Table 2.

TDF themes and subthemes for engaging with support to stop smoking

TDF Domain: Theme title	HCPs perceptions of the barriers/facilitators to engaging with the support (B/F)	Pregnant women’s perceptions of the barriers/facilitators (B/F)
Knowledge: knowledge of available services for pregnant smokers	Midwives and pregnant women’s lack of awareness of the SSiPS and their role (B)	Unaware of the SSiPS before pregnancy and unaware of what the SSiPS offered (B)
Environmental context and resources: uptake of referral to cessation services by pregnant smokers	Increased referrals from opt‐out referral process and risk perception intervention (F) Difficult for the SSiPS to get ‘through the door’ (B). Women who do not continue to engage with the SSiPS (B) Risk perception intervention not being implemented properly in one trust (B).	Ease of referrals to the SSiPS help women to engage (F). Service does not work for all women but offers good support (B & F)
Social influences: smoking norms and role of others on addressing smoking in pregnancy	The SSiPS need midwives to ‘sell’ the service (B) Midwives influenced by their own smoking status and normality of smoking (B)	Pressure from advisors to quit can push women out of the service (B)
Beliefs about capabilities: confidence in delivering and accepting pregnancy smoking cessation support	Midwives’ lack of confidence in talking to women about smoking (B)	Women’s lack of confidence that the service can help them – lack of trust (B) Belief that the SSiPS do not understand what it is like to quit smoking (B)
Beliefs about consequences: beliefs about the risks of smoking in pregnancy and the role of cessation services	Difficult for the SSiPS to engage with women who do not think smoking in pregnancy is unsafe (B)	Belief that the SSiPS were taking something away from them by making them quit (B).
Intentions: intentions to stop smoking in pregnancy	Women’s change of intentions to quit smoking (B & F).
Emotion: fear of judgement from health care professionals for smoking in pregnancy	Fear of being judged by health care professionals and shame of smoking in pregnancy (B).