| Summary: | The pervasiveness of “stacking” between traditional and clean fuels/stoves is moving the household clean cooking research and policy agenda from programs that are centered on one-fuel or stove, to multi-clean fuel/device interventions that could result in a more effective displacement of traditional biomass stoves. However, there is little recognition and knowledge of the benefits realistic clean-stacking cooking solutions can have on indoor air quality and health. In this paper, particulate matter (PM<sub>2.5</sub>) and carbon monoxide (CO) concentration levels that are associated with stove-stacking options (Patsari-U-shaped open fire (U-type), Patsari-liquefied petroleum gas (LPG) stove, U-type-LPG, and Patsari-U-type-LPG) common within rural Mexico were evaluated while using a controlled cooking cycle (CCC) from the Purepecha Highlands, which mimics the most common dishes prepared daily within the region as well as their sequential arrangement. The results confirms that the WHO Interim Target-1 (IT1) of 35 μg/m<sup>3</sup> for PM<sub>2.5</sub> is exceeded whenever woodburning open fires are part of the stacking combination (Patsari-U-type 107 ± 9 μg/m<sup>3</sup>, U-type-LPG 131 ± 55 μg/m<sup>3</sup> and Patsari-U-type-LPG 107 ± 22 μg/m<sup>3</sup>). However, well-designed and properly operated woodburning chimney stoves, such as the Patsari can meet the IT1, either used exclusively (21 ± 8 μg/m<sup>3</sup>) or as a “clean stacking” option with LPG (24 ± 5 μg/m<sup>3</sup>). Given stove stacking patterns, evaluating the health and environmental consequences of stove transitions while assuming the total replacement of traditional fires by clean cooking options will lead to misplaced expectations, and programs should evaluate more realistic “clean-stacking” options.
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