Table 1.

Themes and Examples from Focus Groups with Smokers and Nonsmokers

Social or environmental factor addressed	Theme	Sample Quotes from Smokers	Sample Quotes from Nonsmokers
Individual	Focus on irritating odor effects from smoking and smoke exposure	“I haven’t smoked at home these several years, because the place is relatively small, when I smoke inside my room, the smoke diffuses outdoor to other rooms. My children are disgusted about this since they are nonsmokers.” “It is better to smoke in the backyard, because the area is bigger and the smell of the cigarette will not remain.”	“I dislike that smell [of cigarettes]. I am afraid of it. I nag [my husband] frequently, “For goodness sake please don’t smoke! The whole house is filled with the smell of cigarettes.” I am really afraid to smell that kind of odor.” “[My husband] smokes outside, but the smell will diffuse in. If the wind is strong, it will blow into the house. He leaves the door opened when he smokes and the smell is carried along with the wind.”
	Focus on harm to smoker	“Everyone knows it is bad to smoke…we ourselves know it is bad to smoke too.” “Relatives, such as my wife and my daughter, brothers and sisters, they urged me not to smoke. When I smoked in the past, some relatives brought me cigarettes from Hong Kong. Since I had the resource, I couldn’t quit. Eventually they stopped bringing me cigarettes, and said that it was bad for my health.”	“[My husband] is now smoking increasingly intense, which is, when he gets up every morning from bed, he coughs hard and coughs for half an hour. I told him, ‘How about not smoking? You are coughing very hard! How about quit smoking!’ He did not answer. I said, ‘You smoke and will do harm to your lungs.’ Now my son smokes too. I said, ‘Look! You both smoke together! Stuffed the whole house with the smell of cigarette smoke.’”
	Beliefs that smoking is healthful and quitting is harmful	“I have seen a couple of friends who came from China and lived here for a couple of years. They suddenly quit smoking. I asked, “Quitting smoking so suddenly, will not there be problems?” Less than three months later, they really got diabetes. Now, they have to use adult diapers and even live in senior centers!” (Pair #1)	“[My husband] said, ‘During SARS infection, a lot of people are infected but smokers are not.’ He said, ‘Smoking prevents being infected.’” (Pair #1) “After quitting, his last attempt, he had another try before coming to America. However, for some unknown reason, his nose bled and scared his mother. She said, ‘Why don’t you smoke a cigarette immediately.’ He smoked and the bleeding was over. Since then, he smoked even more! 3 packs a day!”
	Beliefs that quitting requires determination and willpower	“It is a psychological addiction. Being determined should get you to quit.” “Determination is very important. You don’t look at it, don’t smoke it, don’t buy, and stay away from smokers.” “Only if the person is determined, they should be able to quit easily.”	“My husband said if you are determined to quit smoking, you do not need anything. We got the nicotine patch from the health center and only used a few, my husband quit smoking. He said those who cannot quit are just lying to themselves.” “I have 2 relatives… they said quit and they quit! They said to quit in a week, and they did it. It is simple. Determination!”
Relational	Co-workers or friends keep smokers connected to pro- smoking norms of their home culture	“After I quit for a year, since we were working, a lot of our coworkers smoked. Almost everyone smoked in there, 9 out of 10 smoked. So in the factory, there was a room with a lot of people, approximately 20 to 30 people. Everyone was smoking and so I smoked again.” (Pair #10) “When I was trying to quit, however, when I was working, co-worker said to me, ‘Hey! Are you okay? Not smoking? Then what will you do during the 3:15 break? Come on!’ And then they gave you a cigarette. After I smoked, ‘Oops! I smoke again!’ This was the worst!” (Pair #8)	“I think the environment is really important. Maybe promote to co-workers to come and quit smoking together.” (Pair #10) “[My husband] used to smoke. He said, ‘Smoking that cigarette is to make friends.’” I asked him to quit and he listened briefly for a while, quitting smoking on and off. (His quitting method is just not to smoke?) That is smoked for a while and then stop. As long as someone hands him a cigarette, he will take it and start smoking again. (Pair #8)
Relational: Home environment	Conflict with household nonsmoker about smoking	“Family members should not blame you, but provide support, speaking reasonably. I want to quit because I want to prepare a good environment for the grandchildren. This method is very good. If you scold me, I will not listen. But if you tell me the reasons behind and encourage me, then I will be convinced….You scold me; men will not listen to you. You scold me? I will rebel more.”	“My husband smokes but I do not like it. As he steps into the doorstep, he secretly smokes. As soon as he stepped in, I could smell the cigarettes smoke on him. I dislike it and I will cough. I said, ‘You have to quit smoking.’ He said, ‘No. I am only smoking three a day. It is not a lot.’ I said, ‘Three is not a lot? Don’t live here. Move out and live somewhere else. I don’t like you smoking.’” (You asked him to move out) “Yes. I said, ‘You move out. I don’t like you smoking.’” (What happens next? Did he move out?) “No. How can he move out? He needs me to cook food for him to eat … such person as him, very difficult.”
	Smoking cessation improves family harmony and benefits children	“I should prepare a space for the grandchild and next generations, otherwise, they will suffer from second- hand smoking. As a lot of people say, ‘They breathe it in and it’s not good for them.’” “My daughter was just born, that’s why I quit smoking. This is all for the child.”	“And he said, ‘Smoking is not good for me, and not good for my family too.’ Everyone knows that. But he can’t quit.” “The kids are small and we are afraid that the smoke will affect their health.”
Relational: Healthcare environment	Communication with providers insufficient to counter pro- smoking norms and myths	“I have smoked for more than 40 years. I saw doctor around 10 years ago. My doctor did a checkup for me and said, “Don’t smoke anymore! You can’t go on!” Then I starting quitting, kept quitting for a couple years, and then I smoked again. (How serious was it at that time?) Cough, bronchitis, so he said, “You should not smoke!” I said, “Warning, doctor’s warning.” Then I quit. After I quit for a year and a half, I smoked again. After I smoked again, that thing was not going well again. My family said, “Do not smoke anymore!” Then I quit again. However, now when my relatives give me a cigarette, I will smoke again, but not craving for it.”	“Health professionals should give smokers information and let them know that how smoking can harm family members.” “Unless you are sick, then when the doctor explain to you, then it might be helpful. But for my husband, he is fine and is not sick, he eventually continues to smoke.”
Societal	Acceptability of smoking depends on social context	“Now in the States, needless to say, ladies would cover their mouth with their hands as soon as you smoke.” “Some people wave their hands, turn their head away or avoid me.”	“After immigrating to the United States, not as many people smoke, so over time [my husband] has cut back on smoking.” “My son smokes…He smokes a few packs per day while he was in Mainland China, but after he arrived here for 3 or 5 years, everyone encouraged him to quit smoking. Now he is smoking gradually less, he tried to decrease smoking as hard as he could.”

Note: Perspectives within the same household dyad on the same theme are noted by the identical pair number listed in parentheses following a quote.