Table 5 Quotes from stakeholders and clients illustrating the major themes in perceptions of QFNL.

Stakeholders

Appropriateness of model

It was a really good way, I think, of introducing the fact that we really do want to try and help them to stop smoking for the benefit of their babies and themselves. (Midwife)

Smoking does come up a few times in their antenatal and postnatal checks already. So having Quit for new life helped you to expand on that rather than just asking a question. (Aboriginal Health Worker)

Achievements

One of the key things it’s done for me is that it’s increased my prioritising of addressing smoking within pregnancy. (Midwife)

We had success with a whole family quitting and saving $110 a day. (QFNL coordinator)

So we noticed that women were adopting the breastfeed, feed first, have your cigarette after; smoking outside, not smoking in the car, wearing of a smoking shirt, reducing co-sleeping when smoking. (Service manager)

Enablers

We have really tried to promote the Aboriginal health workers taking the lead, they’re the ones that have the best cultural knowledge and skills for engaging with the mums and talking to them in a way that can make them feel comfortable when they’re opening up about their smoking journey. (QFNL coordinator)

But I think the best thing about the program is yeah, the fact that the NRT was available to the woman, the partner and anyone else that’s in the household. (Smoking care advisor)

Challenges

Behavioural support is not yet fully embedded in appointments as it is time consuming in an environment that is already stretched. (QFNL coordinator)

QFNL addresses a health issue which women may not see as a problem. (QFNL coordinator)

We are constantly trying to keep up with changes in staff and organising training. (QFNL coordinator)

It is difficult to follow-up with clients because of the rural area and poor mobile coverage (Smoking care advisor)

Measures on changes in smoking rates doesn’t sensitively capture women who engaged in quit periods during pregnancy. (QFNL coordinator)

Clients

Appropriateness of model

It made me realise a lot of things - the reasons I had to stop…The midwives were pushing for me to do it, because they know the effects it has, I guess. (Client A)

I have a worker and she comes and meets me and we have chats. I get the [NRT] vouchers off her. Whenever I’m needing her, she’s available for me to contact… I left the program at one point and then I was welcome to come back at any time. It was really good. (Client B)

Yeah, about 10 out of 10 probably, because they just offered a whole range of support for me. (Client C)

Achievements

I’ve been trying for months, before getting pregnant, to quit smoking and I just had no sort of motivation or anything like that. So, getting into the program had that sort of motivation. (Client D)

I had two attempts. I think the second attempt - I was on it [NRT] for about maybe a month and a half, two months, and that’s been since I’ve quit. (Client C)

We smoked inside, but now that bub is here we smoke outside. (Client E)

Enablers

Well, just for bub. Yeah, that was my main reason. (Client E)

She [smoking care advisor] has actually been a smoker. So that kind of helped. (Client B)

Challenges

I tried the gum but it was disgusting so I didn’t use it. (Client F)

Really, really pleased [with the support received]. I think it was just me, more that I needed to more want to quit. (Client E)

It was a bit confronting. I guess it’s an addiction. It’s kind of hard to talk about it sometimes (Client A)