Household smoke-exposure risk from cooking fuels and cooking locations in Tanzania: a cross-sectional analysis of nationally representative survey data

Abstract

BackgroundIn Tanzania, smoke exposure from cooking fuels and cooking locations can increase the level of household air pollution and have adverse health effects. We aimed to assess the sociodemographic and economic factors associated with the indoor and outdoor smoke-exposure risks resulting from the use of clean and unclean cooking fuels in Tanzania. MethodsWe analysed data from 12 399 households, obtained from the 2015–16 Tanzania Demographic and Health Survey. An ordered logistic regression model was used to assess the sociodemographic and economic characteristics associated with four levels of household smoke-exposure risk (very low, low, medium, and high) from indoor (more risky) and outdoor (less risky) cooking practices and using unclean (smoke-producing) and clean (non-smoke-producing) cooking fuels. FindingsIn our study, 76·4% (95% CI 74·56–78·12) of households that practised indoor cooking using smoke-producing fuels were at high smoke-exposure risk. Female-headed households were 1·2 times (1·07–1·38) more likely to be in the very low smoke-exposure risk category than were male-headed households. Households with higher educational attainment (OR 2·5 [1·77–3·40]) were more likely to demonstrate a very low smoke-exposure risk relative to those without any educational attainment. The odds of being a household with very low smoke-exposure risk were 0·7 times (0·57–0·84) lower among households with 2–5 members, 0·6 times (0·46–0·71) lower among households with 6–10 members, and 0·5 times (0·38–0·76) lower among households with 11–49 members when compared with single-member households. Both the richer (OR 1·3 [1·00–1·79]) and richest (2·5 [1·77–3·40]) households were more likely to be in very low smoke-exposure risk category relative to the poorest households. InterpretationHousehold sociodemographic and economic characteristics can explain the different levels of household smoke-exposure risk associated with indoor and outdoor cooking using clean and unclean cooking fuels. The significant prevalence of high smoke-exposure risk in Tanzania supports the pursuit of the simultaneous adoption of improved cooking stoves and clean fuels to minimise the adverse effects attributed to household smoke exposure. FundingNone.