LAUSR

China has tried to replace solid fuels with cleaner energy in households. The benefits of fuel switching need to be identified. This article shows that households using solid cooking fuels suffer heavier medical expenses than those using non-solid cooking fuels. After accounting for family characteristics, using solid fuels is associated with 1.4–1.9% increases in medical care. Through the analysis of the impact mechanism, we found that solid cooking fuels harm the health conditions of family members and increase the probability of illness, thereby increasing medical expenses, while the ratio of fuel fees does not change significantly if switching cooking fuels. Furthermore, we explored heterogeneity to better understand the underlying relationship. For urban and higher-educated families with house ownership, the impact of solid fuels on medical expenses was weaker compared to rural and lower-educated households without owned houses. Therefore, considering the costs and benefits, we recommend continuing the conversion from solid fuels to non-solid fuels. In the fuel transition process, it is beneficial to raise residents’ awareness and improve behavior to avoid indoor air pollution.