Table 4 Clinician survey questions and responses (n=28)
1. How much do you agree or disagree with the following statements? | Agree % | Disagree % | Unsure % |
|---|---|---|---|
•I feel confident in my knowledge about the harms of smoking to the fetus to discuss them effectively | 93 | 3 | 3 |
•I feel confident in my knowledge of the harms of secondhand smoke exposure on infants and children to discuss them effectively | 93 | 3 | 3 |
•A harm-reduction approach should be used when addressing smoking (i.e. reduce tobacco consumption, switch to non-tobacco containing products e.g. NRT, electronic cigarettes) | 93 | 0 | 7 |
•Brief smoking cessation advice (e.g. 5A's, motivational interviewing, education) is effective in addressing tobacco use | 73 | 20 | 7 |
•An AOD-based antenatal service is an effective place to implement a smoking cessation intervention | 70 | 13 | 17 |
•These clients generally want to stop smoking but don't have the skills/resources to do so | 63 | 37 | 0 |
•It is not my role to provide smoking cessation treatment to these clients | 20 | 80 | 0 |
•An abstinence approach should be used when addressing smoking (i.e. quit all nicotine/tobacco) | 13 | 87 | 0 |
•It is too difficult for these clients to stop smoking and other substance use together, so I wouldn't suggest it | 7 | 87 | 7 |
Women’s motivators for smoking cessation | |
|---|---|
2. How often do you see or hear the following motivators or reasons to stop smoking? | Sometimes / Often % |
•The desire to improve baby's health outcomes | 97 |
•The need for more disposable income or to save money | 72 |
•The desire to be free of addiction to all substances | 69 |
•The wish to improve physical and/or mental health | 66 |
•Support and encouragement provided by healthcare providers | 66 |
•Pressure from partner, family members or friends to stop | 55 |
•The desire to remove cigarette-smoke odors from house, car etc | 45 |
•The dislike of tobacco smoking | 34 |
•The desire to avoid the stigma-laden reactions of others to smoking while pregnant | 31 |
•The wish to improve hygiene e.g. clean breath, clean fingers, white teeth | 28 |
Women’s barriers to smoking cessation | |
|---|---|
3. How often do you see or hear the following barriers to smoking cessation? | Sometimes / Often % |
•Tobacco smoking is a way of coping with stress | 100 |
•Having a partner who smokes | 97 |
•The belief that it is too difficult to stop smoking and other substances at the one time | 97 |
•The enjoyment of tobacco smoking | 93 |
•The acceptability of smoking within client's social circles—'…everyone around me smokes' | 90 |
•Tobacco smoking helps to relieve boredom | 76 |
•Little understanding of the health consequences of cigarette toxins on baby's health outcomes | 76 |
•Concerns about withdrawal symptoms e.g. irritability, increase in anxiety/depression symptoms | 72 |
•The belief that tobacco is not illegal so is not as important to stop as other substances | 66 |
•The prohibitive cost of pharmacotherapy treatments e.g. NRT | 66 |
•Little or no cessation advice or support given by health service providers | 48 |
•Concerns about the likelihood of weight gain | 41 |
•The belief that smoking may lead to reduced baby size and an easier delivery | 38 |
Effective smoking interventions | ||||
|---|---|---|---|---|
4. How effective do you believe it is to include the following into a smoking treatment tailored to this group? | Not % | Some what % | Very % | Unsure % |
•Women-centered care (i.e. treatment focused on a woman's unique needs) | 0 | 21 | 68 | 11 |
•Support (behavioural or pharmacological) for substance use | 0 | 32 | 64 | 4 |
•A combination of the above strategies | 0 | 25 | 64 | 11 |
•Support (behavioural or pharmacological) for mental health issues | 0 | 36 | 57 | 7 |
•Postpartum smoking relapse prevention | 0 | 36 | 57 | 7 |
•Supply of NRT for partners or other household members who smoke | 0 | 43 | 50 | 7 |
•NRT | 0 | 54 | 43 | 4 |
•Financial incentives to stop smoking | 4 | 32 | 43 | 21 |
•Facilitation of social support (e.g. quit buddy or Quitline referral) | 14 | 46 | 29 | 11 |