Secondhand smoke exposure in outdoor children's playgrounds in 11 European countries



Henderson E, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Gallus S, Lugo A, Semple S, O'Donnell R, Clancy L, Keogan S, Ruprecht A, Borgini A, Tzortzi A & Vyzikidou VK (2021) Secondhand smoke exposure in outdoor children's playgrounds in 11 European countries. Environment International, 149, Art. No.: 105775.

Introduction: Tobacco presence in outdoor children's playgrounds is concerning not only because it leads to secondhand smoke (SHS) exposure, but also cigarette butt pollution and tobacco normalization. Objectives: This study aimed to assess SHS exposure in children's playgrounds, according to area-level socioeconomic status (SES), smoke-free regulations, national smoking prevalence, and SHS exposure prevalence in playgrounds (2017–2018). Methods: We monitored vapor-phase nicotine concentration and tobacco-related variables in 20 different playgrounds in 11 European countries (n = 220 measurements) from March 2017 to April 2018. Playgrounds were selected according to area-level SES. Data on the number of people smoking, and cigarette butts inside the playground and on playground surroundings ( < 1 m away) were recorded. Playground smoking bans, the Tobacco Control Scale (TCS) score, national smoking prevalence and SHS exposure prevalence in playgrounds were used to group countries. To determine nicotine presence, we dichotomized concentrations using the limit of quantification as a cut-off point (0.06 μg/m3). Nicotine median concentrations were compared using non-parametric tests, and nicotine presence and tobacco-related observational variables using the Chi-squared test. Results: Airborne nicotine presence was found in 40.6% of the playgrounds. Median nicotine concentration was less than 0.06 μg/m3 (Interquartile range: less than 0.06–0.125) and higher median concentrations were found in more deprived neighborhoods, non-regulated playgrounds, in countries with lower overall TCS scores, higher national smoking prevalence and higher SHS exposure prevalence in playgrounds. Overall, people were smoking in 19.6% of the playgrounds. More than half of playgrounds had cigarette butts visible inside (56.6%) and in the immediate vicinity (74.4%). Presence of butts inside playgrounds was higher in sites from a low area-level SES, in countries with low TCS scores, and greater smoking prevalence and SHS exposure prevalence (p < 0.05). Conclusions: There is evidence of SHS exposure in children's playgrounds across Europe. These findings confirm the need for smoking bans in playgrounds and better enforcement in those countries with smoking bans in playgrounds.

Tobacco smoke pollution; Child; Playground; Socioeconomic status; Smoke-free regulations

Additional co-authors: Giuseppe Gorini, Angel López-Nicolás, Joan B Soriano, Gergana Geshanova, Joseph Osman, Ute Mons, Krzysztof Przewozniak, José Precioso, Ramona Brad, Maria J López, the TackSHS project investigators

Environment International: Volume 149

FundersEuropean Commission (Horizon 2020)
Publication date30/04/2021
Publication date online20/11/2020
Date accepted by journal28/04/2020

People (2)


Dr Rachel O'Donnell

Dr Rachel O'Donnell

Senior Research Fellow, Institute for Social Marketing

Professor Sean Semple

Professor Sean Semple

Professor, Institute for Social Marketing