Background: Inhalation of biomass fuel smoke is a leading risk factor for diseases especially in high-altitude settings. In recent years, many interventions worldwide have introduced improved cookstoves to decrease harmful smoke inhalation to prevent health conditions such as respiratory infections. However, little is known about the social and cultural barriers to successful and sustained improved cookstove adoption. Design and objectives: To address this knowledge gap, I plan to conduct a 3-month qualitative study of men and women between the ages of 20 and 49 in rural communities of Puno, Peru as part of a large-scale implementation plan to introduce improved cookstoves to 500 households. Enablers and barriers to adoption and consistent use of cookstoves as well as unintended social change effects and participant experiences will be studied. In order to address sustainability in the household, my study will interview both male heads of households and female primary cooks, as perspectives of both sexes may be important for sustainable adoption. Additionally, by presenting the research project as involving men and women comparably, there may be increased community cohesion and mobilization behind the use of improved cookstoves. Methods: This study will employ the following qualitative methods: informal participant observation for developing interview guides, in-depth interviews for collecting data on perceptions, and direct observations for collecting data on cooking practices. Each interviewee and household will be interviewed or observed twice, once before the introduction of the improved cookstove and once after. Local interviewers and observers will be trained to conduct interviews and observations due to the necessity of using Aymara language.