The history of public health has been to identify those things that can be done before everybody gets rich and to provide levers that can achieve a big improvement in health, without waiting. Clean water, vaccinations, vitamin supplements, and clean fuels are those kinds of levers. Air sampling in India has found higher pollution inside homes than outdoors due to the fuels used for cooking and heating. No one yet knows how smoke from cooking increases the risk of TB, although wood smoke has been shown to make laboratory animals less able to resist respiratory diseases. A hint at the mechanism in humans may be found in research done on cigarette smoke, according to Mishra et al .
Cigarettes are also a form of biomass.
Smoking cigarettes has been shown to increase the risk of TB, and tobacco smoke is known to depress the response of the immune system, leaving the body vulnerable to infection. To the extent that exposure to cooking smoke also suppresses the immune system, it may lead to infection or to increased risk of active TB in people infected with the tuberculosis bacterium.