Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Household transitions to clean energy in a multiprovincial cohort study in China


Household solid-fuel (biomass, coal) burning contributes to climate change and is a leading health risk factor. How and why households stop using solid-fuel stoves after adopting clean fuels has not been studied. We assessed trends in the uptake, use and suspension of household stoves and fuels in a multiprovincial cohort study of 753 Chinese adults and evaluated determinants of clean-fuel uptake and solid-fuel suspension. Over one-third (35%) and one-fifth (17%) of participants suspended use of solid fuel for cooking and heating, respectively, during the past 20 years. Determinants of solid-fuel suspension (younger age, widowed) and of earlier suspension (younger age, higher education and poor self-reported health status) differed from the determinants of clean-fuel uptake (younger age, higher income, smaller households and retired) and of earlier adoption (higher income). Clean-fuel adoption and solid-fuel suspension warrant joint consideration as indicators of household energy transition. Household energy research and planning efforts that more closely examine solid-fuel suspension may accelerate household energy transitions that benefit climate and human health.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Cooking and heating fuel transitions from baseline to present.
Fig. 2: Temporal trends in solid-fuel suspension and clean-fuel uptake.
Fig. 3: Distributions in household cooking and heating devices by province.

Data availability

The data that support the findings of this study are available from the corresponding author upon request. Requests for datasets generated and analysed during the current study will be reviewed and made available on a case-by-case basis by the corresponding author with input from co-authors, subject to compliance with Research Ethics Board restrictions for the survey data. Figs. 1–4 and Supplementary Figs. 1–4 contain primary data.

Code availability

Requests for code developed and annotated in Stata 13 and R to process and analyse the primary data collected in this study will be reviewed and made available upon reasonable request.


  1. 1.

    Zheng, Y. et al. Air quality improvements and health benefits from China’s clean air action since 2013. Environ. Res. Lett. 12, 114020 (2017).

    Google Scholar 

  2. 2.

    Tao, S. et al. Quantifying the rural residential energy transition in China from 1992 to 2012 through a representative national survey. Nat. Energy 3, 567–573 (2018).

    Google Scholar 

  3. 3.

    E-Handbook on Sustainable Development Goals Indicators (UNSD, 2018).

  4. 4.

    Rosenthal, J., Quinn, A., Grieshop, A. P., Pillarisetti, A. & Glass, R. I. Clean cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals. Energy Sustain. Dev. 42, 152–159 (2018).

    Google Scholar 

  5. 5.

    Bonjour, S. et al. Solid fuel use for household cooking: country and regional estimates for 1980–2010. Environ. Health Perspect. 121, 784–790 (2013).

    Google Scholar 

  6. 6.

    Carter, E. et al. Assessing exposure to household air pollution: a systematic review and pooled analysis of carbon monoxide as a surrogate measure of particulate matter. Environ. Health Perspect. 125, 076002 (2017).

    Google Scholar 

  7. 7.

    GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the global burden of disease study 2015. Lancet 388, 1459–1544 (2016).

    Google Scholar 

  8. 8.

    Huang, Y. et al. Global radiative effects of solid fuel cookstove aerosol emissions. Atmos. Chem. Phys. 18, 5219–5233 (2018).

    CAS  Google Scholar 

  9. 9.

    Chafe, Z. A. et al. Household cooking with solid fuels contributes to ambient PM2.5 air pollution and the burden of disease. Environ. Health Perspect. 122, 1314–1320 (2014).

    CAS  Google Scholar 

  10. 10.

    Cohen, A. J. et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet 389, 1907–1918 (2017).

    Google Scholar 

  11. 11.

    Johnson, M. A. & Chiang, R. A. Quantitative guidance for stove usage and performance to achieve health and environmental targets. Environ. Health Perspect. 123, 820–826 (2015).

    CAS  Google Scholar 

  12. 12.

    Shen, G. et al. Evaluating the performance of household liquefied petroleum gas cookstoves. Environ. Sci. Technol. 52, 904–915 (2018).

    CAS  Google Scholar 

  13. 13.

    Quinn, A. K. et al. An analysis of efforts to scale up clean household energy for cooking around the world. Energy Sustain. Dev. 46, 1–10 (2018).

