TABLE 2.

Unifying themes, subthemes, and representative codes with quotations^a

		Representative codes
Theme	Subtheme	Caregivers	Clinicians
Barriers	Predisposing (Intrapersonal)	• Stress: Q1, Q2 • Addiction: Q3, Q4 • Weight gain: Q5 • Perceived lack of harm to child: Q6	• Addiction: Q15 • Stress: Q16 • Not ready to quit: Q17, Q18 • Unwilling to disclose smoking status • Lack of caregiver awareness of harm: Q19
	Reinforcing (Interpersonal)	• Lack of understanding and support from family and friends: Q7 • Presence of other smokers • Shaming into quitting: Q8, Q9	• Smoking is a social norm: Q20, Q21 • Shaming into quitting: Q22
	Enabling (Structural)	• Cost of cessation aids: Q10, Q11 • Side effects of cessation aids: Q12, Q13 • No CF-specific information about the harms of smoke exposure: Q14	• Not a priority in CF care: Q23, Q24 • Lack of guidance and protocols • Time constrains: Q25 • Lack of provider knowledge/training: Q26 • Inability to prescribe to and treat adults: Q27 • Lack of CF educational materials/tools: Q28, Q29
Facilitators	Predisposing (Intrapersonal)	• Desire to quit: Q30 • The health of one’s child: Q31	• Alternative ways to cope with stress: Q37 • Quitting for child’s sake: Q38
	Reinforcing (Interpersonal)	• Supportive family and friends: Q32 • Child’s awareness that smoking harms: Q33 • Nonjudgmental clinical providers: Q34	• Educating the extended family about smoke exposure: Q39 • Nonjudgmental attitude of providers: Q40
	Enabling (Structural)	• Information about the harms of smoke exposure to CF children: Q35 • Incentives for reaching goals: Q36	• Research to develop evidence: Q41 • CF Foundation guidelines for cessation: Q42 • Standardized protocols: Q43 • Educational materials/resources: Q44 • Biochemical verification • Prescription of pharmacotherapy: Q45, Q46 • Incentives for reaching goals: Q47
Solutions	Predisposing (Intrapersonal)	• Change routines • Use counseling for motivation and to avoid triggers: Q48 • Treat self for reaching goals: Q49	• Offer positive reinforcement: Q52
	Reinforcing (Interpersonal)	• Engage the extended family: Q50	• Provide letter and materials for extended family: Q53 • Local peer support group: Q54
	Enabling (Structural)	• Provide information and education • Provide access to cessation aids • Provide access to professional counselors: Q51	• Develop the evidence base: Q55 • Develop educational resources: Q56-Q59 • Include in center performance review: Q60 • Develop clinical protocols: Q61 • Train staff • Select clinical point person: Q62 • Offer professional counseling: Q63 • Provide tailored follow-up • Routine screening as part of care: Q64

Abbreviation: CF, cystic fibrosis

^aRepresentative quotations provided in Tables S3a (barriers), S3b (facilitators), and S3c (solutions).