Background Indoor air pollution from household cooking fuels remains a pressing public health issue in lowand 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.