I used a modern version of the ancient flint and steel to light my stove every day in Antarctica. It would take a little bit of effort to get it going, depending on how well I hit the fumes with the sparks. But there was nothing to ever go wrong. Altitude affects lighters. Flint and steel doesn’t even notice. A spark is a spark. When wet, it still works, unlike matches. Even if I broke the little handle holding the flint and the steel blade was dulled, I could still make sparks with my knife.
And, of course, I brought a spare with me. The four lighters I brought were nothing but dead weight.
Hail stone age tools!