Table 2 Quotes related to each COM-B theme

Physical capability

I always feel a bit concerned about doing actually more

harm than good insofar as you know these women that appear

to not be smoking very much. HP- Bar-Zeev, 2019- 1st order

.. . I think it was a very minimal plan that had been laid out. I think there was two or three questions and that was it.

Women- Bovill, 2018- 1st order

Psychological capability

Sometimes they have so many stressors in their life that they just don’t think they can give it (smoking) up…. A lot of pregnant women...would cut down on smoking, but if...their stress level rose...their smoking rose with their stress level.

HP- Aquilino, 2003- 1st order

I think that if the woman gets too much stressed about the fact that it is forbidden to smoke, then the only thing you can say, is: “Alright, you can smoke a few cigarettes a day.”

HP-Gynaecologist-De Wilde, 2015- 1st order

I advised this patient to see her GP for patches or gum, but her doctor told her that to use replacement products would be more dangerous than smoking so he said either keep smoking or do cold turkey so I don’t bother now HP-Health Visitor, Bull, 2007- 1st order

I could use more information. There’s new stuff every day that relates to smoking, so I know there’s new and up-to-date stuff that we probably don’t know about.

HP- Aquilino, 2003- 1st order

I can remember the conversation we had about it and [the smoking cessation advisor] was letting me know where I can put [the patches] and what not, but to myself I just thought no, that’s just a bit too – you know you sit there thinking about it. I don’t know, it’s weird, I just think it’s too close to the baby to be having all that nicotine going in.

Woman- Bowker, 2015- 1st order

The doctor so scared me at the ante-natal clinic when she said that there were new studies showing that the baby flinches every time you puff the cigarette, that it is really painful (for the fetus). I didn’t think it was that serious. So every time I smoke and I feel the baby move, I think of this. That makes me stop smoking at once.

Woman- Hauglan, 1996-1st order

Her (HP’s) eyes were just locked on mine when she was telling me (referring to the harm to the baby from smoking) and I was just like. .. OK! I thought stop looking at me!

Woman- Gamble, 2015 [37, 20], − 1st order

You’re doing it for yourself. A pat on the back and someone telling you that you done really good is enough to make you feel good, you know.

Woman- Butterworth, 2013 [36]- 1st order

Another mother described how she had been asked if she was a smoker when she visited the clinic when her baby had a bad cough. When she confirmed that she smoked the doctor said: ‘Then quit’, but he never offered any support. Women, Lendahls, 2002- 2nd order

Physical opportunity

I don’t have the time. I am not the kind of person who wants to spend half an hour to motivate smoking cessation.

HP-Gynaecologist, DeWilde, 2015- 1st order

Lack of attractive educational resources to distribute to pregnant smokers. HP-Doctor, Everett, 2005 2nd order

The posters prompt you to ask your doctor and while in the waiting room, since you have nothing to do you can read.

Woman- Colomar, 2015-1st order

Social opportunity

Having established a high-quality relationship with their patients and being able to provide continuity of care were perceived as potentially enabling midwives to promote smoking cessation.

HP-Midwife, Herberts, 2012 [46]- 2nd order

They don’t just do it because they think ‘Oh let’s have a cigarette’ but it is usually because something has happened that is unpredictable and they cannot go up against that unless they have a good buddy system in place.

HP- Health visitor, Bull, 2007- 1st order

I think it’d be easier to quit smoking if you had something like an AA meeting but for smokers…I think if I had the urge to have a cigarette, and you could call somebody and say “Well, you know, I’m really stressed out right now and I really need to talk or I’m going to light up a cigarette.

Woman, Britton,2007 [35]- 1st order

I think hearing other people’s stories and how they cope with it is helpful.

Woman, Bovill, 2018 [33]- 1st order

Automatic motivation

If you have a patient who maybe smokes 40 cigarettes [a day], it is impossible that she will quit smoking.

HP- Colomar, 2015- 1st order

I say that the baby becomes smaller due to the lack of nourishment, that it has a smaller refrigerator, thinner arteries. If they still don’t get it I show them a pretty horrible picture.

HP- Midwife, Abrahamsson, 2005 [19]- 1st order

Not addressed in the articles

Reflective motivation

And if everything is actually uncomplicated and low risk, except for the fact that they’re smoking, yeah, I’d just – I don’t think it’s really our primary or part of our core job.

HP- Obstetrician, Longman, 2018- 1st order

I don’t have the time. I am not the kind of person who wants to spend half an hour to motivate smoking cessation. I think that I am too highly qualified. That’s not my job, I have too many other things to do. I want to refer them [smokers] to a specialist. HP-Gynaecologist, DeWilde 2015- 1st order

It is a waste of resources to talk to women about how to stop smoking if they are not interested. HP- Bull, 2007, 1st order

Not addressed in the articles