My weird arc with gas stoves.

Some politicians are saying that keeping gas stoves is a right. Perhaps. My plan to eventually get rid of mine is a privilege.

Before the pandemic, I basically thought that low-grade environmental exposures to harmful substances like carbon dioxide were a variation on the “tragedy of the commons” framework. That is, routine exposures are so small and inconsequential that the effects can not be measured on a person-to-person level. Only at the population level does it matter (and really only at the worst extremes). My thinking on this has evolved somewhat.

For the last few months, I’ve wanted to get rid of my gas stove. The fact that this became a political fracas in the last few days was definitely not on my bingo card. I actually thought that even considering replacing our gas stove with an induction heat stove was as an immense form of privilege. I actually felt a little sheepish about the whole thing. This was something I could do to make my family’s life a little healthier, I thought. But I would also be widening the gulf between fortunate people like me and those who are less well off. So, this was something that I planned to do at some point, but it would not be something I would brag about; doing so would feel like a form of conspicuous consumption.

To anyone who wants to keep their gas stove, whatever small Libertarian streak I may have says to go right ahead. My public health brain, however, says that if you can afford to replace your gas stove with an induction heat range, you absolutely should.

Let me back up and tell you where I started and where I am now.

Here’s me in, say, 2019: “Days with increased pollution probably do not affect me and my family in any measurable way. On a population-level, smoggy days are bad and may even be responsible for a few more medical emergencies like heart attacks and strokes than usual. It takes millions of people being exposed for epidemiologists to notice anything statistically meaningful in the short-term, but it’s possible to detect a signal from big data. An ER doctor like me can’t correctly notice such increases on the ground, because the numbers are so small in absolute terms.”

Number crunch time. Example: California. 18,000 stroke deaths per year divided by 365 days = 49 stroke deaths per day. Even if all 49 stroke deaths were treated by the 100 largest hospitals in California, that would amount to 0.5 stroke deaths per day per hospital. If a week of very bad pollution (say from large fires in the area) increased the stroke death rate by 100% (a very high estimate), stroke deaths would rise to 1 death per day, on average. But random variation means that some days a hospital sees 0, 1, or 2 stroke deaths, routinely. Noticing a few consecutive days with 1 or 2 (instead of 0) would not be a meaningful observation. It would be impossible for doctors like me to untangle such anecdotal experience from random chance.

Of course, big data gives us answers that ground-level vision can’t provide. Thus my belief that exposure to high rates of carbon dioxide on bad pollution days was a systemic problem, not one I needed to worry about in my own life or home. Like I said, all of this was a variation on the “tragedy of the commons” mental model.

The indoor air quality gurus changed my mind on this, somewhat. I bought a portable carbon dioxide monitor when my 4-year-old got Covid last summer to see if our house had decent air turnover. Mostly, it did. Opening windows, even for a little while, had an impressive effect. The real surprise, though, was the kitchen. Right around dinner time, the carbon dioxide levels would skyrocket, sometimes to nearly dangerous levels. I couldn’t believe my eyes.

Do higher levels of CO2 in my kitchen really mean anything? Could these levels actually harm my kids, in some subtle but legitimately measurable way? Yes, said my colleague Dr. Joe Allen, an indoor air quality expert we’ve met on Inside Medicine. Test scores in kids in high-CO2 environments are worse, he told me. “CO2 reduces your concentration,” he told me. “It makes you tired. Why do you think you fall asleep during long car rides?”

In fairness, I am not yet convinced that’s why we sleep in the car. But the test score data are interesting and alarming. The levels of CO2 in my kitchen while our gas stove was on were indeed at a range where scientists have expressed some concern regarding cognitive performance. Such levels might even slow me down. On top of that, there’s nitrogen dioxide—which can make asthma worse.

I was sold. I decided that at some point, we’d replace our gas stove with an induction-based one. Little did I think that gas stoves would become a hot-button political wedge point. But alas, after some off-the-cuff remarks by the commissioner of the Consumer Product Safety Commission, a bunch of politicians started foaming at the mouth about liberty gas stoves for all.

Suffice it to say, banning all gas stoves right now would be a logistical nightmare. Angry politicians are pounding their fists anyway, essentially saying that keeping gas stoves is a right, not a privilege. Funny. The way I see it, my privilege means I may soon be able to toss mine.