Cooking With Liquefied Petroleum Gas or Biomass and Quality of Life: Results From a Randomized Controlled Trial

Household air pollution from biomass fuel combustion affects approximately 36% of the world′s population and is associated with negative health, environmental, economic, and social impacts. Although randomized controlled trials (RCTs) designed to reduce household air pollution have largely focused on health and environmental outcomes, evidence regarding their impact on quality of life (QOL) and household financial status remains limited. We conducted an RCT to evaluate the impact of a liquefied petroleum gas (LPG) intervention on health outcomes among 180 women aged 25–64 years who were the primary cooks in their households. We randomly assigned half of the participants to receive an LPG stove, continuous fuel supply for 12 months, and behavioral reinforcement. The other half continued usual cooking practices. We assessed QOL as a secondary outcome using the Short Form 36 Version 2 (SF-36-v2) and the EuroQol-5D-3L (EQ-5D). We also asked participants to report any perceived change in their household financial status 12 months after randomization. A total of 179 women (mean [±SD] age 48.3 ± 10.1 years) completed the surveys. In intention-to-treat analyses, participants in the intervention arm had similar SF-36 scores at 12 months compared with controls (mental component score: 48.3 vs. 50.9, p = 0.59; physical component score: 53.1 vs. 47.6, p = 0.08) and EQ-5D health state scores were also similar (67.0 vs. 71.7, p = 0.05). Exposure–response analyses did not reveal a significant association between personal PM_2.5 exposure and QOL scores. However, a significantly larger proportion of women in the intervention group reported feeling financially better off (42% vs. 13%; p < 0.001) and higher income (33% vs. 9%; p < 0.001) at 12 months compared with baseline. Although the intervention did not result in measurable differences in QOL scores, participants perceived meaningful improvements in their household financial status. Future research should explore the broader QOL, social, and economic benefits of transitioning to cleaner cooking fuels.