    Google Scholar 

  14. 14.

    State of Electricity Access Report 2017 (World Bank, 2017).

  15. 15.

    Kowsari, R. & Zerriffi, H. Three-dimensional energy profile: a conceptual framework for assessing household energy use. Energy Policy 39, 7505–7517 (2011).

    Google Scholar 

  16. 16.

    Masera, O. R., Saatkamp, B. D. & Kammen, D. M. From linear fuel switching to multiple cooking strategies: a critique and alternative to the energy ladder model. World Dev. 28, 2083–2103 (2000).

    Google Scholar 

  17. 17.

    van der Kroon, B., Brouwer, R. & van Beukering, P. J. H. The energy ladder: theoretical myth or empirical truth? Results from a meta-analysis. Renew. Sustain. Energy Rev. 20, 504–513 (2013).

    Google Scholar 

  18. 18.

    Campbell, B. M., Vermeulen, S. J., Mangono, J. J. & Mabugu, R. The energy transition in action: urban domestic fuel choices in a changing Zimbabwe. Energy Policy 31, 553–562 (2003).

    Google Scholar 

  19. 19.

    Trac, C. J. Climbing without the energy ladder: limitations of rural energy development for forest conservation. Rural Soc. 20, 308–320 (2011).

    Google Scholar 

  20. 20.

    Alkon, M., Harish, S. P. & Urpelainen, J. Household energy access and expenditure in developing countries: evidence from India, 1987–2010. Energy Sustain. Dev. 35, 25–34 (2016).

    Google Scholar 

  21. 21.

    Snider, G. et al. Impacts of stove use patterns and outdoor air quality on household air pollution and cardiovascular mortality in southwestern China. Environ. Int. 117, 116–124 (2018).

    CAS  Google Scholar 

  22. 22.

    Kar, A. et al. Real-time assessment of black carbon pollution in Indian households due to traditional and improved biomass cookstoves. Environ. Sci. Technol. 46, 2993–3000 (2012).

    CAS  Google Scholar 

  23. 23.

    Hanna, R., Duflo, E. & Greenstone, M. Up in smoke: the influence of household behavior on the long-run impact of improved cooking stoves. Am. Econ. J. Econ. Policy 8, 80–114 (2016).

    Google Scholar 

  24. 24.

    Beltramo, T. & Levine, D. I. The effect of solar ovens on fuel use, emissions and health: results from a randomised controlled trial. J. Dev. Eff. 5, 178–207 (2013).

    Google Scholar 

  25. 25.

    Agarwal, B. Diffusion of rural innovations: some analytical issues and the case of wood-burning stoves. World Dev. 11, 359–376 (1983).

    Google Scholar 

  26. 26.

    Manibog, F. R. Improved cooking stoves in developing countries: problems and opportunities. Annu. Rev. Energy 9, 199–227 (1984).

    Google Scholar 

  27. 27.

    Ruiz-Mercado, I. & Masera, O. Patterns of stove use in the context of fuel–device stacking: rationale and implications. Ecohealth 12, 42–56 (2015).

    Google Scholar 

  28. 28.

    Malla, S. & Timilsina, G. R. Household Cooking Fuel Choice and Adoption of Improved Cookstoves in Developing Countries: A Review Working Paper No. 6903 (World Bank, 2014).

  29. 29.

    Rehfuess, E. A., Puzzolo, E., Stanistreet, D., Pope, D. & Bruce, N. G. Enablers and barriers to large-scale uptake of improved solid fuel stoves: a systematic review. Environ. Health Perspect. 122, 120–130 (2014).

    Google Scholar 

  30. 30.

    Puzzolo, E., Pope, D., Stanistreet, D., Rehfuess, E. A. & Bruce, N. G. Clean fuels for resource-poor settings: a systematic review of barriers and enablers to adoption and sustained use. Environ. Res. 146, 218–234 (2016).

    CAS  Google Scholar 

  31. 31.

    Lewis, J. J. & Pattanayak, S. K. Who adopts improved fuels and cookstoves? A systematic review. Environ. Health Perspect. 120, 637–645 (2012).

    Google Scholar 

  32. 32.

