Smoke - the Killer in the Kitchen

A Practical Action report

Smoke in the home from cooking on wood, dung and crop waste kills nearly one million children a year. In its report, Smoke: the Killer in the Kitchen, published in 2004, Practical Action called for global action to save the lives of two million men, women and children lost each year to lethal levels of household smoke.

Smoke: the Killer in the KitchenRead the report online by following the links to the chapters below, order a printed copy, or download as PDF files.

ARCHIVE CONTENT: Please note, this report was published in 2004, and figures quoted may now longer be current

Smoke: the Killer in the Kitchen

Executive summary

Of the four greatest risks of death and disease in the world's poorest countries - being underweight; unsafe sex; unsafe water, sanitation and hygiene; and smoke from solid fuel - the international community has mobilized resources to combat the first three. It is nothing short of an international scandal that the fourth has been largely ignored. This report calls for global action to fight the killer in the kitchen - smoke from cook stoves.

The killer in the kitchen

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.

Around two-thirds of women with lung cancer in China and India are non-smokers.

The smoke from burning these fuels turns kitchens in the world's poorest countries into death traps. Indoor air pollution from the burning of solid fuels kills over 1.5 million people, predominately women and children, each year. This is more than three people per minute. It is a death toll almost as great as that caused by unsafe water and sanitation, and greater than that caused by malaria. Smoke in the home is one of the world's leading child killers, claiming nearly one million children's lives each year.

Women and children hit hardest

Indoor air pollution is not an indiscriminate killer. It is the poor who rely on the lower grades of fuel and have least access to cleaner technologies. Specifically, indoor air pollution affects women and small children far more than any other sector of society. Women typically spend three to seven hours per day by the fire, exposed to smoke, often with young children nearby.

Over half of all people cooking on biomass live in India and China. However the proportion of the population cooking on biomass is highest in sub-Saharan Africa, rising to over 90% of the population in many countries. This is a chronic problem for people living in rural areas of developing countries, but not exclusively - there is a growing problem in the cities as well.

A problem set to get worse

On current trends an extra 200 million people worldwide will rely on biomass for their cooking and heating needs by 2030, according to the International Energy Agency. In parts of Central Asia where gas and electricity used to be available people are reverting back to using biomass as their main fuel source. In Tajikistan since 1991 the incidence of acute respiratory infection, the world's greatest child killer, has risen by 35% largely as a result of burning wood indoors.

The effects of smoke on health

In the cities of the industrialized world air pollution has long been recognized as a major health hazard. A great deal of time and effort is put into measures that will reduce exposure to air pollution. Yet in poor people's homes throughout the developing world levels of exposure to pollutants are often 100 times greater than recommended maximums.

The use of poorly ventilated, inefficient stoves 'can have the same adverse health impacts as smoking two packs of cigarettes a day'.
- United Nations Development Programme

Illnesses caused by indoor air pollution include acute lower respiratory infection. A child is two to three times more likely to contract acute lower respiratory infection if exposed to indoor air pollution. Women who cook on biomass are up to four times more likely to suffer from chronic obstructive pulmonary disease, such as chronic bronchitis. Lung cancer in women in China has been directly linked to use of coal burning stoves. In addition there is evidence to link indoor air pollution to asthma, tuberculosis, low birth weight and infant mortality and cataracts.

Reducing lethal levels of smoke

Billions of people would lead a healthier life if their exposure to lethal levels of smoke were reduced. Public awareness of the health risks of smoke is a crucial first step. The most effective way to reduce smoke in the home is to switch to a cleaner fuel, such as liquid petroleum gas (LPG), kerosene or biogas.

However, the vast majority of people at risk are too poor to change to a cleaner fuel, or have no access to modern fuels. In these homes, the answer will be to reduce exposure, for example by using well designed chimney stoves, or smoke hoods which can reduce indoor air pollution by up to 80%.

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.

Realizing the need for action

The international community is slowly gearing up to tackle indoor air pollution, with new initiatives from the World Health Organization and the launch of the United States Environmental Protection Agency-led Partnership for Clean Indoor Air and the United Nations Development Programme's LPG Challenge. Organizations such as the Shell Foundation and a number of nongovernmental organizations, including Practical Action, are working directly with poor communities to find solutions and scale up their efforts. However, compared with action on the other main risks of death, there has been extremely limited funding and insufficient high-level international political backing for such initiatives.

How to stop this killer

Reducing the exposure of approximately half the world's population to smoke will take concerted political will, international co-ordination, government action and targeted funding. It will require energy, environment, health, shelter and development sectors to work together in partnership.

For relatively little outlay, massive health benefits and savings in life could be achieved. Solutions are already available. The total cost of providing three billion people with access to healthy indoor air would be in the region of US$2.5 billion annually over the next 12 years. To kickstart an effective market in distributing low-cost smoke solutions, it is estimated that government spending and international development aid would be in the region of 20% of this total, around $500 million a year - less than one per cent of total western aid spending.

What is urgently required 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.

A Global Action Plan

Practical Action calls on the United Nations to instigate a Global Action Plan to address this neglected killer. The first step would be for the UN Secretary General to convene urgently a high level international conference to set in motion action plans with the necessary resources.

The conference should agree the following four-part strategy:

  • Millennium Development Goals - a specific reference to and action on preventing and reducing child mortality through reducing risk from indoor air pollution.
  • A global partnership - which puts the global political weight and resources into the existing Partnership for Clean Indoor Air, bringing together the leading international players from the health, development, energy, shelter and environment sectors to work towards a global solution and to prepare strategic plans to tackle indoor air pollution.
  • Sustainable finance - that establishes the extra and sustainable resources from traditional and non-traditional donors needed to bring clean air to millions of homes.
  • National task forces - that bring together the key national and local level stakeholders to enable them to address the problem with international support.


The full text of the report can be read online as web pages:

Executive summary

1 Smoke - the killer in the kitchen

  • A crisis affecting mainly poor women and children
  • Smoke and the Millennium Development Goals

2 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

3 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

4 Weighing up the cost of smoke alleviation

  • Lessons from stoves programmes
  • Smoke reduction efforts and health spending

5 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


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Smoke: the Killer in the KitchenDownload 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 online, or order a printed version from Practical Action Publishing.

The full text of the report can also be read online as web pages, which should download faster. (The PDF versions are recommended for printing, and have comprehensive notes and references.)

Smoke - the killer in the kitchen | Smoke's increasing cloud across the globe | Reducing exposure to indoor air pollution | Weighing up the cost of smoke alleviation | A Global Action Plan | Appendices and notes

Download further information

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

Smoke, health and household energy
Vol 1: Participatory methods for smoke alleviation technologies;
Vol 2: Researching pathways to scaling up sustainable and effective kitchen smoke alleviation

These two publications describes a UK-Government funded research project done by Practical Action (formerly ITDG) in three very different communities under a Department for International Development (DFID) research grant. Practical Action has developed a framework to strengthen those living in poverty to work together, participating in all levels of the decision making process and leading to a sound redistribution and management of resources. Women in particular are supported through this approach.


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Smoke: the Killer in the Kitchen


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