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 |