    Xie, Y. & Hu, J. An introduction to the China Family Panel Studies (CFPS). Chin. Sociol. Rev. 47, 3–29 (2014).

    Google Scholar 

  33. 33.

    Qiu, H. G., Yan, J. B. & Jiang, Y. Renewable energy consumption in rural China: current situation and major driven factors. J. Beijing Inst. Technol. 17, 10–15 (2015).

    Google Scholar 

  34. 34.

    Luo, Z. in Encyclopedia of Energy Vol. 5 (ed. Cleveland, C.) 493–506 (Elsevier, 2004).

  35. 35.

    Zhang, L., Yang, Z., Chen, B. & Chen, G. Rural energy in China: pattern and policy. Renew. Energy 34, 2813–2823 (2009).

    CAS  Google Scholar 

  36. 36.

    Sinton, J. E. et al. An assessment of programs to promote improved household stoves in China. Energy Sustain. Dev. 8, 33–52 (2004).

    Google Scholar 

  37. 37.

    Chan, K. H. et al. Trans-generational changes and rural–urban inequality in household fuel use and cookstove ventilation in China: a multi-region study of 0.5 million adults. Int. J. Hyg. Environ. Health 220, 1370–1381 (2017).

    Google Scholar 

  38. 38.

    Duan, X. et al. Household fuel use for cooking and heating in China: results from the first Chinese Environmental Exposure-Related Human Activity Patterns Survey (CEERHAPS). Appl. Energy 136, 692–703 (2014).

    Google Scholar 

  39. 39.

    Clark, S. et al. Adoption and use of a semi-gasifier cooking and water heating stove and fuel intervention in the Tibetan Plateau, China. Environ. Res. Lett. 12, 075004 (2017).

    Google Scholar 

  40. 40.

    Ru, M. et al. Direct energy consumption associated emissions by rural-to-urban migrants in Beijing. Environ. Sci. Technol. 49, 13708–13715 (2015).

    CAS  Google Scholar 

  41. 41.

    Chen, Y. et al. Transition of household cookfuels in China from 2010 to 2012. Appl. Energy 184, 800–809 (2016).

    CAS  Google Scholar 

  42. 42.

    Shen, G. et al. Factors influencing the adoption and sustainable use of clean fuels and cookstoves in China: a Chinese literature review. Renew. Sustain. Energy Rev. 51, 741–750 (2015).

    Google Scholar 

  43. 43.

    Thomas, E., Wickramasinghe, K., Mendis, S., Roberts, N. & Foster, C. Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review. BMC Public Health 15, 650 (2015).

    Google Scholar 

  44. 44.

    Leach, G. & Mearns, R. Beyond the Woodfuel Crisis: People, Land and Trees in Africa (Routledge, 2013).

  45. 45.

    Heltberg, R. Fuel switching: evidence from eight developing countries. Energy Econ. 26, 869–887 (2004).

    Google Scholar 

  46. 46.

    Joon, V., Chandra, A. & Bhattacharya, M. Household energy consumption pattern and socio-cultural dimensions associated with it: a case study of rural Haryana, India. Biomass-. Bioenergy 33, 1509–1512 (2009).

    Google Scholar 

  47. 47.

    Andadari, R. K., Mulder, P. & Rietveld, P. Energy poverty reduction by fuel switching. Impact evaluation of the LPG conversion program in Indonesia. Energy Policy 66, 436–449 (2014).

    Google Scholar 

  48. 48.

    Johnson, N. G. & Bryden, K. M. Energy supply and use in a rural West African village. Energy 43, 283–292 (2012).

    Google Scholar 

  49. 49.

    Johnson, N. G. & Bryden, K. M. Factors affecting fuelwood consumption in household cookstoves in an isolated rural West African village. Energy 46, 310–321 (2012).

    Google Scholar 

  50. 50.

    Mukhopadhyay, R. et al. Cooking practices, air quality, and the acceptability of advanced cookstoves in Haryana, India: an exploratory study to inform large-scale interventions. Glob. Health Action 5, 19016 (2012).

    Google Scholar 

  51. 51.

    Thurber, M. C., Phadke, H., Nagavarapu, S., Shrimali, G. & Zerriffi, H. ‘Oorja’ in India: assessing a large-scale commercial distribution of advanced biomass stoves to households. Energy Sustain. Dev. 19, 138–150 (2014).

