Table 3 Patient Quotations of Experiences of
Themes/subthemes | Quotations |
|---|---|
Realising well-being and creating agency | |
Giving the best start to baby | “oh I’m pregnant I have to quit smoking” [26] |
“I would, I would quit straight away if I found out I was pregnant, cause that would give me a reason to quit, you know, your baby,,,, if I was pregnant it would be, like it would make me do it, it would be hard, but I would actually do it and I would for my kid” [31] | |
“I didn’t want my kid, my son, to come out deformed or something, with something wrong with him” [39] | |
Pride in being a healthy mum | “need to be motivated to quit for yourself and supported by encouragement” [28] |
“I’m pretty proud of myself that I can just quit just like that. There’s a lot of people that can’t do that” [27] | |
“I will do it when I am ready. When I want to do it so there is no pressure … I don’t want someone to tell me I have got to do it” [26] | |
“If I could give up it would give me the world of good” [30] | |
“for my health” [30] | |
Influence of women role models | “Mum’s voice was always in my head” [27] |
“I’m the doctor I know, so you have to do what I say and I’m sorry you don’t tell me what to do you are not my mother you know” [26] | |
“I just said I’m trying to give up cigarettes and smoking and she’s like you know you can do it, you don’t need it and all of this sort of stuff. That gave me a bit of confidence in myself that I knew I could do it” [27] | |
“mum used to rip me every time I used to smoke in front of her she said ‘you want to chuck them away I’d say yeah but I just kept smoking” [26] | |
Importance of family support | “the father tells me to give up” [30] |
“even though she smokes she doesn’t like me smoking” [30] | |
“too hard when you have got like, when everyone in your house is smoking kind of thing, and you are the only one trying to quit” [31] | |
“I just told everybody don’t give me smoke any day. And I kept on asking and they were like ‘no you told me not to give it to you’ and I am like ‘oh well” [31] | |
Understanding drivers for smoking | |
Impact of stress and chaos | “All I know is that my smoking is aligned with times of chaos and stress” [27] |
“I knew it wasn’t good for me or baby at the time, but like it was just mores stress...because I had so much of it” [27] | |
“She gave it away but then she could not deal with the stress that was going on” [26] | |
“there’s heaps of stress in Aboriginal families. It doesn’t matter what it is, always stressing after something” [31] | |
“I would say that it relaxes ya after you have a feed or a sit down, or a yarn with somebody, you are talking and you are smoking and yeah” [31] | |
Social acceptability of smoking | “smoking as a normal and accepted behaviour, a low health priority” [31] |
“Living with no smokers’ or at least that people around you don’t smoke around you. It’s pretty hard when other people are smoking around you” [28] | |
“Well I am pregnant now and I smoke but it is just really hard to give up. I just can’t like everyone else around me just smokes and it is just hard I just can’t do it” [26] | |
“Just people tend to say ‘oh it’s not going to hurt you know, it won’t affect the baby, it’s alright I did it when I was pregnant” [26] | |
Guilt and judgement | ‘I didn’t want anyone to know that I’d started again, so I was hiding it for a bit” [27] |
“I made that choice, I wanted to smoke again so I did it. I’m glad this last time that I’ve quit for good” [27] | |
“He has got breathing problems now and I reckon that’s smoking all the way through” [26] | |
Lack of information to support decision-making | “Would be more helpful for health professionals to “go through the pamphlets” [28] |
“More advertising in the cigarette pack itself for pregnant women, have a graphic picture” [28] | |
“You have got to push more ‘this is what it is going to do to your child, your child could have this in so many years” [26] | |
“The doctor should give us advice. He should know about the research and they should know the right information” [28] | |
“They often talked to me about my smoking and they did say if you can slow down as much as you can, but try not to go cold turkey” [29] | |
“They gave me patches and chew you try but like I didn’t feel comfortable taking them while I was pregnant” [29] | |
“They just drum into you it’s more of a low body weight and that’s what starts them off wrong” [26] | |
Appreciating culturally responsive approaches | |
Valuing indigenous programs | “midwife of the same culture … or a kaupapa Maori service, that is grounded in a Maori worldview and operated in accordance with Maori cultural protocols [quitline] couldn’t give me any information ..I’m trying to find a Maori midwife but its hopeless” [28] |
“Trying it in with the whole family more than the individual I think because then it’s not just one person going home … because I don’t think that works very well because it’s one person trying to preach” [26] | |
“More readily available services for Maori women and easily accessible, ring and they come round and see me, especially if they are a Maori person” [28] | |
“Most people listen to their elders. Like I can go to the doctor’s and listen to the midwives telling me not to do stuff, it’s like I don’t know you. Who are you? You’re just a doctor here that works here. You don’t know my life, you don’t know where I live, actually be like, I know what you’re going through, don’t worry, stop stressing Like they know more about that family and just be able to support more” [29] | |
Increasing accessibility of programs | “There’s more support needed or this one thing than there is anything else” [29] |
“Find out what the options are and allow her easy access to those options at no cost” [28] | |
“It should be offered to every pregnant woman, that there are services available. Make it more aware that there are services out there, more than quitline, I didn’t know there are subsidised patches and gum” [28] | |
“Doctors should prescribe things, I was quite shocked especially for a doctor not to” [28] | |
Needing something to replace smoking | “Just got to have something in my hands, It’s not that I like it” [30] |
“Would be helped to quit if they had something to occupy them, such as a programme that offered an “alternative”, that would keep them busy, “like a hobby, fitness”...interest or maybe a support group” [28] | |
“No they’ve only offered me the gum once” [29] | |
“I felt like having a cigarette this morning when I got up, but instead of doing that I walked the kids to school rather than driving them to school and you think oh that’s something I haven’t thought about trying maybe I’ll do that...I think hearing other people’s stories and how they cope with it is helpful” [29] | |