Smoke - the killer in the kitchen

Every day thousands of men, women and children in the world's poorest countries die as a result of lethal levels of smoke in their homes.

Over half of the world's population rely on using wood, dung, coal and charcoal for cooking and heating, and the smoke from these fires turns kitchens in poor communities into death traps. 1.6 million die every year from lethal levels of smoke - a life lost every 20 seconds. It is a larger killer than malaria and is the fourth greatest risk to death and disease in the world's poorest countries.

Practical Action is working hard to reduce the threat of this lethal smoke, using simple technology and working with poor people to help them improve their health. But this is a global problem that needs a global solution, and so far the threat of indoor smoke has been largely ignored. Practical Action is campaigning for urgent international action to tackle the killer in the kitchen.

We welcome the British government's support for initiatives to tackle indoor smoke. It now needs to go further, and mobilise international efforts to combat the problem of indoor smoke.

Take action now! E-mail Hilary Benn and call for the introduction of an UN-led Global Action Plan to eradicate the killer in the kitchen

In its report, Smoke: the Killer in the Kitchen, ITDGPractical Action is calling for global action to save the lives of 1.6 million men, women and children lost each year to lethal levels of household smoke.

• Summary of the report
• Read the report online
• Download the report
• Buy a copy from ITDG Publishing
• Find out more: key questions and answers
• Further information
• Links

The problem

More than a third of humanity, 2.4 billion people, burn biomass (wood, crop residues, charcoal and dung) for cooking and heating. When coal is included a total of 3 billion people - half the world's population - cook with solid fuel.

The smoke from burning these fuels turns kitchens in the world's poorest countries into death traps. Particles from fuels like wood and charcoal make lungs vulnerable to acute lower respiratory infections, such as pneumonia, chronic obstructive pulmonary disease or cancer. In addition there is evidence to link indoor air pollution to asthma, tuberculosis, low birth weight and infant mortality and cataracts.

While the world spends millions of dollars combating levels of pollution in Western cities, it has neglected to tackle the death toll caused by lethal levels of smoke in the homes of the poor world.

What can be done

The scale of the problem is immense. What is needed is a global campaign that matches the level of this chronic problem, in line with the international community's response to hunger, HIV/AIDS, dirty water, poor sanitation and malaria. Read ITDGPractical Action's call for a Global Action Plan

However, there are solutions - and they need not cost the earth. ITDGPractical Action has worked with communities in Kenya, Sudan and Nepal to develop improved stoves, smoke hoods, chimneys and improved ventilation.

You can read about our work in these countries, and see how simple technology - affordable, accessible and appropriate - can make a real difference to people's lives.

	Smoke and health in Kenya In the Kajiado region of Kenya, ITDGPractical Action has been working with Maasai women to develop a simple smoke hood, which has reduced smoke levels by up to 80%.
	Smoke and health in Sudan In Kassala, eastern Sudan, an ITDGPractical Action project is working with households to develop solutions to indoor air pollution, including a switch to LPG.
	Smoke and health in Nepal In Nepal ITDGPractical Action has been working with the community to develop improvements in home insulation and stove design to reduce fuel use.

In the past, one of the excuses for inaction on household smoke has been that there was insufficient medical evidence of its impact. There is now ample evidence. And as we have shown, there are also simple and effective ways of reducing levels of smoke. What is missing is the political will to act.

ITDGPractical Action is calling on the United Nations to instigate a Global Action Plan to address the neglected killer of indoor air pollution, and to back the newly formed Partnership for Clean Indoor Air with the necessary resources and political will.

This partnership, which is backed by the World Health Organisation, the World Bank, the US Environmental Protection Agency and others, is beginning to turn around the inaction on smoke in the home, but needs high-level political and financial support if it is to have a significant impact.

Find out more

Key questions and answers

• Why is ITDGPractical Action highlighting this problem?
• How does smoke affect people's health?
• How bad is the smoke inside a home?
• What is in the smoke that causes these problems?
• Where is the problem worst?
• Why do people cook on these fuels?
• Why use fires inside the home in the first place, why not simply cook outside?
• What can be done to reduce the levels of smoke?
• Even reducing smoke levels by 80 per cent levels are still high?
• Can the poor afford a smoke hood and how much do they cost?
• Don't fuel efficient stoves help reduce levels of smoke?
• Why not use solar cookers?
• Will the poor be able to afford cleaner fuels?
• Wouldn't the large take up of fossil fuel put a lot of people out of work who depend on selling firewood and charcoal?
• Why is ITDGPractical Action supporting the use of fossil fuels?
• Is the use of fossil fuels a short-term fix which should be replaced by renewable energy in the future?
• What is being done about smoke in the home?
• If it is such a problem how come nothing has been done about it?
• Why has this problem not been highlighted by ITDGPractical Action before now?
• What exactly is ITDGPractical Action calling for?
• How could this come about?
• How much will all this cost?
• Who will fund the changes?
• What should the British Government be doing about the situation?

