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To tackle the severe fine particle (PM_2.5) pollution in China, the government has implemented stringent control policies mainly on power plants, industry, and transportation since 2005, but estimates of the effectiveness of the policy and the temporal trends in health impacts are subject to large uncertainties. By adopting an integrated approach that combines chemical transport simulation, ambient/household exposure evaluation, and health-impact assessment, we find that the integrated population-weighted exposure to PM_2.5 (IPWE) decreased by 47% (95% confidence interval, 37–55%) from 2005 [180 (146–219) μg/m³] to 2015 [96 (83–111) μg/m³]. Unexpectedly, 90% (86–93%) of such reduction is attributed to reduced household solid-fuel use, primarily resulting from rapid urbanization and improved incomes rather than specific control policies. The IPWE due to household fuels for both cooking and heating …