A neglected source of household air pollution? A preliminary, mixed methods study of purposely produced household smoke in Wollo, Ethiopia

Abstract

Background
Ill health associated with Household Air Pollution (HAP) is increasingly recognised as a public health problem in sub-Saharan Africa. To date, attempts to reduce HAP have focussed on smoke from cooking fires and have ignored traditional cultural practices which generate Purposely Produced Smoke (PPS). This study aimed to investigate prevalence of PPS use, reasons for use and perceptions of PPS safety.

Methods
The study was conducted in Wollo, Ethiopia, and used a mixed methods approach of quantitative surveys (analysed descriptively) and qualitative interviews with householders and healthcare workers (analysed thematically).

Results
PPS use was reported by 99% of survey respondents and it was considered a fundamental part of life; reasons for use included housekeeping, culture/religion and wellbeing. Both householders and healthcare workers appeared to assume PPS is safe except for people with certain underlying conditions. Healthcare workers felt the lack of evidence of harm from PPS meant there was no justification for intervention.

Conclusion
This study, the first in-depth study of PPS, has shown its use to be widespread, with many perceived benefits and thus a very important part of local culture in this sample Ethiopian community. Consequently, any public health interventions aimed at reducing HAP in this setting need to consider PPS.

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Identifiers

ORCID for Merlin Willcox: orcid.org/0000-0002-5227-3444

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