Read the report online

You can buy a copy of the report from ITDG Publishing, download it as a PDF file, or read it online as web pages: Executive summary Smoke - the killer in the kitchen A crisis affecting mainly poor women and children Smoke and the Millennium Development Goals Smoke's increasing cloud across the globe Why has so little been done? How smoke kills and injures Exposure in poor homes far exceeds accepted safety levels Researching how smoke affects health Health effects of indoor air pollution Reducing exposure to indoor air pollution Cooking on a cleaner fuel Getting smoke out of the house Cutting smoke volumes Reducing the need for fire Changing patterns of behaviour Heating the home Identifying appropriate solutions Weighing up the cost of smoke alleviation Lessons from stoves programmes Smoke reduction efforts and health spending A Global Action Plan High level international conference Millennium Development Goals A global partnership Sustainable finance National task forces Appendix 1: Lessons to be learnt from improved stoves programmes Appendix 2: Getting the market right for wide-scale dissemination Appendix 3: Action by key stakeholders on indoor air pollution World Health Organization Energy Sector Management Assistance Programme Partnership for Clean Indoor Air United Nations Development Programme National governments Global Village Energy Partnership Shell Foundation Research community Development community

Download PDF version

Download the report Smoke: the Killer in the Kitchen ~ 4.7Mb

NB: this is a very large file, and is only suitable to be downloaded over a broadband connection. You may prefer to download individual chapters, below, read the text online, or order a printed version from ITDG Publishing.

• Executive summary ~ 51k
• Smoke - the killer in the kitchen ~ 1.6Mb
• Smoke's increasing cloud across the globe ~ 754k
• Reducing exposure to indoor air pollution ~ 2.5Mb
• Weighing up the cost of smoke alleviation ~ 643k
• A Global Action Plan ~ 62k
• Appendices and notes ~ 85k

To read these files, you will need the current version of Adobe Acrobat reader, which can be downloaded from Adobe's website.
More information on PDF files, troubleshooting and alternatives.

Buy the report Printed copies of the report are available to buy, price £7.95 plus postage and packing. Order online from www.developmentbookshop.com or write to: Practical Action Development Bookshop Schumacher Centre for Technology & Development Rugby CV23 XZ, United Kingdom email: orders@itpubs.org.uk T +44 (0) 1926 634501 F +44 (0) 1926 634502 Add £1.20 p&p per copy for UK, £1.60 for Europe, and £2 for rest of the world. Discounts are available for 10 or more copies.

Further information

In-depth information on ITDGPractical Action's work on reducing indoor air pollution:

• Kenyan Smoke and Health project: illustrated summary ~670k
• Kenyan Smoke and Health project: full ITDGPractical Action report (text) ~334k
  Kenyan Smoke and Health project : full ITDGPractical Action report (illustrated version) ~3.4Mb
  Please note that the illustrated report is over 3MB and is only suitable for broadband connections.
• Read more about the Smoke and Health project on the Technology for Sustainable Livelihoods website
• Read more about household energy and poverty reduction in ITDGPractical Action's journal Boiling Point including:
  Participatory approaches for alleviating indoor air pollution in rural Kenyan kitchens ~141K
• Smoke Health HHE issues paper ~232K
  an introduction to a DFID-funded smoke-alleviation study, outlining the issues regarding smoke for poor communities in Kenya, Nepal and Sudan

Links to external websites

Smoke, health and household energy Volume 1: Participatory methods for design, installation, monitoring and assessment of smoke alleviation technologies This publication describes a UK-Government funded research project done by ITDG in three very different communities. The project has worked with around 30 households in each country, comprising: a peri-urban district in Kenya a village community in a high cold region in Nepal a community of displaced persons around Kassala in Sudan. The project worked with communities to identify, install and monitor sustainable technologies to alleviate smoke. This led to very different solutions in each country. In Kenya, a wide spectrum of options from very low cost 'fireless cookers' to metal smoke hoods was adopted. In Nepal, space heating is needed, and insulation, improved stoves and smoke hoods have been researched. In Sudan, LPG stoves were universally adopted, and the project has led to nearly 1000 households adopting this cleaner fuel. The project is now in a second phase, developing the interventions that have proved popular but have not shown the levels of smoke reduction required, and scaling up those that have been successful through commercial routes. Partnerships and collaboration have been vital to the project, and as the work enters this 'scaling up' phase, these early relationships are proving to be even more valuable. This publication tells the story of how the project is working with communities and what it has achieved. Read summary and download publication ...