    Google Scholar 

  52. 52.

    Kammen, D., Goldemberg, J. & Johansson, T. in Energy as an Instrument for Socio-Economic Development (eds Goldemberg, J. & Johansson, T. B.) Ch. 5 (UN Development Programme, 1995).

  53. 53.

    Geels, F. W. Disruption and low-carbon system transformation: progress and new challenges in socio-technical transitions research and the multi-level perspective. Energy Res. Soc. Sci. 37, 224–231 (2018).

    Google Scholar 

  54. 54.

    Geels, F. W., Sovacool, B. K., Schwanen, T. & Sorrell, S. Sociotechnical transitions for deep decarbonization. Science 357, 1242–1244 (2017).

    CAS  Google Scholar 

  55. 55.

    Verbong, G. & Geels, F. The ongoing energy transition: lessons from a socio-technical, multi-level analysis of the Dutch electricity system (1960–2004). Energy Policy 35, 1025–1037 (2007).

    Google Scholar 

  56. 56.

    Singh, D., Pachauri, S. & Zerriffi, H. Environmental payoffs of LPG cooking in India. Environ. Res. Lett. 12, 115003 (2017).

    Google Scholar 

  57. 57.

    Davis, S. J. & Socolow, R. H. Commitment accounting of CO2 emissions. Environ. Res. Lett. 9, 084018 (2014).

    Google Scholar 

  58. 58.

    Turnheim, B. & Geels, F. W. Regime destabilisation as the flipside of energy transitions: lessons from the history of the British coal industry (1913–1997). Energy Policy 50, 35–49 (2012).

    Google Scholar 

  59. 59.

    Aung, T. W. et al. Health and climate-relevant pollutant concentrations from a carbon-finance approved cookstove intervention in rural India. Environ. Sci. Technol. 50, 7228–7238 (2016).

    CAS  Google Scholar 

  60. 60.

    Barrington-Leigh, C. et al. An evaluation of air quality, home heating and well-being under Beijing’s programme to eliminate household coal use. Nat. Energy 4, 416–423 (2019).

    Google Scholar 

  61. 61.

    Barrett, J. R. How good is good enough? Cookstove replacement scenarios to reach indoor air goals. Environ. Health Perspect. 123, A216 (2015).

    Google Scholar 

  62. 62.

    Stamler, J. et al. INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary). J. Hum. Hypertens. 17, 591–608 (2003).

    CAS  Google Scholar 

  63. 63.

    Yan, L. et al. Study protocol: the INTERMAP China Prospective (ICP) Study. Wellcome Open Res. 4, 154 (2019).

    Google Scholar 

  64. 64.

    Cragg, J. G. Some statistical models for limited dependent variables with application to the demand for durable goods. Econometrica 39, 829–844 (1971).

    Google Scholar 

  65. 65.

    Wooldridge, J. M. Econometric Analysis of Cross Section and Panel Data (MIT Press, 2010).

Download references


We thank the study participants and field staff involved in the ICP study. This publication was supported by the Wellcome Trust, UK (grant 103906/Z/14/Z); National Natural Science Foundation of China, China (grant 81473044 and Innovative Research Groups grant 51521005); the Canadian Institutes for Health Research (grant 137535). E.C. received support through NIH/Fogarty’s Clean Cooking Implementation Science Network with support from the NIH Common Fund.

Author information




J.B., Q.C., M.E., P.E., F.K., X.Y., Y.W. and L.Z. designed, or contributed to the design of, the study. J.B., Q.C., E.C., L.Y. and Y.F. led the fieldwork. E.C. carried out the analysis. E.C., J.B., B.R., L.Y. and Q.C. wrote the paper, and all other authors contributed to discussion of the results and commented on the manuscript.

Corresponding authors

Correspondence to Ellison Carter or Jill Baumgartner.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary Information

Supplementary Figs. 1–5 and Tables 1–5.

Reporting Summary

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carter, E., Yan, L., Fu, Y. et al. Household transitions to clean energy in a multiprovincial cohort study in China. Nat Sustain 3, 42–50 (2020).

Download citation

Further reading


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing