Gas Stoves and Respiratory Health: Decades of Data, but Not Enough Progress

A recent publication (1), which attributed 12.7% of current childhood asthma in the United States to gas cooking stoves, and the media attention that followed (2, 3) have restarted and reinvigorated discussion on the association of gas stoves with adverse respiratory health effects, especially asthma symptoms. This renewed interested has sparked inspired debate from concerned citizens, proponents of fossil fuels, defenders of the fossil fuel industry, and even politicians (4). For context, associations of gas stoves with adverse health outcomes have been documented for decades, and this latest kerfuffle comes as no surprise to experts in indoor air and respiratory disease. In this Viewpoint, we provide an overview of the indoor air pollution associated with gas stoves and the literature on adverse health effects, the human and climate-relevant consequences of such use, and opportunities to mitigate exposures.

Gas Stove Basics

An estimated 38% of U.S. homes have gas-fueled cooking appliances (which include ranges, cook tops, and ovens; hereafter referred to as gas stoves) (5). Gas stoves are fueled by natural gas, of which methane is the principal component (6), and propane. The combustion of both generates multiple pollutants of public health concern, including nitrogen dioxide (NO₂) (7). Although other gas-powered appliances can contribute to indoor air pollution, gas stoves may be particularly harmful because of the proximity of individuals and their children to high-concentration emissions from combustion while cooking is taking place. During cooking, peaks of NO₂ are generated that may reach hundreds of parts per billion, exceeding 100 ppb—the outdoor short-term 1-hour National Ambient Air Quality Standard—after only a few minutes (7–9). Since 1990, gas stoves sold in the United States have been required to have electronic ignition systems, whereas previously many had continuously burning pilot lights—a steady source of emissions. Building codes dictate ventilation of gas-powered furnaces and dryers, but there are few overarching standards for gas stove installation and ventilation.

NO₂ and Human Health

The problem of NO₂ emissions into homes was identified by the early 1970s (10), leading to a wave of epidemiological studies that continued into the 1990s (11). Health outcomes addressed in these early studies focused on acute respiratory infections because of findings from animal models suggesting that NO₂ inhalation weakened respiratory defense mechanisms (12). Since then, scores of epidemiologic studies have shown associations between exposure to NO₂ and increased asthma symptoms, including chest tightness, shortness of breath, wheeze, and cough; an increase in rescue inhaler use; and an increased number of asthma attacks among children (9, 13, 14). Adverse health effects are not limited to people with asthma; NO₂ exposure has been linked to chronic obstructive pulmonary disease morbidity and to respiratory exacerbations, even among those without known lung disease (12, 15–17).

Methane and Climate Change

In addition to generating NO₂ during active combustion, gas stoves emit methane, a greenhouse gas, both when the appliance is on and when it is off (7, 18), highlighting the potential for gas stoves to continuously contribute to indoor air pollution and to greenhouse gases even when not in use. This leakage is largely driven by loose and leaky pipe fittings and connectors, and although these emissions may be mitigated with tightening of connections, methane leakage can occur even with newly installed gas stoves (7). One study estimates that the annual contribution of gas stoves from across the United States is equivalent in climate impact to the annual carbon dioxide emissions of 500,000 cars (7).

Opportunities for Intervention

Removing the predominant source completely and replacing a gas stove with an electric stove has been shown to reduce indoor NO₂ concentrations and is generally the most effective intervention in real-world settings. A randomized controlled trial of 100 homes in Baltimore City showed that replacement of gas stoves with electric stoves resulted in 1-week indoor NO₂ concentration reductions of 51% and 42% in the kitchen and the bedroom, respectively (19). A pilot study of 20 apartments within the New York City Housing Authority showed that replacement of gas stoves with induction stoves resulted in a 35% reduction in daily NO₂ concentration (20). In both studies, reductions in NO₂ concentrations were observed even though the majority of homes had other gas-powered appliances, including gas furnaces and clothes dryers, highlighting the role of gas stoves in driving a home’s NO₂ concentration.

Adequate ventilation using a ventilation hood while cooking may help to decrease household NO₂ concentrations. Studies done in controlled laboratory facilities demonstrate that the efficacy of ventilation hoods in decreasing indoor NO₂ concentration can vary widely, some reducing NO₂ concentration by a modest 10%, whereas use of an appropriately sized ventilation hood with adequate air flow can decrease the NO₂ concentration by up to 95% when cooking is limited to the back cooktop burners (8). These reductions are less impressive in real-world settings (19), likely because of difficulty in adhering to best practices with each cooking event (21).

Finally, portable air filter devices may be effective for reducing household air pollution related to gas stove use. High-efficiency particulate air filter devices that include activated carbon filters to adsorb gases have been shown to decrease indoor NO₂ concentration to a modest extent and are an attractive option for decreasing concentrations of multiple pollutants within the home, including particulate matter (19, 22).

Policy and Clinical Implications

Replacement of gas stoves on a large-scale basis requires careful planning and consideration of the context. For example, cost is a barrier for many people, improvements in rental housing require landlord interventions, and construction and other building limitations may interfere with retrofits. Recent federal legislation passed in 2022 authorizes a total of $8.8 billion in rebates as part of the Home Energy Rebates, which include home energy efficiency and electrification projects intended to save on energy costs and improve air quality (23). As part of this program, individual households meeting income requirements are eligible for rebates toward the cost of a new appliance and converting and upgrading electric power. This and similar programs to replace gas stoves should be widely publicized and supported, as access to intervention strategies should not be determined by the ability to afford them.

An increasingly common and rational policy approach is to prohibit the installation of new gas stoves. In recent years, several municipalities, including New York City, have passed laws that prohibit natural gas hookups in new building construction, an approach recommended by the National Center for Healthy Housing based on their STOVE (Studying the Optimal Ventilation for Environmental Indoor Air Quality) study (24). The study found that ventilation was not associated with a decrease in NO₂ concentration, leading to a recommendation for source control.

Unfortunately, these recent legislative efforts have been met with resistance, and gas stoves have become yet another symbol in the polarized views on public health interventions. In January 2023, a commissioner of the U.S. Consumer Products Safety Commission mentioned the possibility of stricter regulation of gas stoves, resulting in media backlash and scrambling by several states to pass laws that prohibit local governments from adopting measures that restrict utility providers (25). In May 2023, there was a hearing before the House Oversight and Accountability Committee to examine the “regulatory assault on Americans’ gas stoves” (26). In today’s contentious climate around public health, the rapidity with which the gas stove issue has become politicized and part of the “culture wars” is unfortunate, but unsurprising (27). This sort of quick and aggressive response to public health matters compromises the serious discussions that are needed to address the direct health effects of gas stove pollution and the greenhouse gas emissions of gas stove use for all Americans, regardless of political alliance.

The Consumer Products Safety Commission has requested input from the scientific community and the public on health hazards surrounding gas stove emissions and potential strategies to decrease exposures (28). We recommend that pulmonary clinicians and scientists consider gas stoves as a potential risk factor in their practice (Table 1) and continue to quantify the risks associated with gas stove exposure. A randomized controlled trial to investigate the relationship between gas stove replacement and health outcomes in children with asthma was recently funded by the California Energy Commission and will provide additional insight on the potential benefits of transitioning away from gas-fueled cooking appliances (29). Similar studies aiming to decrease exposure to gas stoves and associated pollutants, and to determine the relationship between such interventions and health outcomes, would be valuable for further characterizing the potential for improving health, particularly for those with respiratory disease, by reducing exposure to gas stove emissions. We do know with certainty, however, that gas stoves are a source of indoor air pollution and a contributor to greenhouse gas emissions, and there is a precautionary imperative to protect those who are susceptible and to look to mitigation of one source of greenhouse gas emissions to protect the planet.

Table 1.

Recommendations for clinicians to address health concerns related to gas stove emissions

Domain of Practice	Specific Action Items
Professional education	Learn the association of gas stoves with methane (greenhouse gas) and nitrogen dioxide (respiratory irritant).
	Gain knowledge on the respiratory health risks associated with gas stove exposure.
	Become familiar with interventions to decrease exposure to emissions from gas stoves.
Clinical setting	Include questions about gas stoves as part of the environmental exposure history.
	Counsel patients on harms of gas stove exposure, particularly if in a susceptible group.
	Recommend specific interventions based on available patient resources and circumstances.
Advocacy	Engage in local advocacy efforts to raise awareness on the harms of gas stove use and legislative efforts to decrease exposure to emissions.