A silent and devastating health crisis is unfolding in Uganda, where an increasing number of women who have never smoked a cigarette are being diagnosed with lung cancer. Doctors at the Uganda Cancer Institute (UCI) have identified a pervasive and overlooked culprit: chronic exposure to smoke from traditional cooking fires.
Dr. Najib Bogere, a medical oncologist at UCI, reported that his team recently discovered a disturbing pattern. Women diagnosed with lung cancer exhibited lung damage strikingly similar to that of long-term smokers. Upon investigation, a common thread emerged: most had been exposed to firewood smoke since early childhood, some as young as eight years old.
In millions of Ugandan households, particularly in rural areas, cooking over open fires with wood or crop residue is a daily necessity. In kitchens lacking proper ventilation, this practice releases microscopic particles of soot and ash that hang in the air for hours. These fine particles penetrate deep into the lungs, triggering inflammation that can lead to chronic respiratory disease and, eventually, cancer.
“Even when firewood smoke is not visibly thick, the fine particles can cause long-term damage,” Dr. Bogere warned, adding that by the time symptoms like a persistent cough appear, the disease is often advanced.
The findings from UCI are corroborated by a recent large-scale study from the Makerere University Lung Institute. Between 2021 and 2025, researchers screened women across several districts and found that more than 60 percent tested positive for lung cancer, yet very few had ever smoked.
Dr. Irene Najjingo, who led the study, confirmed that of the 311 confirmed cases, the majority cooked daily with shrubs and firewood. The study also revealed a critical distinction: women who cooked outdoors had a noticeably lower risk than those confined to indoor kitchens without chimneys or windows.
This household health crisis is part of a larger, global problem. The World Health Organisation estimates that household smoke contributes significantly to the seven million premature deaths caused by air pollution each year. In East Africa alone, air pollution is the second-largest health risk after malnutrition, causing an estimated 300,000 deaths annually, with women and children bearing the heaviest burden due to the time they spend near cooking fires.
Experts are calling for a multi-pronged response to combat the threat. Dr. Najjingo recommends a transition to cleaner fuels like gas or electricity where possible, and for those who can’t, building well-ventilated kitchens or cooking outdoors.
Beyond household changes, medical professionals are being urged to rethink their approach. Dr. Patricia Alupo, a respiratory physician, is calling on clinicians to incorporate air-quality assessments into patient histories to identify risks early.
“Just like we prescribe medication, we must also prescribe clean air,” Dr. Alupo stated, emphasizing the need to educate families and advocate for safer cooking practices. Government subsidies for cleaner stoves and community education campaigns could further accelerate this life-saving shift.
