Table 3.

Perceived barriers and suggestions to improve cessation support for pregnant/postpartum women

Theme	Barriers	Suggestions to address barriers
Policy	Absence of provincial cessation strategy	Comprehensive cessation strategy that involves cross-sector and cross-ministerial collaboration
	Sustainable funding and organizational capacity issues	Funding for capacity building, program development and sustainability
		Organizational cessation polices, practices and procedures
	Hesitancy prescribing NRT to pregnant women	Medical directive for off-label use of NRT and education for providers
Program and service provision	Lack of comprehensive programming approach	Social determinants of health and harm reduction approaches
		Programs accessible through multiple sectors
		Address partner and family smoking
	Engagement and accessibility issues	Engage women in program development/implementation
		Incentives, transportation, childcare and snacks
		Program promotion through local venues
		Home visits
		Address stigma and misconceptions through:
		• Training health care providers to understand issues faced by women and role of smoking in lives
		• Cessation training for providers who work with disadvantaged women
		• Positive messaging
		• Provincial media campaigns
		Affordable NRT options
	Inconsistent provider practice	Annual training in MCI and cessation best practices for pregnant/postpartum women
		Perinatal cessation modules in educational curriculums/continuing education credits
		Knowledge exchange channels to facilitate patient referral and promote inter-professional learning