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Household air pollution is a pervasive environmental health problem wherever access to cleaner fuels is poor. Despite numerous attempts to transition households away from polluting fuels, interventions are rarely sustainable. This intractability indicates that structural (i.e., systemic) dynamics act to maintain the status quo. In this case study of Ghana's Rural Liquefied Petroleum Gas (LPG) Promotion Program, our objectives were to 1) identify system structures affecting sustained fuel use, and 2) test strategies for improving intervention outcomes. To address these objectives, we applied a system dynamics approach, informed by a systematic literature review. A virtual simulation model was constructed to represent the implementation of the Rural LPG Program and its outcomes. By analyzing the model's structure and behavior, we proposed strategies that would improve the intervention's outcomes and tested the effectiveness of the strategies within the simulation model. Our results show that distributing two LPG cylinders to households (instead of one) contributed toward primary use of the fuel, whereas free weekly delivery of LPG (for up to four years) had limited long-term benefits and diminishing returns. Furthermore, reducing the time for users to perceive the benefits of cleaner fuels enhanced willingness-to-pay, and thereby helped to sustain higher rates of LPG use. This suggests that intervention planners should identify new users' expectations of benefits and proactively design ways to realize those benefits quickly (in a few weeks or less), while policy makers should support this as a design requirement in approval processes.