of tobacco use. (22).
Together, these findings show that cooking-related air pollution is not confined to traditional or biomass-fueled settings. Across homes and professional kitchens alike, prolonged exposure to cooking smoke—especially in enclosed spaces—can pose significant health risks for women worldwide.
Mitigation and protection strategies
The most effective way to reduce women’s exposure to indoor cooking smoke is by transitioning to cleaner fuels and improved stove designs, supported by adequate ventilation—principles that apply across both household and professional cooking environments. Cleaner energy sources—such as electricity or solar—dramatically reduce the amount of harmful particulate matter and toxic gases released during cooking. Modern, efficient cookstoves further limit emissions while improving safety and fuel efficiency.
However, because access to clean fuels and modern stoves remains uneven, interim measures can still help lower exposure. Improving ventilation—through chimneys, strategically opened windows, exhaust hoods—can help direct smoke away from living spaces. Where feasible, wearing a properly-fitted KN95/FFP2 mask during cooking can reduce inhalation of biofuel pollutants. Cooking outdoors when weather permits can also significantly reduce indoor air pollution.
Encouragingly, large-scale interventions show that progress is possible. In Rwanda, the government launched the Energy Access and Quality Improvement Project to reduce reliance on firewood and charcoal in favor of cleaner cooking fuels and improved cookstoves. Beyond health benefits, the program has helped reduce pressure on forests, cut the time women spend gathering fuel, and create local jobs through the distribution and installation of cleaner cooking solutions across the country (23).
The takeaway
Indoor cooking smoke is a preventable health risk that harms women worldwide, contributing to millions of premature deaths each year. The solution lies in scalable interventions: cleaner fuels, improved stove designs, and better ventilation.
With so many people still reliant on inefficient stoves and open fires, challenges will remain. Bridging this gap will depend on sustained policy action, investment, and global cooperation to expand access to clean cooking solutions.
