Air pollution in India is often discussed in terms of traffic, industry, and the air outside. Yet smoke generated inside a home can also affect what people breathe each day. In some households, wood, dung, crop waste, or coal is used for cooking or heating, bringing the source of pollution close to daily activities. 

A UK study of wood-burning stoves drew attention to particles released indoors during stove use. The fuels, appliances and patterns of exposure in Indian homes can be different. For healthcare professionals, the wider question is whether household air forms part of a patient’s exposure history. 

Wood-burning stoves and household smoke in India

When fuels such as wood, dung, crop waste or coal are burned for cooking or heating, they can release fine particles and other pollutants into the home. The amount of smoke a person breathes depends on more than the fuel alone. The type of stove, whether cooking takes place in a separate area, how air moves through the home, and how long someone remains near the fire can all influence exposure.

These circumstances vary across India. Some households use cleaner cooking fuels, while others rely on solid fuels or use a combination of fuels. Therefore, it would be inaccurate to assume every patient has the same home environment. The WHO household air pollution fact sheet provides a starting point for understanding how polluting household fuels affect indoor air and why access to cleaner options matters. 

What is PM2.5, and why does it matter?

PM2.5 refers to airborne particles measuring 2.5 micrometres or less in diameter. They are small enough to reach deep into the lungs. Household smoke contains these particles along with other pollutants. The World Health Organization links household air pollution with illnesses affecting the lungs and cardiovascular system.

WHO’s global air quality guidelines set a PM2.5 level of 15 µg/m³ averaged over 24 hours and 5 µg/m³ averaged over a year. These time periods are essential to interpreting the numbers. A reading recorded during a few hours of stove use cannot be compared directly with a full day’s average. In patient discussions, it is more useful to understand the source of smoke, how often it is present, and who spends time near it than to rely on a single measurement without context. 

Who may be more affected by household smoke?

People who spend more time near wood-burning stoves may breathe more of the smoke. WHO explains that women and children may have greater exposure to smoke from household stoves and fires because they spend more time in kitchens or polluted living spaces. 

Children and older adults deserve attention, as do patients with existing respiratory or cardiovascular conditions. This does not mean every person exposed to household smoke will become ill. Exposure can differ with the fuel used, the cooking environment, and the time each person spends nearby. Asking who cooks, where cooking takes place, and whether smoke reaches other rooms can help healthcare professionals understand a patient’s circumstances without making assumptions about their home. 

What does research from India show?

An Odisha study published in BMC Public Health examined cooking fuel use and respiratory health among 1,120 women who had never smoked. Researchers asked about respiratory symptoms, measured lung function and recorded the fuels used in participants’ homes. They also measured indoor PM2.5 in a subset of households.

In the population studied, using solid biomass fuel for cooking was associated with chronic bronchitis and airflow obstruction. The findings give healthcare professionals an India-specific example of why cooking fuel may be relevant when taking a respiratory history.

The study was conducted in communities in Odisha during 2013 and 2014. Because it was cross-sectional, it cannot establish that fuel use caused an individual woman’s condition. Its results should not be treated as estimates for all of India. 

How can healthcare professionals address wood-burning stoves and household smoke?

Ask about exposure at home

When a patient reports persistent cough, breathing difficulties or another relevant concern, a few questions about the home can add context to their clinical history. What fuel does the household use for cooking or heating? Where does cooking take place? Does smoke enter the rooms where people spend time? Who usually cooks or stays near the source? The answers may reveal an exposure that would otherwise go unmentioned.

Discuss options that fit the household

If smoke exposure is a concern, healthcare professionals can discuss cleaner cooking fuels and ways to improve ventilation where these are feasible. Such conversations should take account of fuel costs, access and the design of the home. Ventilation may help reduce exposure, but it does not make smoke from polluting fuels harmless. The WHO guidelines for household fuel combustion provide a useful basis for discussing cleaner household energy. Advice should complement the patient’s clinical assessment and circumstances. 

Conclusion: Make indoor air part of the conversation

Outdoor pollution deserves attention, but the air inside a patient’s home can also be relevant to their health. Asking about cooking fuel, smoke, and time spent near the source can help healthcare professionals recognise a possible exposure and offer advice that fits the household’s circumstances. 

These questions can become a practical part of a wider conversation about respiratory and cardiovascular health. Healthcare professionals who want to learn more can view CMEPEDIA’s course, “The impact of air pollution in clinical practice”.