Efforts to reduce the health and ecological burdens of household biomass combustion are underway in Ghana, principally by promoting clean cookstoves and fuels. Recent studies have focused on the sustained use of clean cookstoves, but sometimes household adopt a new cookstove and then end use of that stove. In this study, we introduce a novel framework for understanding and encouraging household transitions to cleaner cooking: clean fuel discontinuance. We leveraged data from the Ghana Randomized Air Pollution and Health Study (GRAPHS) (N=1412) where pregnant women received either improved biomass (BioLite) or dual burner LPG stoves for free. LPG users were given free LPG refills during GRAPHS. Weekly questionnaires were administered. Stove use monitors tracked a sub-cohort (n=220) 6 months before and after the fuel subsidy. We examined social and ecological determinants of stove use and discontinuance. Overall intervention stove use adherence was high throughout GRAPHS, with self-reported use at 69% and 86% of participant-weeks for BioLite and LPG arms respectively. Participants used intervention stoves less for meals requiring vigorous stirring. Burns from intervention stoves decreased use among BioLite (RR: 0.96, p=0.009), but not LPG users. Device breakage was mentioned as an impediment in 18% of free-text responses for LPG users and 1% for BioLite. Tree canopy within a spatial buffer—a plausible proxy for biomass fuels access—was the only variable explaining LPG discontinued stove use in adjusted Cox time-to-event analyses (HR=−0.56, p<0.001). Future studies should consider the stove use discontinuance framework.

加纳正在努力减少家庭生物质燃烧的健康和生态负担，主要是通过推广清洁炉灶和燃料。最近的研究重点是持续使用清洁炉灶，但有时家庭会采用新炉灶，然后停止使用该炉灶。在这项研究中，我们引入了一个新的框架来理解和鼓励家庭向清洁烹饪过渡：停止使用清洁燃料。我们利用加纳随机空气污染与健康研究 (GRAPHS) (N=1412) 的数据，其中孕妇免费获得改进的生物质 (BioL​​ite) 或双燃烧器液化石油气炉。液化石油气用户在 GRAPHS 期间可免费补充液化石油气。每周进行问卷调查。炉灶使用监测员对燃料补贴前后 6 个月的一个小组 (n=220) 进行了追踪。我们研究了炉灶使用和停用的社会和生态决定因素。在整个 GRAPHS 中，干预炉具使用的总体依从性很高，BioLite 组和 LPG 组的参与者自我报告的使用周数分别为 69% 和 86%。参与者较少使用干预炉来处理需要剧烈搅拌的膳食。干预炉灶造成的烧伤减少了 BioLite 的使用（RR：0.96，p=0.009），但液化石油气用户没有减少。 18% 的 LPG 用户和 1% 的 BioLite 用户在自由文本回复中提到设备损坏是一个障碍。空间缓冲区内的树冠（生物质燃料获取的合理代表）是调整后的 Cox 事件时间分析中解释 LPG 炉灶停止使用的唯一变量（HR=−0.56，p<0.001）。未来的研究应考虑炉灶使用停止框架。