New research links indoor air to lung cancer and heart disease

After joining the GBD 2021 Household Air Pollution Team, an international effort to quantify global Health The burden of household air pollution from 1990 to 2021 I expected a familiar task: analyzing how indoor smoke harms the body. Instead, what initially appeared to be domestic data revealed a much darker picture of global inequality.

The urgency of that inequality has rarely been felt so urgently. In December 2025, the UK government published an updated environmental plan impose strict restrictions on wood burning stoves – A move aimed at reducing PM2.5 pollution, microscopic particles small enough to enter the lungs and bloodstream, which are associated with serious health risks.

Working with data felt personal. Each night, I look at projections of the country, images of families preparing meals over smoky stoves, inhaling toxins they can’t see and probably don’t even realize are harming their health. For many communities, switching to clean fuels isn’t just about convenience. It’s about survival.

Our study examined how exposure to household air pollution changed in 204 countries between 1990 and 2021. Although the use of solid fuels such as wood, coal and cow dung has declined, exposure to household air pollution remains widespread and its health consequences are severe.

Indoor air pollution rarely makes headlines, yet it kills millions of people every year. Whenever a food is cooked over a smoky fire, families inhale toxins that can shorten lifespans, hinder children’s development and deepen structural inequalities.

Research links childhood exposure to impaired cognitive development, respiratory vulnerability, and long-term health impairment. These effects are often hidden, emerging slowly over years, making them easy to miss and difficult to address.

Household air pollution is a major risk factor for chronic obstructive pulmonary disease, strokelower respiratory infections, lung cancer and ischemic heart diseaseAlso called coronary heart disease and occurs when the heart becomes starved of oxygen because its arteries become narrowed or blocked. These health risks unfold unevenly around the world, and the global patterns in our data underscore that disparity.

Wealthy areas have seen a steady decline in risk. A global data set tracking access to clean and modern energy shows that households in high-income countries are now much less dependent on polluting stoves than before. Yet many parts of sub-Saharan Africa and South Asia remain heavily dependent on polluting fuels. Cleaner alternatives such as liquefied petroleum gas, electricity, ethanol, improved biomass stoves and biogas are financially out of reach for many households.

But our research can inform investments in clean energy, help shape health policy, and strengthen public understanding of the risks.

Governments and development partners can accelerate access to clean fuels by improving infrastructure such as fuel storage, transportation and local retail networks. They can also strengthen power systems so that homes have a consistent power supply that supports electric cooking.

Subsidies can help reduce the cost of clean fuels and stoves so that households are not pushed back toward cheaper, more polluting alternatives. Investment in locally appropriate technologies matters because stoves work best when they are tailored to the foods people prepare, the sizes of utensils they use, and the rhythms of daily life.

Health systems can improve the diagnosis and treatment of chronic conditions associated with household air pollution, especially in places where exposure remains high. Strong data systems also matter, as many countries still lack reliable monitoring of pollution exposure. Without accurate data it is difficult to identify communities at highest risk, measure progress or plan effective interventions.

Community engagement is central to sustainable progress. Uptake improves when stoves fit local cooking styles, meet household preferences and are introduced through trusted local groups rather than being imposed from outside. People are more likely to try using a new stove when it comes from sources they know and when it fits in with their everyday routine.

Although indoor air pollution may be viewed as an individual or household problem, its effects extend far beyond the home. Clean cooking isn’t just a matter of sustainability or climate. This is a matter of health equity. Clean cooking doesn’t just mean changing the stove or fuel type. It’s about protecting health, expanding opportunity and giving every child the chance to grow up in an environment that doesn’t silently harm them.

Reducing smoke in homes means fewer chronic diseases, fewer premature deaths and a stronger foundation for global health. If progress is slow, the burden will continue to fall most heavily on those places least able to bear it.