Sixty-two caregivers in a mountainous region of western Nepal were interviewed about factors related to improving the indoor air quality. The study included 25 households with improved iron stoves and 37 households that cooked on a traditional open fire. In a subsample of 27 households, the field team observed kitchen characteristics and the stoves in everyday use, employing a standardized checklist. All the caregivers with improved stoves expressed satisfaction with their stoves, whereas only 16% of caregivers with traditional stoves were satisfied. There were no differences with respect to time spent in the kitchen or time spent on cooking. The main motivational factors for installing an improved stove were reduced smoke and better health. The villagers were willing to contribute 8% of total annual income per capita to have an improved stove installed. The survey identified weaknesses in stove design that might have influenced the smoke reduction potential of the improved stoves. This paper discusses how local conditions can determine the motivational factors and the success of future programs for improving indoor air quality in this setting.