Understanding household smoke exposure risks (SER) in Nigeria: A regional analysis from the 2018 NDHS

Abstract

Background: Indoor air pollution from household cooking fuels remains a pressing public health issue in low- and middle-income countries such as Nigeria. Reliance on solid fuels, including wood and charcoal, significantly contributes to respiratory diseases and premature mortality. Methods: This study utilized data from 39,725 households in the 2018 Nigeria Demographic and Health Survey (NDHS) to examine the prevalence and determinants of smoke exposure risk (SER). Multivariable ordinal regression was employed to investigate the associations between SER and household characteristics such as size, wealth, education, and regional disparities. Results: The findings indicate that 29% of households experienced high smoke exposure risk (SER), with significant disparities observed across regions. Households in the richest quintile were significantly less likely to face high SER, with an adjusted odds ratio (AOR) of 0.05 (95% CI: 0.04–0.06, p < 0.001), indicating a 95% reduction in odds, compared to the poorest quintile. Educational attainment further reduced SER, with households led by individuals with higher education exhibiting lower odds of high SER (AOR = 0.43, 95% CI: 0.38–0.49, p < 0.001), a 57% reduction in odds, compared to those headed by individuals with no formal education. Conclusion: This study underscores the importance of wealth and education in mitigating SER, and highlights the need for targeted interventions to address regional inequalities.