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Smoky cookflres contribute to global climate change and kill approximately four million people annually. While many studies have examined the effects of fuel-efficient cookstoves, this study does so while selling stoves at market prices. After introducing a fuel-efficient cookstove, fuelwood use and household air particulates declined by 12% and by smaller percentages after adjusting for observer-induced bias, or the Hawthorne effect. These reductions were less than laboratory predictions and fell well short of World Health Organization pollution targets. Even when introducing a second stove, most households continued to use their traditional stoves for most cooking. Future research should focus on improving the usability of fuel-efficient cookstoves and/or policies that assist consumers to shift to safer fuels like gas or electricity coupled with mechanisms to disable the existing smoky cookfire. Keywords: Technology adoption, Household air pollution, Biomass fuel, Climate change, Hawthorne Effect, Sensors, 1. INTRODUCTION Almost 3 billion people cook with wood, charcoal, and dung using traditional cookstoves (Bonjour et al. 2013). These stoves cause environmental degradation (Bailis et al. 2015), global climate [...]

BACKGROUND: Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers. OBJECTIVES: We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers. METHODS: During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with RESULTS: During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference p-values = 0.001, 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26). DISCUSSION: Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907, Introduction An estimated 3 billion people still cook and heat their homes using open fires or leaky stoves fueled by kerosene, biomass, or coal (WHO 2018). Combustion of these fuels [...]