More general information about how energy can aid poverty reduction:

• Energy for the Poor - ITDGPractical Action's energy advocacy work
• Sustainable Energy for Poverty Reduction, ITDGPractical Action and Greenpeace's joint Action Plan
• Power to the People - sustainable energy solutions for the world's poor, ITDGPractical Action's briefing paper on energy and poverty
• The Choose Positive Energy campaign

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Smoke - the Killer in the Kitchen

Every day thousands of men, women and children in the world's poorest countries die as a result of lethal levels of smoke in their homes.

	Take action now! E-mail Hilary Benn and call for the introduction of an UN-led Global Action Plan to eradicate the killer in the kitchen

Practical Action is working with poor communities and using simple technology to reduce the threat from this lethal smoke and improve people's lives. But this is a global problem that needs a global solution. Practical Action is campaigning for international action to fight the killer in the kitchen - smoke from cooking fires.

The 'silent killer'

Poverty condemns around half of the world's population to use solid fuels, including wood, dung and coal, for cooking and heating their homes. The smoke from burning these fuels turns kitchens into death traps. In poor people's homes throughout the developing world, levels of exposure to dangerous pollutants are often 100 times higher than recommended limits. Indoor smoke from burning solid fuels kills over 1.6 million men, women and children each year. That is a life lost every 20 seconds - a death toll greater than that caused by malaria.

Indoor smoke is not an indiscriminate killer - it is the poorest who suffer most. It is the poorest who rely on fuels like wood and dung for cooking because they cannot access gas or electricity. Indoor smoke also hits women and small children the hardest. Women typically spend three to seven hours a day by the fire and exposed to smoke, often with young children nearby. Children are particularly vulnerable to the effects of indoor smoke - it is responsible for the deaths of nearly one million children a year.

And the story gets worse. In most communities it is the women's responsibility to find the fuel for cooking, and in rural areas women often have to walk long distances to collect wood. As well as taking up large amounts of time, women are vulnerable to injury from carrying heavy loads in challenging terrains, and in conflict zones such as Sudan, they are at risk from violence including beatings and rape.

Illnesses caused by indoor smoke include pneumonia, chronic respiratory disease and lung cancer. A child exposed to smoke in the home is two to three times more likely to catch pneumonia, which is one of the world's leading killers of young children. Women who cook on solid fuels are up to four times more likely to suffer from chronic obstructive pulmonary diseases, such as chronic bronchitis. Lung cancer in women in China has been directly linked to the use of coal-burning stoves. In addition, there is evidence to link indoor smoke to asthma, tuberculosis, cataracts, low birth weight and high infant mortality.

Reducing lethal levels of smoke

	Key facts • Half of humanity - over 3 billion people - cook using wood, dung, crop waste, coal and charcoal. • According to the World Health Organisation, at least 1.6 million people die each year from smoke in their homes. • Indoor smoke is the fourth greatest risk to death and disease in the world's poorest countries. • Women spend three to seven hours a day by the fire, and they are often exposed to levels of smoke more than 100 times above accepted safety levels. • The smoke produced from indoor cooking fires is the equivalent to smoking two packs of cigarettes a day, according to the World Energy Assessment.

Billions of people would lead a healthier life if their exposure to lethal levels of smoke was reduced. Public awareness of the health risks of smoke is a crucial first step. Simple changes in the way women cook can reduce smoke levels, such as using a pot lid when cooking (which speeds up the cooking) and drying wood before burning it.

Though simple, low-cost solutions are available, a technical fix alone is not the answer. Cooking is a deeply cultural and domestic task and communities themselves, particularly the women, must be directly involved in developing solutions that suit their circumstances.

The international community is slowly gearing up to tackle indoor air pollution, with initiatives from the World Health Organisation, the launch of the Partnership for Clean Indoor Air and the United Nations Development Programme's LPG Challenge. However, compared with the international community's response to hunger, HIV/AIDS, dirty water, poor sanitation and malaria, there has been extremely limited funding and insufficient high-level political backing for such initiatives. Without concerted action on indoor smoke, the international community will fail to meet its own targets for poverty reduction - the Millennium Development Goals.

