Rapid urbanization and population migration encountered in developing countries results in an increasing need for transportation. To investigate the impact of vehicular emissions on air pollution/quality and respiratory health we conducted a comparative 2:1 cross-sectional study in rural and urban communities, 150 adult respondents and 30 children comprised the study population. Structured interviewer administered questionnaires; Clinical respiratory examination and digital Spirometry were conducted. Informed consent was obtained; data were analyzed using Epi info statistical software version 7. Results showed Mean age: (36.3± 12.9 years), Linear height: (median 1.65, range: 1.40 – 1.86). Adult Male: female ratio 1:1. Average Distance of households to roads/highway: 36.03±23.79 meters and prevalent duration of daily transit 2- 5 hours. In urban settlements: distance to highway/road <50 meters (OR 32.4, 95% CI: 8.57- 122.3) and Non-use of protective devices (OR: 12.43, 95% CI: 2.60-59.34) showed significant associations. Twenty two (22) Spirometry results were within the obstructive index. Abnormalities detected on Spirometry in the absence of a history of respiratory conditions or abnormalities on clinical chest examination require further investigation. Recommendations were targeted to improve health education, provide sustainable mass transit, urban planning, support focused research and ensure effective emissions control.