“We just don’t have time”: a qualitative study on health care providers’ experiences with smoking cessation counseling in Egyptian maternity hospitals

BACKGROUND: Despite the established risks associated with tobacco exposure during pregnancy, the implementation of smoking cessation counseling by healthcare providers in Egypt is inconsistent. This study aimed to assess health care providers' (HCPs) knowledge about the hazards of smoking exposure during pregnancy, investigate their attitudes and practices concerning smoking cessation, and determine the perceived barriers to addressing this issue during routine care. METHODS: We employed a qualitative approach to conduct semi-structured interviews with 22 health care professionals (15 obstetricians and 7 nurses) from four Cairo government hospitals. Purposive sampling was used to choose participants. Arabic-language interviews were recorded, verbatim transcribed, and subjected to thematic analysis using NVivo 12 Pro. RESULTS: Six major themes emerged: (1) differences in knowledge about smoking hazards; (2) differences in attitudes regarding counseling; (3) inconsistency regarding history taking and counseling practices; (4) obstacles to effective intervention; (5) recommendations for improvement; and (6) expressed desire for training. Although there was an overall sense of awareness of risk, counseling practices were found to be selective and faced barriers, including cultural sensitivity, time constraints, and role uncertainty. CONCLUSION: Targeted training and structural support are necessary for HCPs to deliver consistent smoking cessation counseling. Systematic incorporation of cessation counselling into antenatal care is necessary to tackle the impact of maternal tobacco exposure.