Table 3.

Themes and representative quotations from student responses to a prompt for additional comments.

Theme	Definition	Representative quotations (participant number, NEP category)
Pharmacists have a responsibility	Belief that pharmacists have a professional responsibility and/or ethical obligation to mitigate environmental harms	‘Our profession seeks to aid all individuals and this should be seen in how we treat our environment we practice in to ensure it is sustainable for our future’ (P112, mid-environmental) ‘No profession or person should be exempt from doing our part for our planet’ (P87, pro-environmental) ‘I feel like health practitioners not actively contributing to people dying is somewhere close to the bare minimum of basic Not Having Conflicts Of Interest and just Not Being An Awful Health Practitioner In General’ (P145, mid-environmental)
Not pharmacists' role or responsibility	Belief that environmental sustainability is irrelevant or outside the scope of pharmacists' roles and responsibilities	‘A pharmacist job is to provide and educate people on medicines Nothing to do with climate change Not our job’ (P68, mid-environmental) ‘I don't believe pharmacists have a responsibility to assist the public in adapting to climate change impacts but we need to have plans in place if these things do occur’ (P161, pro-environmental) ‘Nuclear power is there, use it’ (P102, mid-environmental)
Responsibility of the pharmaceutical industry	Perception that the pharmaceutical industry has a greater responsibility and needs to reduce its environmental footprint	‘The pharmaceutical industry has an important role to play in their packaging and delivery of medications’ (P116, pro-environmental) ‘Big companies have the biggest impact and should be held accountable by government and legislation instead of passing responsibility on to the consumer’ (P126, mid-environmental) ‘Pharmaceutical companies … have a much larger responsibility and burden on producing harmful pollutants compared to the local community pharmacy or hospital’ (P21, mid-environmental)
Environmental issues in healthcare	Perception that aspects of healthcare provision are not environmentally sustainable	‘There is a large amount of waste created, with limited recycling’ (P27, mid-environmental) ‘It is challenging in terms of single use medical devices but we should do all we can in all other areas to combat this’ (P72, pro-environmental)
Desire for environmentally sustainable profession	Desire for advocacy and change towards ESPP by the pharmacy profession	‘I would really like to see pharmacy advocate and change to be sustainable and environmentally friendly’ (P153, pro-environmental) ‘I'd love to see more ESSP taught, … it feels like an area that's not well understood or practised’ (P95, pro-environmental) ‘Teaching about this should influence change in the next wave of pharmacists … it would be difficult for one pharmacist but if others had been exposed to ESPP they may be more on board and can help create change’ (P144, pro-environmental)
Caring for the environment can engender public trust	Belief that pharmacists can earn trust by acting to protect the environment	‘Pharmacist[s] should be trusted by the public and caring for the environment is one way they can do that’ (P142, mid-environmental)
Pharmacists' roles in environmental sustainability	Perception of specific ways pharmacists can promote environmental sustainability in practice	‘I don't think many people understand the implications of throwing out medications in the normal waste bin instead of bringing them into a pharmacy to be properly disposed of’ (P63, mid-environmental)
Environmental sustainability action needs top-down and bottom-up support	Perception of barriers to individual action, and belief that top-down and/or bottom-up support is needed to drive systems change towards environmental sustainability	‘It is difficult as a single pharmacist to create change in larger systems…' (P144, pro-environmental) ‘If we can make it easy for people to make environmentally sustainable decisions I think people will be more likely to engage’ (P116, pro-environmental) ‘Much of the blame is placed on the consumer to individually fix this issue rather than collectively breaking down larger manufacturers, but it has been improving with the pledge for 0% carbon’ (P110, pro-environmental)
Tension between environmental sustainability and other priorities	Perception that environmental sustainability must be balanced against other priorities in pharmacy practice	‘Most medications come in cardboard boxes with plastic in the blister packets because it's kinda needed. Especially for something as important as the actual health and well-being of out (sic) customers’ (P128, mid-environmental) ‘It is important that confidentiality is still kept’ (P74, mid-environmental) ‘Not enough pharmacies are offering ways of recycling blister packs which means it is expensive for the pharmacists who do recycle them’ (P157, pro-environmental)