ArticleCanadian journal of public health = Revue canadienne de sante publique2026
Enablers and barriers to smoking cessation counselling: Experiences of midwives and pregnant smokers in the 5A-QUIT-N pilot project.
Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesA pilot population health intervention (5A-QUIT-N) was implemented in a French region with the aim of organizing smoking cessation counselling during pregnancy. The intervention is offered to pregnant women regardless of the stage of pregnancy. This initiative took place in a national context where smoking screening is established, but systematic smoking cessation support is not yet in place. The objective of this research was to assess the viability of the intervention by exploring four criteria: "practical", "affordable", "suitable", and "helpful". The study aimed to identify enablers and barriers for each criterion, based on the experiences of midwives and women who smoked during pregnancy.
methodA qualitative methodology was used to explore enablers and barriers to the 5A-QUIT-N pilot intervention viability. Semi-structured interviews were conducted with midwives involved in the intervention and women who smoked during pregnancy and gave birth in the maternity ward of the pilot area. Interview data were analyzed thematically, using viability criteria as categories.
resultsAmong the four viability criteria explored, barriers and levers were identified at three levels: factors related to women and their environment; factors related to healthcare professionals' practices; and factors related to the healthcare system and its organization. Smoking cessation counselling was considered relevant and was highly valued by women. The intervention led to a change in the smoking cessation practices of midwives. Barriers were identified by both groups such as living with a smoker for women and women's reluctance to attempt to quit, according to midwives.
conclusionSome adaptations are needed to better align the intervention with the daily difficulties of pregnant smokers as well as the way healthcare professionals can encourage them to quit. This study shows that the intervention meets the viability criteria. These results are encouraging for broader implementation in other contexts.
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