How to stop this killer - a Global Action Plan

Reducing the exposure to smoke of approximately half the world's population will take concerted political will, international coordination, government action and targeted funding. It will require energy, environment, health, shelter and development sectors to work together in partnership. What is urgently required is a global campaign that matches the severity of this chronic problem.

Practical Action is calling for a Global Action Plan to address this neglected killer. This would include:

• National task forces , that bring together national governments, private companies and non-governmental organisations. Each task force would be charged with increasing national awareness of the dangers of smoke, making cleaner fuels more available to poor communities and developing other appropriate solutions to get smoke out of homes.
• A global partnership , which puts global political weight and resources into the existing Partnership for Clean Indoor Air. This Partnership brings together leading international players from the health, development, energy, shelter and environment sectors. Increased political weight and resources will enable it to work towards a global solution and to prepare strategic plans to tackle indoor air pollution in the longer term.
• A global fund , which secures extra resources from governments and international donors like the World Bank and International Monetary Fund, to finance further research and bring clean air to millions of homes. For relatively little outlay, massive health benefits could be achieved and millions of lives could be saved. Around $500 million a year would kick-start an effective market in low-cost smoke solutions.

Practical Action welcomes the British government's support for initiatives to tackle indoor smoke, for example by joining the Partnership for Clean Indoor Air. Now the government must show international leadership on this issue, and champion a Global Action Plan with international donors and governments around the world.

Take action now! E-mail Hilary Benn and call for the introduction of an UN-led Global Action Plan to eradicate the killer in the kitchen

• Download this page as a full-colour illustrated booklet (PDF, 1Mb) to print

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What can be done

The scale of the problem is immense. However, there are solutions - and they need not cost the earth. ITDGPractical Action has worked with communities in Kenya, Sudan and Nepal to develop improved stoves, smoke hoods, chimneys and improved ventilation.

You can read about our work in these countries, and see how simple technology - affordable, accessible and appropriate - can make a real difference to people's lives.

	Smoke and health in Kenya In the Kajiado region of Kenya, ITDGPractical Action has been working with Maasai women to develop a simple smoke hood, which has reduced smoke levels by up to 80%.
	Smoke and health in Sudan In Kassala, eastern Sudan, an ITDGPractical Action project is working with households to develop solutions to indoor air pollution, including a switch to LPG.
	Smoke and health in Nepal In Nepal ITDGPractical Action has been working with the community to develop improvements in home insulation and stove design to reduce fuel use.

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Find out more

Key questions and answers

• Why is ITDGPractical Action highlighting this problem?
• How does smoke affect people's health?
• How bad is the smoke inside a home?
• What is in the smoke that causes these problems?
• Where is the problem worst?
• Why do people cook on these fuels?
• Why use fires inside the home in the first place, why not simply cook outside?
• What can be done to reduce the levels of smoke?
• Even reducing smoke levels by 80 per cent levels are still high?
• Can the poor afford a smoke hood and how much do they cost?
• Don't fuel efficient stoves help reduce levels of smoke?
• Why not use solar cookers?
• Will the poor be able to afford cleaner fuels?
• Wouldn't the large take up of fossil fuel put a lot of people out of work who depend on selling firewood and charcoal?
• Why is ITDGPractical Action supporting the use of fossil fuels?
• Is the use of fossil fuels a short-term fix which should be replaced by renewable energy in the future?
• What is being done about smoke in the home?
• If it is such a problem how come nothing has been done about it?
• Why has this problem not been highlighted by ITDGPractical Action before now?
• What exactly is ITDGPractical Action calling for?
• How could this come about?
• How much will all this cost?
• Who will fund the changes?
• What should the British Government be doing about the situation?

---

Report - Smoke: the Killer in the Kitchen

In its report, Smoke: the Killer in the Kitchen, ITDGPractical Action is calling for global action to save the lives of 1.6 million men, women and children lost each year to lethal levels of household smoke.

• Summary of the report
• Read the report online
• Download the report
• Buy a copy from ITDG Publishing
• Find out more: key questions and answers
• Further information
• Links

