Smokefree signage at children’s playgrounds: Field observations and comparison with Google Street View

BACKGROUND Although there is global growth in outdoor smokefree areas, little is known about the associated smokefree signage. We aimed to study smokefree signage at playgrounds and to compare field observations with images from Google Street View (GSV). METHODS We randomly selected playgrounds in 21 contiguous local government areas in the lower North Island of New Zealand, all of which had smokefree playground policies. Field data were collected on smokefree signage along with dog control signage to allow for comparisons. The sensitivity and specificity of using GSV for data collection were calculated. RESULTS Out of the 63 playgrounds studied, only 44% (95% CI: 33%-57%) had any smokefree signage within 10 m of the playground equipment. The mean number of such signs was 0.8 per playground (range: 0 to 6). Sign size varied greatly from 42 cm2 up to 2880 cm2; but was typically fairly small (median = 600 cm2; ie, as per a 20 × 30 cm rectangle). Qualitatively the dog signs appeared to use clearer images and were less wordy than the smokefree signs. Most playground equipment (82%), could be seen on GSV, but for these settings the sensitivity for identifying smokefree signs was poor at 16%. Yet specificity was reasonable at 96%. CONCLUSIONS The presence and quality of smokefree signage was poor in this sample of children's playgrounds in this developed country setting. There appears to be value in comparing smokefree signage with other types of signage (eg, dog control signage). Google Street View was not a sensitive tool for studying such signage.