Perspectives about smoking cessation during pregnancy and beyond of Aboriginal women in Australia: A qualitative analysis using the COM‐B model

Abstract

Objective Aboriginal and Torres Strait Islander women (hereafter Aboriginal) and their babies experience poor health outcomes for which smoking is a major risk factor. This paper explores Aboriginal women's perspectives on and experiences of smoking cessation, within and outside pregnancy, and their use of smoking cessation services using the COM‐B (Capability, Opportunity, Motivation as determinants of Behaviour) model to understand Aboriginal women's capabilities, opportunities, and motivation for smoking cessation. Methods Data came from 11 focus groups conducted in regional New South Wales, Australia, with 80 women aged between 16 and 68 years. Thematic analysis was performed following the COM‐B model. Results Seven themes related to capability, opportunity, motivation, and smoking cessation behaviors were identified. The themes highlighted that agency, knowledge, and self‐efficacy (as capability), a supportive social environment, and access to culturally appropriate services and resources (as opportunities), together with automatic and reflective motivations for quitting, may enable short‐ or long‐term smoking cessation. Conclusion Smoking cessation interventions may be more effective if the dynamics of the COM‐B factors are considered. Policy and practice changes for further enhancing regional Aboriginal women's psychological capability and supportive social environments, and making smoking cessation services culturally appropriate are warranted.

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

“…This mapping approach was unique to this study, although similar approaches have been reported elsewhere in the literature (e.g. Flannery et al, 2018 ; Gould, 2014 ; Rahman et al, 2021 ).…”

The lives of women and babies matter: A call for action in Indigenous and First Nations women’s health and wellbeing

“…The issue highlights the voices of those usually not heard in research, in clinical care, and in health service design, [1][2][3][4][5][6] and calls out the silence and invisibility commonly imposed on Indigenous women. [7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…This is done in order to empower women in healthcare, 12 to develop and trial culturally safe and community-based approaches, 2,6 to partner with communities, 3,5 to employ Indigenous methods and knowledge, 8,14 to privilege Indigenous voices, 4,9,10,11 to move towards risk assessment and management tailored to Indigenous populations and context, 15,16 and to explore women's experiences in new ways. 1,9,13 Much of the research responds to the silence/invisibility of First Nations and Indigenous women by challenging the norms of women's healthcare provision, such as persistent discrepancies in structural/social determinants of health, healthcare access and health outcomes, systemic racism, and trauma.…”

“…Twelve articles in the special issue investigate a range of topics related to pregnancy care and birth. De La Cruz‐Ramirez et al, 4 Khalil et al, 9 Jumah et al, 5 and Gould et al 13 explored how maternity care is provided and how it can better meet the needs of Indigenous women. De La Cruz‐Ramirez et al 4 found that Quechua‐speaking Indigenous women in Peru were largely satisfied with telephone support from midwives during the COVID‐19 pandemic and identified how to strengthen the program further.…”

“…Jumah et al 5 described the prioritization of Indigenous voices during the development of a virtual training and mentoring program for maternal‐child workers in remote First Nations communities in Canada. Gould et al 13 used the COM‐B model to better understand Aboriginal and Torres Strait Islander women's capabilities, opportunities, and motivation for smoking cessation.…”