Read the report online

You can buy a copy of the report from ITDG Publishing, download it as a PDF file, or read it online as web pages: Executive summary Smoke - the killer in the kitchen A crisis affecting mainly poor women and children Smoke and the Millennium Development Goals Smoke's increasing cloud across the globe Why has so little been done? How smoke kills and injures Exposure in poor homes far exceeds accepted safety levels Researching how smoke affects health Health effects of indoor air pollution Reducing exposure to indoor air pollution Cooking on a cleaner fuel Getting smoke out of the house Cutting smoke volumes Reducing the need for fire Changing patterns of behaviour Heating the home Identifying appropriate solutions Weighing up the cost of smoke alleviation Lessons from stoves programmes Smoke reduction efforts and health spending A Global Action Plan High level international conference Millennium Development Goals A global partnership Sustainable finance National task forces Appendix 1: Lessons to be learnt from improved stoves programmes Appendix 2: Getting the market right for wide-scale dissemination Appendix 3: Action by key stakeholders on indoor air pollution World Health Organization Energy Sector Management Assistance Programme Partnership for Clean Indoor Air United Nations Development Programme National governments Global Village Energy Partnership Shell Foundation Research community Development community

Download PDF version

Download the report Smoke: the Killer in the Kitchen ~ 4.7Mb

NB: this is a very large file, and is only suitable to be downloaded over a broadband connection. You may prefer to download individual chapters, below, read the text online, or order a printed version from ITDG Publishing.

• Executive summary ~ 51k
• Smoke - the killer in the kitchen ~ 1.6Mb
• Smoke's increasing cloud across the globe ~ 754k
• Reducing exposure to indoor air pollution ~ 2.5Mb
• Weighing up the cost of smoke alleviation ~ 643k
• A Global Action Plan ~ 62k
• Appendices and notes ~ 85k

To read these files, you will need the current version of Adobe Acrobat reader, which can be downloaded from Adobe's website.
More information on PDF files, troubleshooting and alternatives.

Buy the report Printed copies of the report are available to buy, price £7.95 plus postage and packing. Order online from www.developmentbookshop.com or write to: Practical Action Development Bookshop Schumacher Centre for Technology & Development Rugby CV23 XZ, United Kingdom email: orders@itpubs.org.uk T +44 (0) 1926 634501 F +44 (0) 1926 634502 Add £1.20 p&p per copy for UK, £1.60 for Europe, and £2 for rest of the world. Discounts are available for 10 or more copies.

---

Further information

In-depth information on ITDGPractical Action's work on reducing indoor air pollution:

• Kenyan Smoke and Health project: illustrated summary ~670k
• Kenyan Smoke and Health project: full ITDGPractical Action report (text) ~334k
  Kenyan Smoke and Health project : full ITDGPractical Action report (illustrated version) ~3.4Mb
  Please note that the illustrated report is over 3MB and is only suitable for broadband connections.
• Read more about the Smoke and Health project on the Technology for Sustainable Livelihoods website
• Read more about household energy and poverty reduction in ITDGPractical Action's journal Boiling Point including:
  Participatory approaches for alleviating indoor air pollution in rural Kenyan kitchens ~141K
• Smoke Health HHE issues paper ~232K
  an introduction to a DFID-funded smoke-alleviation study, outlining the issues regarding smoke for poor communities in Kenya, Nepal and Sudan
• Links to partners and other sources of information on indoor air pollution

Smoke, health and household energy Volume 1: Participatory methods for design, installation, monitoring and assessment of smoke alleviation technologies This publication describes a UK-Government funded research project done by ITDG in three very different communities. The project has worked with around 30 households in each country, comprising: a peri-urban district in Kenya a village community in a high cold region in Nepal a community of displaced persons around Kassala in Sudan. The project worked with communities to identify, install and monitor sustainable technologies to alleviate smoke. This led to very different solutions in each country. In Kenya, a wide spectrum of options from very low cost 'fireless cookers' to metal smoke hoods was adopted. In Nepal, space heating is needed, and insulation, improved stoves and smoke hoods have been researched. In Sudan, LPG stoves were universally adopted, and the project has led to nearly 1000 households adopting this cleaner fuel. The project is now in a second phase, developing the interventions that have proved popular but have not shown the levels of smoke reduction required, and scaling up those that have been successful through commercial routes. Partnerships and collaboration have been vital to the project, and as the work enters this 'scaling up' phase, these early relationships are proving to be even more valuable. This publication tells the story of how the project is working with communities and what it has achieved. Read summary and download publication ...

More general information about how energy can aid poverty reduction:

• Energy for the Poor - ITDGPractical Action's energy advocacy work
• Sustainable Energy for Poverty Reduction, ITDGPractical Action and Greenpeace's joint Action Plan
• Power to the People - sustainable energy solutions for the world's poor, ITDGPractical Action's briefing paper on energy and poverty
• The Choose Positive Energy campaign

Stay informed If you would like to receive regular updates about Practical Action's campaigning work on indoor air pollution and other issues, please give us your details and we will let you know of upcoming events and activities. You can opt out at any time. subscribe to our email newsletter