Substantial quantities of air pollution and related health impacts are ultimately attributable to household consumption. However, how consumption pattern affects air pollution impacts remains unclear. Here we show, of the 1.08 (0.74-1.42) million premature deaths due to anthropogenic PM2.5 exposure in China in 2012, 20% are related to household direct emissions through fuel use and 24% are related to household indirect emissions embodied in consumption of goods and services. Income is strongly associated with air pollution-related deaths for urban residents in which health impacts are dominated by indirect emissions. Despite a larger and wealthier urban population, the number of deaths related to rural consumption is higher than that related to urban consumption, largely due to direct emissions from solid fuel combustion in rural China. Our results provide quantitative insight to consumption-based accounting of air pollution and related deaths and may inform more effective and equitable clean air policies in China.